目的   剖析中医药治疗儿童哮喘的随机对照试验（RCT）结局指标，为中医药治疗该病临床试验的核心指标集构建提供初步依据。方法   检索中国知网（CNKI）、万方（WanFang）、维普网（VIP）、中国生物医学文献数据库（SinoMed）、PubMed、Cochrane Library、EmBase、Web of Science。时间跨度为建库至2024年7月1日。此次检索全面覆盖了中医药疗法治疗儿童哮喘的临床随机对照研究，由两名研究者根据纳排标准独立完成文献筛选和资料提取，提取文献基本特征和结局指标。结果   初步检索出2 449篇文献，最终纳入165个RCT，包括205个结局指标，分为症状/体征、中医症状/证候、理化检查、生活质量评价、远期预后、安全性指标六域。结论   中医药治疗儿童哮喘尚存在中医证候诊断和疗效标准不完善、主要和次要结局指标界限不清等问题，应当构建统一规范且广为认可的核心指标集，以促进儿童哮喘核心指标集的完善。

        Objective  To analyze the outcome indicators of randomised controlled trials（RCTs）of traditional Chinese medicine（TCM）for the treatment of childhood asthma，and to provide a preliminary basis for the construction of a core set of indicators for clinical trials of TCM for the treatment of this disease．Methods  A database search was conducted on China Knowledge Network（CNKI），WanFang，VIP，SinoMed，PubMed，Cochrane Library，EmBase，and Web of Science，covering the period from the establishment of the database to 1 July 2024．The search comprehensively covered clinical randomised controlled studies of TCM therapies in the treatment of childhood asthma，and was completed independently by two investigators who screened the literature and extracted information according to the criteria，and extracted the basic characteristics of the literature and outcome indicators．Results  Initially，2 449 literatures were retrieved，and 165 RCTs were finally included，including 205 outcome indicators，which were classified into six domains：symptoms/signs，TCM symptoms/evidence，physical and chemical examination，quality of life evaluation，long-term prognosis，and safety indicators．Conclusions  Currently，there are problems such as imperfect diagnostic and efficacy criteria for TCM evidence，and unclear boundaries between primary and secondary outcome indicators in the treatment of childhood asthma with TCM．A unified，standardised and widely recognised core indicator set should be constructed to promote the improvement of the core indicator set for childhood asthma．

目的 探讨护理目标执行理念护理在哮喘患儿治疗中的价值。方法 前瞻性选取泉州市妇幼保健院于2021年8月—2023年8月收治的100例支气管哮喘患儿,应用随机数字表法将其分为两组,每组均为50例。对照组采取常规护理,观察组在常规护理基础上给予护理目标执行理念护理。3个月后,对比两组家属对患儿的疾病管理能力、哮喘控制状况、生活质量。结果 护理后两组患儿家属相关家庭管理测量量表（FaMM）评分均升高,且观察组高于对照组（P<0.05）;观察组患儿哮喘控制率高于对照组（P<0.05）;护理后两组患儿情感、活动、症状相关标准儿童哮喘生活质量评分表（PAQLQ）评分均升高,且观察组高于对照组（P<0.05）。结论 护理目标执行理念护理可改善哮喘患儿家属对患儿疾病的管理能力,改善哮喘控制效果,提升患儿生活质量。

Objective To explore the value of nursing goal execution concept intervention in the treatment of children with asthma．Methods From August 2021 to August 2023,100 children with bronchial asthma admitted to Quanzhou Maternal and Child Health Hospital were Prospective selected．They were randomly divided into observation group and control group,with 50 cases in each group．The control group of children received routine care,while the observation group of children received intervention based on the nursing goals execution concept in addition to routine care．After 3 months of intervention,The disease management ability,compliance,asthma control and quality of life of the two groups were compared．Results Family-related FaMM scores were increased in all two groups after the intervention,and the observation group was higher than the control group（P<0.05）．The asthma control rate of the children in the observation group was higher than that in the control group（P<0.05）;after nursing,the PAQLQ score increased,and the observation group was higher than the control group（P<0.05）．Conclusions Intervention based on the nursing goals execution concept can improve the management ability of family members of asthma patients towards their diseases,and enhance their quality of life,which is worthy of clinical application and promotion．

