【目的】 分析宣肺止咳颗粒治疗哮喘急性发作期风热犯肺证患儿的疗效及其对肺功能、免疫功能和炎症反应的影响。 【方法】 选取2022年7月至2024年10月海宁市第二人民医院收治的124例哮喘急性发作期风热犯肺证患儿为研究对象。采用 随机数字表法将入组患儿随机分为观察组和对照组，每组各62例。对照组给予常规西医治疗，观察组在对照组的基础上加 用宣肺止咳颗粒治疗，疗程均为1个月。观察2组患儿治疗前后血清免疫功能指标、炎症因子及肺功能指标的变化情况，并 评价2组患儿的临床疗效。【结果】（1）脱落情况方面，治疗过程中，观察组脱落5例，对照组脱落7例，最终共112例患儿纳 入疗效统计，其中观察组57例，对照组55例。（2）疗效方面，治疗1个月后，观察组的总有效率为96.49%（55/57），对照组为 76.36%（42/55），组间比较（χ2 检验），观察组的疗效明显优于对照组（P＜0.01）。（3）免疫功能指标方面，治疗后，2组患儿的 血清免疫球蛋白G（IgG）、免疫球蛋白M（IgM）水平均较治疗前明显升高（P＜0.05或P＜0.001），血清免疫球蛋白E（IgE）水平 均较治疗前明显降低（P＜0.001），且观察组对血清IgG、IgM水平的升高幅度及对血清IgE水平的降低幅度均明显优于对照组 （P＜0.001）。（4）炎症因子方面，治疗后，2组患儿的血清白细胞介素4（IL-4）、白细胞介素6（IL-6）、白细胞介素10（IL-10）、 白细胞介素17（IL-17）、干扰素γ（INF-γ）、肿瘤坏死因子α（TNF-α）水平均较治疗前明显降低（P＜0.001），且观察组对血清 IL-4、IL-6、IL-10、IL-17、INF-γ、TNF-α 水平的降低幅度均明显优于对照组（P＜0.001）。（5）肺功能指标方面，治疗后， 2 组患儿的呼气流量峰值（PEF）、第 1 秒用力呼气容积（FEV1 ）、用力肺活量（FVC）等肺功能指标均较治疗前明显改善（P＜ 0.001），且观察组对PEF、FEV1、FVC等肺功能指标的改善幅度均明显优于对照组（P＜0.001）。【结论】 在常规西医治疗基础 上联合宣肺止咳颗粒治疗哮喘急性发作期风热犯肺证患儿具有较好的临床疗效，可有效改善患儿免疫功能与肺功能，降低 炎症因子表达，减轻炎症反应。

Objective To analyze the efficacy of Xuanfei Zhike Granules in children with acute exacerbation of asthma and to observe their impact on pulmonary function， immune function， and inflammatory responses. Methods A total of 124 children with acute exacerbation of asthma and wind-heat invading the lung syndrome， admitted to Haining Second People’s Hospital from July 2022 to October 2024， were selected as the studying subjects. The enrolled children were randomly divided into an observation group and a control group using a random number table，with 62 cases in each group. The control group received conventional western medicine treatment， while the observation group received Xuanfei Zhike Granules in addition to the conventional treatment. The treatment course for both groups was one month. Changes in serum immune function indicators， inflammatory factor levels，and pulmonary function parameters were observed before and after treatment. The clinical efficacy of the two groups was evaluated. Results （1） Regarding study attrition， during the treatment period， 5 cases dropped out from the observation group and 7 from the control group. Ultimately，112 children were included in the efficacy analysis，comprising 57 in the observation group and 55 in the control group.（2） In terms of efficacy， after one month of treatment，the total effective rate was 96.49% （55/57） in the observation group，significantly higher than 76.36% （42/55） in the control group. Intergroup comparison （by chi-square test） showed that the efficacy of the observation group was significantly superior to that of the control group （P＜0.01）.（3） Regarding immune function indicators， after treatment， serum levels of immunoglobulin G （IgG） and immunoglobulin M （IgM） were significantly increased in both groups compared to those before treatment （P＜0.05 or P＜0.001）， while serum immunoglobulin E （IgE） levels was significantly decreased （P＜0.001）. The increases in IgG and IgM levels and the decrease in IgE level were significantly greater in the observation group than in the control group （P＜0.001）.（4） Regarding inflammatory factors levels，after treatment，serum levels of interleukin-4（IL-4）， interleukin-6（IL-6），interleukin-10（IL-10），interleukin-17（IL-17），interferon-gamma （IFN- γ），and tumor necrosis factor-alpha （TNF- α） were significantly decreased in both groups compared to those before treatment （P＜0.001）. The reductions in these factors levels were significantly greater in the observation group than in the control group （P＜0.001）.（5） Regarding pulmonary function parameters，after treatment，peak expiratory flow （PEF），forced expiratory volume in one second （FEV1 ），and forced vital capacity （FVC） were significantly improved in both groups compared to those before treatment （P＜0.001）. The improvements in PEF，FEV1 and FVC were significantly greater in the observation group than in the control group （P＜0.001）. Conclusion The combination of Xuanfei Zhike Granules with conventional western medicine treatment demonstrates favorable clinical efficacy in children with acute exacerbation of asthma and wind-heat invading the lung syndrome. The combined therapy effectively improves immune function and pulmonary function， reduces the expression of inflammatory factors，and alleviates inflammatory responses.

R256.12

国家自然科学基金资助项目（编号：81704118）