RESUMO
Background: Cough variant asthma is a prevalent condition among children with chronic cough, significantly impacting their health and well-being. Objective: This study aimed to assess the impact of spleen aminopeptide oral lyophilized powder and fluticasone/salmeterol powder inhaler on pulmonary function and the incidence of adverse reactions in children with cough variant asthma. Methods: A total of 60 children with cough variant asthma admitted to the Pediatric Department of Cangzhou Central Hospital between July 2019 and June 2020 were enrolled in the study. Using the random number table method, they were assigned to either the observation group or the control group, with 30 cases in each group. The control group received treatment with fluticasone/salmeterol powder inhalers, while the observation group received a combination of fluticasone/salmeterol powder inhalers and spleen aminopeptide oral lyophilized powder. After 8 weeks of treatment, various clinical parameters, including forced vital capacity, forced expiratory volume per second/forced vital capacity, peak expiratory flow, fractional exhaled nitric oxide (FeNO), interleukin-4 (IL-4), IL-10, eosinophils in induced sputum, and serum CD4+ and CD8+ levels, were compared between the two groups. Results: The observation group exhibited a higher total effective rate of clinical efficacy compared to the control group [90.00% vs. 63.33%; OR (95% CI) 3.00 (1.01-8.92), P = .048)]. After 8 weeks, the observation group demonstrated higher levels of forced vital capacity, forced expiratory volume per second/forced vital capacity, peak expiratory flow [OR (95% CI) 0.48 (0.26-0.88), P = .017; OR (95% CI) 0.29 (0.14-0.57) 2.57 (1.46-4.52) 0.33 (0.16-0.70), P = .000, .001, .003], IL-10 [OR (95% CI) 0.29 (0.14-0.57), P = .000], and lower levels of FeNO [OR (95% CI) 0.48 (0.26-0.88), P = .017], IL-4, and eosinophils [OR (95% CI) 2.57 (1.46-4.52) 0.33 (0.16-0.70), P = .001, .003] compared to the control group (P < .05). Furthermore, the observation group exhibited higher levels of CD4+ and CD4+/CD8+ compared to the control group [OR (95% CI) 0.41 (0.25-0.67) 0.33 (0.20-0.56) 1.73 (1.18-2.55), P = .000, .000, .001]. Computed tomography measurements revealed significantly lower airway wall thickness, basement membrane thickness, and total airway wall area in the observation group compared to the control group [OR (95% CI) 0.18 (0.10-0.33) 0.23 (0.13-0.41) 0.28 (0.15-0.51), P = .000, .000, .000]. The incidence of adverse reactions did not significantly differ between the groups (6.67% vs. 3.33%; P > .05). Conclusion: The combination treatment of spleen aminopeptide oral lyophilized powder and fluticasone/salmeterol powder inhaler effectively improves lung function, FeNO levels, and airway inflammation, while enhancing cellular and humoral immune function in children with cough variant asthma. These findings have significant clinical implications and warrant further promotion and application of this treatment approach.