目的 探讨苏黄止咳胶囊联合多索茶碱对慢性持续期支气管哮喘的疗效及对肺功能、呼出气一氧化氮（FeNO）的影响。方法 选择2020年3月—2022年3月70例慢性持续期支气管哮喘患者,随机分为2组各35例,对照组仅予以多索茶碱治疗,研究组在对照组基础上加服苏黄止咳胶囊治疗。治疗3个月,采用哮喘控制测试（ACT）对患者进行评估,记录哮喘急性加重、急救药物使用情况及急诊入院情况,测定肺功能和呼出FeNO。结果 2组治疗1月的ACT评分比较无统计学意义（P>0.05）,治疗2、3个月时研究组的ACT评分高于对照组（P<0.05）。研究组哮喘急性加重次数、急救药物使用次数均少于对照组（P<0.05）,而2组急诊入院次数比较差异无统计学意义（P>0.05）。与基线值相比,2组治疗3个月时的肺功能指标无改变（P>0.05）且组间比较差异亦无统计学意义（P>0.05）;2组治疗3个月时的FeNO无改变（P>0.05）,而研究组的FeNO低于对照组（P<0.05）。结论 苏黄止咳胶囊联合多索茶碱治疗慢性持续期支气管哮喘可降低FeNO,提高哮喘控制水平。

Objective To investigate the effect of Suhuang Zhike capsule combined with doxofylline on chronic persistent bronchial asthma, pulmonary function and exhaled nitric oxide（FeNO）．Methods Seventy patients with chronic persistent bronchial asthma from March 2020 to March 2022 were randomly divided into two groups, 35 cases in each group．The control group was only treated with doxofylline, and the study group was treated with Suhuang Zhike capsule additionally．After 3 months of treatment, the patients were evaluated by asthma control test（ACT）, the acute exacerbation of asthma was recorded, and the pulmonary function and exhaled FeNO were measured．Results There was no statistical significance in the ACT score of the two groups after one month of treatment（P>0.05）．The ACT scores of the study group after two months and three months of treatment were significantly higher than those of the control group（P<0.05）．The times of acute exacerbation of asthma and the use of emergency drugs in the study group were less than those in the control group（P<0.05）, but there was no significant difference in the number of emergency hospitalizations between the two groups（P>0.05）．Compared with the baseline value, there was no significant change in lung function indexes in the two groups after 3 months of treatment（P>0.05）．Compared with the baseline value, there was no significant change in FeNO in the two groups after 3 months of treatment（P<0.05）, while FeNO in the study group was lower than that in the control group（P<0.05）．Conclusions Suhuang Zhike capsule combined with doxofylline in the treatment of chronic persistent bronchial asthma can reduce FeNO and improve the level of asthma control．

目的 分析中山市博爱医院妊娠合并哮喘急性发作患者相关危险因素。方法 选取2019年7月—2021年2月中山市博爱医院收治100例的妊娠合并哮喘患者作为研究对象,将100例妊娠合并患者分为哮喘急性发作组(n=46)与未发作组(n=54),采用多因素Logistic回归分析进行调查分析。结果 100例患者中发作人数为46例,占46.0%。Logistic回归分析显示孕周、哮喘药物的使用、焦虑、IL-17是妊娠合并支气管哮喘急性发作的危险因素(P<0.05)。发作组剖宫产率发生率、住院时间以及并发症发生率均高于未发作组,差异有统计学意义(P<0.05)。结论 孕周、哮喘药物的使用、焦虑、IL-17是妊娠合并支气管哮喘急性发作的独立危险因素,应对此类患者给予高度重视。

Objective To analyze the risk factors of pregnancy complicated with acute attack of asthma in Zhongshan Bo'ai Hospital.Methods A total of 100 patients with pregnancy complicated with asthma treated in Zhongshan Bo'ai Hospital from July 2019 to February 2021 were selected as the research objects.Patients were divided into acute attack group (n=46) and no attack group (n=54).Multivariate logistic regression analysis was used for investigation and analysis.Results The patient number of attack was 46,accounting for 46.0%. The incidence of cesarean section,length of hospital stay and complications in the attack group were higher than those in the no attack group,and the difference was statistically significant (P<0.05).Conclusions Gestational age,use of asthma drugs,anxiety and IL-17 level were independent risk factors for pregnancy complicated with acute attack of asthma.Great attention should be paid to these patients.

