【作者】 王海；

【导师】 张琪；

【作者基本信息】 黑龙江中医药大学 ， 中医内科学， 2009， 博士

【摘要】 咳嗽变异性哮喘(cough variant asthma，CVA)是儿童慢性咳嗽的最常见原因，约30％～50％的CVA预后可转变为典型哮喘。及早发现CVA预后转归的危险因素并予以治疗，可以预防哮喘，降低发病率。目的：研究体格生长与儿童CVA预后的关系；探讨身高矮小与儿童肾虚的联系；研究补益肺肾法对CVA患儿免疫失衡的影响。方法：实验一：追踪528例CVA，其中1 40例转变为典型哮喘，为哮喘组，其余缓解为对照组；评价体格生长情况，并研究其与典型哮喘发作的关系。实验二：将1 60例CVA患儿随机分为治疗组80例和对照组80例，治疗组予补益肺肾方“防哮汤”治疗；对照组吸入丙酸倍氯米松气雾剂，两组疗程均为8周，研究治疗前后外周血IgE、PBMC培养上清液IL-4、IFN-γ的变化。结果：实验一：哮喘组男童身高低于正常男童，与同组女童及对照组男童比较有显著性差异。体重及BMI指数等方面，虽然有组间或组内差异，但均大于正常儿童均值。实验二：治疗组治疗后IgE、IL-4显著降低，IFN-γ显著升高，与治疗前相比有显著性差异(P＜0．05)；对照组治疗后IgE较治疗前亦有降低(P＜0．05)。结论：男童身高矮小可能是CVA转为典型哮喘的危险因素，补益肺肾方“防哮汤”可能通过改善CVA患儿的免疫失衡，进而起到预防哮喘的作用。更多还原

【Abstract】 Background:Cough variant asthma (CVA)is one of the most commonreasons of chronic cough in childhood.About 30% to 50% cases of CVAeventually developed into classic asthma.To decrease the incidence ofchildhood asthma,we should identify the related risk factors which leadCVA into classic asthma and find effective treatment methods of CVA.Objective:The aim of this study was to evaluate the association betweenbody stature and the development of classic asthma in childhood CVA.Toanalyse the impact of short stature on kidney function in children.To studythe effect of herb drug on immune system.by nourishing the kidney and thelung.Design:In experiment one,528 cases of children patients suffered fromCVA were followed up and studied.In which 140 cases developed intoclassic asthma,we set up as observed group,while the others ascontrast.The body stature data was collected from two groups and studied.The relationship between body stature and incidence of classic asthma inCVA was analysed In experiment two,160 cases of CVA patients wererandomized into observed group and the contrast,one 80 cases and the other80 cases.In observed group,80 cases of CVA patients were treated with“Fang_Xiao_Tang”,.a chinese medicinal herb recipe.For comparison,80patients with CVA were inhaled beclomethasone dipropionate aerosol astreatment.The course of treatment in both two groups are 8 weeks.Afterthat the changes of levels of the immune factors IgE,IL-4,IFN-r in serumwere studied before and after treatment. Result:In experiment one the average stature of boys in observed group isshorter than the girls in the same group and the boys in contrast group.Onthe contrary,the average weight and BMI index of observed boys are higherthan the average level after adjusting for a variance inner group and intergroup.In another experiment,after treating with“Fang_Xiao Tang”,aChinese medicinal herb recipe,the IgE,IL-4 levels in serum in CVA patientshave dramatically decreased,whereas IFN-r level increased.Analysis ofvariance was used to estimate the effect before and after treatment.Therewas significant difference between the two groups(P＜0.05).The IgE levelin contrast group was also found decreased after treatment(P＜0.05).Conclusion:This study shows a positive association between short statureand development of classic asthma in childhood CVA.The recipe of“Fang_Xiao_Tang“may be more effective on improving the immune systemfunction and preventing the progression of CVA to classic asthma.更多还原