定喘汤加减治疗老年急性发作期哮喘临床研究
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摘要
目的:观察定喘汤加减辅助治疗老年急性发作期哮喘的临床疗效。方法:90例老年急性发作期哮喘患者按随机数字表法平均分为对照组和观察组。对照组45例予以常规疗法治疗,观察组45例在对照组治疗基础上予以定喘汤加减治疗。比较两组临床症状,肺功能变化,炎症介质,血清Ig E、NO及超氧化物歧化酶(superoxide dismutase,SOD)水平,临床疗效及并发症状况。结果:对照组有效率75.56%低于观察组有效率91.11%,差异具有统计学意义(P<0.05)。与对照组比较,观察组治疗后喘憋、咳嗽、肺部湿啰音及哮鸣音缓解时间缩短,治疗后第1秒用力呼气量(forced expiratory volume in 1 second,FEV1)、用力肺活量(forced vital capacity,FVC)、FEV1%和FEV1/FVC显著升高,差异均有具有统计学意义(P<0.05);治疗后血清白细胞介素-4(interleukin 4,IL-4)、IL-8、IL-9水平降低,IL-10水平升高,差异均有具有统计学意义(P<0.05);治疗后血清Ig E及NO水平降低,SOD水平升高,差异均有具有统计学意义(P<0.05)。结论:定喘汤加减辅助治疗老年急性发作期哮喘临床疗效显著,同时能改善肺功能及缓解炎症反应。
Objective: To investigate the clinical effect of Dingchuan decoction in the treatment of acute episode of asthma in the elderly. Methods: 90 cases of elderly patients with acute attack of asthma were selected and patients or family member signed an agreement,and randomly divided into 2 groups,45 cases in the control group were treated with symptomatic and supportive therapy,45 cases in the experiment group were treated on the base of the control group with Dingchuan decoction. Clinical symptoms,pulmonary function,inflammatory mediators and serum levels of Ig E,NO and SOD,and the clinical efficacy and complications were compared. Results: The effective rate of the control treatment group( 75. 56%) was lower than the experiment group( 91. 11%),with significant difference( P < 0. 05),and compared with the control group,the time of asthma suppress,cough,lung wet rales and wheezes sound remission time in the experiment group were shorter,FEV1,FVC,FEV1% pre and FEV1 / FVC were higher,serum IL-4 and IL-8,IL-9 levels were lower,levels of IL-10 was higher,serum levels of Ig E and NO were lower and SOD level was higher( P < 0. 05). Conclusion: Dingchuan decoction auxiliary treatment of acute exacerbation of asthma in the elderly has significant effect,which can improve lung function and relieve inflammation reaction with high safety.
Objective: To investigate the clinical effect of Dingchuan decoction in the treatment of acute episode of asthma in the elderly. Methods: 90 cases of elderly patients with acute attack of asthma were selected and patients or family member signed an agreement,and randomly divided into 2 groups,45 cases in the control group were treated with symptomatic and supportive therapy,45 cases in the experiment group were treated on the base of the control group with Dingchuan decoction. Clinical symptoms,pulmonary function,inflammatory mediators and serum levels of Ig E,NO and SOD,and the clinical efficacy and complications were compared. Results: The effective rate of the control treatment group( 75. 56%) was lower than the experiment group( 91. 11%),with significant difference( P < 0. 05),and compared with the control group,the time of asthma suppress,cough,lung wet rales and wheezes sound remission time in the experiment group were shorter,FEV1,FVC,FEV1% pre and FEV1 / FVC were higher,serum IL-4 and IL-8,IL-9 levels were lower,levels of IL-10 was higher,serum levels of Ig E and NO were lower and SOD level was higher( P < 0. 05). Conclusion: Dingchuan decoction auxiliary treatment of acute exacerbation of asthma in the elderly has significant effect,which can improve lung function and relieve inflammation reaction with high safety.
引文
[1]张添威,毛立群.噻托溴铵对重症哮喘患者肺功能及预后的影响[J].实用药物与临床,2014,17(2):189-192.
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[5]中华医学会呼吸病学分会哮喘学组,中华医学会全科医学分会.中国支气管哮喘防治指南(基层版)——支气管哮喘的诊断与鉴别诊断[J].中国全科医学,2013,16(31):3030.
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[7]陈旭东,孙金林,解现金,等.小剂量激素吸入与噻托溴铵联用对支气管哮喘患者血清细胞因子及肺功能的影响[J].国际医药卫生导报,2014,20(5):669-672.
[8]忽景泰,吴怀敏.噻托溴铵联合布地奈德治疗轻中度支气管哮喘的疗效观察[J].实用心脑肺血管病杂志,2014,22(8):82-83.
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[10]宋玮洋,曲妮妮.定喘汤联合西药治疗支气管哮喘系统综述与Meta分析[J].实用中医内科杂志,2015,29(6):1-4.