目的 探讨哮喘患者的气道炎症表型分布及肺功能指标情况。方法 选择226 例哮喘患者为研究对象,其中50 例为重症哮喘,76 例为普通哮喘,对比哮喘患者的气道炎症表型分布情况及患者肺功能指标情况。结果 226 例哮喘患者中,嗜酸性粒细胞型最为常见,占36.73%,之后为中性粒细胞型（31.86%）、混合细胞型（22.12%）、寡细胞型（9.29%）;重度哮喘患者中,中性粒细胞型患者肺功能相关指标均低于其它类型的重症患者（P<0.05）。结论 在哮喘气道炎症表型中,最常见的表型为嗜酸性粒细胞型,其中中性粒细胞型的哮喘患者的肺功能最差。

Objective To explore the phenotype distribution and lung function indicators of airway inflammation in asthmatic patients. Methods 226 cases of asthma patients were chosen as the research objects,in which 50 cases of severe asthma,76 cases of asthma,to compare asthma airway inflammation phenotype distribution and lung function index. Results Among 226 asthma patients,eosinophilic granulocytes were the most common,accounting for 36.73%,followed by neutrophilic granulocytes （31.86%）,mixed cell types （22.12%） and oligocytes （9.29%）. Among patients with severe asthma, the lung function of neutrophil patients was lower than that of other severe patients（P < 0.05）. Conclusion Among asthmatic airway inflammatory phenotypes, the most common phenotype is eosinophilic granulocyte type, among which neutrophil asthmatic patients have the worst lung function.

目的 分析小儿葫芦散应用于儿童喘息性支气管炎中的治疗效果。方法 在我院2015年8月—2018年12月诊治的喘息性支气管炎患儿中选取68例,并严格按照系统随机分配原则分为对照组和观察组,各34例。其中对照组采用常规治疗,观察组采用小儿葫芦散治疗,观察对比两组患儿治疗效果和临床症状消失时间。结果 对照组总有效率为76.47%,观察组总有效率为94.12%,对照组总有效率低于观察组,且对照组临床症状消失时间均长于观察组,差异有统计学意义(P<0.05)。结论 小儿葫芦散应用于喘息性支气管炎患儿中具有显著疗效,进一步改善肺功能情况,促进患儿康复,值得推广。

目的 探讨布地奈德联合特布他林对中度哮喘患儿血清变态反应及Th相关指标的影响。方法 选择本院2016年3月—2017年4月收治的中度哮喘患儿100例,将其随机分为2组,各50例。对照组采用布地奈德雾化吸入治疗,观察组采用布地奈德联合特布他林雾化吸入治疗,比较两组临床疗效、血清变态反应与Th相关指标、药物不良反应。结果 1周后,观察组治疗总有效率较对照组高,MCP-1、IgE、IL-10及IL-6水平均较对照组低,差异具有统计学意义(P＜0.05);观察组药物不良反应率与对照组相比,差异无统计学意义(P＞0.05)。结论 布地奈德联合特布他林可提高中度哮喘患儿临床疗效,减轻血清变态反应,改善Th相关指标,且用药安全性较高。

目的 探讨无创呼吸机辅助常规药物治疗重症哮喘的疗效及对肺功能的影响。方法 选取我院于2014年2月—2017年6月间收治的60例重症哮喘患者作为研究对象,按照随机数字法分为对照组和研究组,对照组30例予以常规药物治疗,研究组30例予以无创呼吸机辅助常规药物治疗。比较两组患者临床疗效、肺功能指标、气血指标、心率、哮喘症状评分以及药物使用情况。结果 研究组临床有效率(96.66%)高于对照组(76.66%)(P＜0.05)。2组患者干预前肺功能指标、气血指标及心率比较无差异(P＞0.05),干预后两组心率、PaCO₂均较干预前降低,PaO₂、FEV1、FEV1/FVC均较干预前升高(P＜0.05),研究组较对照组改善明显(P＜0.05)。两组患者干预前哮喘症状评分比较无差异(P＞0.05),干预后两组哮喘症状评分均较干预前降低,且研究组较对照组降低明显(P＜0.05)。研究组使用茶碱类药物、糖皮质类激素、受体激动剂药物比例均低于对照组(P＜0.05)。结论 无创呼吸机辅助常规药物治疗重症哮喘可显著改善患者血气指标及肺功能,疗效确切。

目的 观察不同剂量卡介苗核酸(Bacille Calmette-guerin DNA , BCG-DNA)在不同干预时间对哮喘小鼠气道高反应性及气道炎症的干预作用。方法 1.将Balb/c雌鼠随机分为哮喘模型组、NS对照组、BCG- DNA干预组。干预组根据干预的时间和干预制剂剂量的不同分为-7DNA1 μg、-7DNA10 μg、-7DNA100 μg、10DNA1 μg、10DNA10 μg、10DNA100 μg、17DNA1 μg、17DNA10 μg、17DNA100 μg组。2.在末次激发48小时后,测定各浓度级乙酰甲胆碱激发下的增强的呼气间歇 (Enhanced Pause, Penh)值,将其与小鼠激发前吸入NS后的Penh的百分比(Penh%NS),作为其气道反应性评价指标;其次对肺泡灌洗液进行细胞学分析。结果 1.气道反应性:①-7DNA1 μg组从Mch为3.12～50 mg/mL之间的Penh%NS显著低于哮喘组(P<0.05);②-7DNA10 μg组和-7DNA 100 μg组从Mch为6.25～25 mg/mL之间的Penh%NS显著低于哮喘组(P<0.05);③10DNA10 μg组从Mch为12.5～25 mg/mL之间的Penh%NS显著低于哮喘组(P<0.05);④10DNA100 μg组从Mch为3.12、12.5～50 mg/mL之间的Penh%NS显著低于哮喘组(P<0.05);⑤17DNA1 μg组在Mch为3.12、12.5 mg/mL的Penh%NS显著低于哮喘组(P<0.05);⑥17DNA10 μg组在Mch为12.5 mg/mL之间的Penh%NS显著低于哮喘组(P<0.05) 2.气道炎症:10DNA1 μg、-7DNA10 μg、10DNA10 μg和17DNA10 μg组的BALF细胞分类Eos%分别为:35.34±3.81、27.30±6.91、38.20±6.56、42.17±5.17;显著低于哮喘组的Eos%(48.8±6.12)(P<0.05);10DNA1 μg组的Eos%显著低于-7DNA1 μg组的Eos%(P<0.05);-7DNA10 μg组的Eos%显著低于10DNA10 μg、17DNA10 μg、-7DNA1 μg和-7DNA100 μg组的Eos%(P<0.05)。结论 BCG-DNA能降低哮喘小鼠的气道高反应性,减轻哮喘小鼠的气道炎症,早期(－7 d)中小剂量的干预效果较佳。

Objective To investigate the effect of Bacille Calmette-Guerin BCG-DNA on airway hyperresponsiveness and airway inflammation in asthmatic mouse model. Methods 1.According to different intervention, mouse were divided into asthma groups, NS control group, BCG-DNA group. According to different time and dosage intervened with asthma model, the BCG-DNA group were subdivided into -7DNA1 μg、-7DNA10 μg、-7DNA100 μg、10DNA1 μg、10DNA10 μg、10DNA100 μg、17DNA1 μg、17DNA10 μg and 17DNA100 μg group. 2.48 hours after the final incitation, the mice were stimulated with increasing concentrations of methacholine, and the airway resistance was measured. Enhance pause (Penh) was taken for each group. Bronchoalveolar lavage cytology was performed to evaluate the airway inflammation. Results 1.Airway hyperresponsiveness: ① Penh%NS of-7DNA1 μg group was significantly lower than the asthma group when Mch was 3.12~50 mg/mL (P<0.05); ② Penh%NS of -7DNA10 μg group and -7DNA100 μg group were significantly lower than the asthma group when Mch was 6.25~50 mg/mL (P<0.05);③ Penh%NS of 10DNA10 μg group was significantly lower than the asthma group when Mch was 12.5~25 mg/mL (P<0.05); ④ Penh%NS of 10DNA100 μg group was significantly lower than the asthma group when Mch was 3.12,12.5~50 mg/mL (P<0.05); ⑤ Penh%NS of 17DNA1 μg group was significantly lower than the asthma group when Mch was 3.12 or 12.5 mg/mL (P<0.05);⑥Penh%NS of 17DNA10 μg group was significantly lower than the asthma group when Mch was 12.5 mg/mL(P<0.05). 2.Airway inflammation: The Eos% of 10DNA1 μg, -7DNA10 μg,10DNA10 μg and 17DNA10 μg group (35.34±3.81、27.30±6.91、38.20±6.56、42.17±5.17) were lower than the asthma group (P<0.05); The Eos% of 10DNA1 μg group was lower than the -7DNA1 μg group (P<0.05); The Eos% of -7DNA10 μg group was lower than the 10DNA10μg, 17DNA10 μg,-7DNA1 μg and -7DNA100 μg group (P<0.05). Conclusion BCG-DNA can inhibit the airway inflammation and hyperresponsiveness in asthmatic mouse model. Early interventions with middle dose bring better results.

支气管哮喘是由多种细胞和和细胞因子参与的气道慢性炎症性疾病,白细胞介素、干扰素、集落刺激因子、肿瘤坏死因子、趋化因子等细胞因子在哮喘发生发展过程中发挥着重要作用。