[11]顾慧玲.老年支气管哮喘患者Fe NO与肺功能的相关性[J].临床肺科杂志,2015,20(7):1293-1295.
[12]朱晓红.定喘汤治疗支气管哮喘46例[J].中国中医药现代远程教育,2014,12(12):47-48.
[13]王尚,苏国德.沙丁胺醇联合布地奈德治疗小儿急性发作期哮喘效果观察[J].河北医药,2015,37(7):1029-1031.
[14]卢继芳,刘振玲.孟鲁司特联合沙美特罗替卡松治疗儿童中度哮喘的疗效及对IL-13和TNF-α水平的影响[J].临床和实验医学杂志,2014,13(8):647-650.
[15]解玉,郑含笑,杨子珍,等.孟鲁司特钠、布地奈德对哮喘小鼠气道重塑及肺组织MMP-9、TIMP-1表达的影响[J].山东医药,2013,53(23):33-35.
[16]区秀燕,袁小玲,郭伟洪.布地奈德福莫特罗干粉吸入剂联合孟鲁司特对中重度支气管哮喘肺功能的影响[J].辽宁医学院学报,2014,35(2):12-14.
[17]云俊杰,王健,徐影,等.Fe NO在慢性阻塞性肺疾病急性发作期患者中的临床应用[J].现代生物医学进展,2015,15(21):4074-4077.
[18]周敏,丁宇,程胜,等.布地奈德/福莫特罗对咳嗽变异性哮喘患者Fe NO及血浆hs-CRP影响的研究[J].临床内科杂志,2014,31(3):164-167.
[2]许淑文,李艳,郑红云,等.沙美特罗替卡松联合孟鲁司特治疗儿童哮喘疗效的Meta分析[J].中国医药,2015,10(2):172-176.
[3]孙荣,侯伟,刘海燕,等.沙美特罗替卡松对哮喘患儿Fe NO和肺功能影响[J].中国妇幼健康研究,2013,24(3):410-411.
[4]付淑媛.定喘汤化裁治疗热哮型支气管哮喘发作期临床观察[J].四川中医,2015,33(10):50-52.
[5]中华医学会呼吸病学分会哮喘学组,中华医学会全科医学分会.中国支气管哮喘防治指南(基层版)——支气管哮喘的诊断与鉴别诊断[J].中国全科医学,2013,16(31):3030.
[6]刘绍霞,郑瑞娟,张国俊.噻托溴铵粉雾剂治疗重度支气管哮喘患者的临床研究[J].中华肺部疾病杂志:电子版,2015,8(3):53-54.
[7]陈旭东,孙金林,解现金,等.小剂量激素吸入与噻托溴铵联用对支气管哮喘患者血清细胞因子及肺功能的影响[J].国际医药卫生导报,2014,20(5):669-672.
[8]忽景泰,吴怀敏.噻托溴铵联合布地奈德治疗轻中度支气管哮喘的疗效观察[J].实用心脑肺血管病杂志,2014,22(8):82-83.
[9]侯亚楠,贺爱燕.中医论治小儿哮喘的近况[J].内蒙古中医药,2014,33(2):113-115.
[10]宋玮洋,曲妮妮.定喘汤联合西药治疗支气管哮喘系统综述与Meta分析[J].实用中医内科杂志,2015,29(6):1-4.
[11]顾慧玲.老年支气管哮喘患者Fe NO与肺功能的相关性[J].临床肺科杂志,2015,20(7):1293-1295.
[12]朱晓红.定喘汤治疗支气管哮喘46例[J].中国中医药现代远程教育,2014,12(12):47-48.
[13]王尚,苏国德.沙丁胺醇联合布地奈德治疗小儿急性发作期哮喘效果观察[J].河北医药,2015,37(7):1029-1031.
[14]卢继芳,刘振玲.孟鲁司特联合沙美特罗替卡松治疗儿童中度哮喘的疗效及对IL-13和TNF-α水平的影响[J].临床和实验医学杂志,2014,13(8):647-650.
[15]解玉,郑含笑,杨子珍,等.孟鲁司特钠、布地奈德对哮喘小鼠气道重塑及肺组织MMP-9、TIMP-1表达的影响[J].山东医药,2013,53(23):33-35.
[16]区秀燕,袁小玲,郭伟洪.布地奈德福莫特罗干粉吸入剂联合孟鲁司特对中重度支气管哮喘肺功能的影响[J].辽宁医学院学报,2014,35(2):12-14.
[17]云俊杰,王健,徐影,等.Fe NO在慢性阻塞性肺疾病急性发作期患者中的临床应用[J].现代生物医学进展,2015,15(21):4074-4077.
[18]周敏,丁宇,程胜,等.布地奈德/福莫特罗对咳嗽变异性哮喘患者Fe NO及血浆hs-CRP影响的研究[J].临床内科杂志,2014,31(3):164-167.