三拗汤雾化吸入联合中药外敷治疗小儿咳嗽临床观察
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摘要
目的观察三拗汤雾化吸入联合中药外敷治疗小儿咳嗽的临床疗效。方法收集2014年1月至12月荆门市康复医院就诊的200例咳嗽患儿为研究对象,按照随机数字表法分为观察组和对照组,各100例。观察组给予三拗汤煎汁制剂雾化吸入,每次10 m L,每日2次,并联合小儿咳喘膏外敷;对照组给予氨溴特罗,每次2.5~15 m L口服,每日2次。结果观察组总有效率高于对照组[88.0%(88/100)比98.0%(98/100)],两组疗效比较差异有统计学意义(P<0.05);观察组患儿平均住院时间显著短于对照组[(10.0±2.3)d比(20.2±1.2)d],痰鸣、喘息、咳嗽症状消失时间均显著短于对照组[(2.21±0.3)d比(4.08±1.2)d、(3.35±0.3)d比(5.23±0.8)d、(10.12±3.0)d比(12.65±3.5)d],差异有统计学意义(P<0.01)。观察组患儿治疗期间,1例出现敷贴局部皮肤红、伴痒感,未作任何处理并继续治疗,其余患儿未出现不良反应症状。结论以三拗汤雾化吸入联合中药外敷治疗小儿咳嗽,具有很好的治疗效果,增加了小儿咳嗽的临床治疗手段,医疗设备简单,价格低廉,操作简便,依从性高,预期可缩短病程,明显减轻患儿家庭经济及心理负担,前景广阔,值得推广。
Objective To observe the clinical efficacy of atomizing inhalation of decoction of three crude drugs and external application of Chinese medicine in treating cough in children. Methods Total of 200 cases of children with cough were studied Jingmen Rehabilitation Hospital from January to December 2014 were included in the study. They were divided into an observation group and a control group by random number table method,100 cases each. The observation group received atomizing inhalation of decoction of three crude drugs,10 m L per time,twice a day,and combined with external application of pediatric cough plaster;the control group received ambrocol,2. 5-15 m L per time,twice a day. Results The total effective rate of the observation group was higher than the control group[98. 0%( 98 /100) vs 88. 0%( 88 /100) ],the difference was statistically significant( P < 0. 05); the average length of hospital stay of the observation group was significantly shorter than the control group[( 10. 0 ± 2. 3) d vs( 20. 2 ± 1. 2) d]. Symptom disappearance time of phlegm,wheezing,cough of the observation group were all significantly shorter than the control group[( 2. 21 ±0. 3) d vs( 4. 08 ± 1. 2) d,( 3. 35 ± 0. 3) d vs( 5. 23 ± 0. 8) d,( 10. 12 ± 3. 0) d vs( 12. 65 ± 3. 5) d,P <0. 01]. In the observation group,there was 1 case of local skin red with itching during the treatment,which was not dealt with and did not affect the whole treatment process,and the remaining patients did not have adverse symptoms. Conclusion Atomizing inhalation of decoction of three crude drugs and external application of Chinese medicine treatment for cough in children,has a very good therapeutic effect,featured with simple medical equipment requirement,low price,simple operation,high compliance,shortened expected course of disease,which can significantly reduce the economic and psychological burden of the children' s family and is a good clinical treatment option with broad prospects,thus is worthy to be popularized.
Objective To observe the clinical efficacy of atomizing inhalation of decoction of three crude drugs and external application of Chinese medicine in treating cough in children. Methods Total of 200 cases of children with cough were studied Jingmen Rehabilitation Hospital from January to December 2014 were included in the study. They were divided into an observation group and a control group by random number table method,100 cases each. The observation group received atomizing inhalation of decoction of three crude drugs,10 m L per time,twice a day,and combined with external application of pediatric cough plaster;the control group received ambrocol,2. 5-15 m L per time,twice a day. Results The total effective rate of the observation group was higher than the control group[98. 0%( 98 /100) vs 88. 0%( 88 /100) ],the difference was statistically significant( P < 0. 05); the average length of hospital stay of the observation group was significantly shorter than the control group[( 10. 0 ± 2. 3) d vs( 20. 2 ± 1. 2) d]. Symptom disappearance time of phlegm,wheezing,cough of the observation group were all significantly shorter than the control group[( 2. 21 ±0. 3) d vs( 4. 08 ± 1. 2) d,( 3. 35 ± 0. 3) d vs( 5. 23 ± 0. 8) d,( 10. 12 ± 3. 0) d vs( 12. 65 ± 3. 5) d,P <0. 01]. In the observation group,there was 1 case of local skin red with itching during the treatment,which was not dealt with and did not affect the whole treatment process,and the remaining patients did not have adverse symptoms. Conclusion Atomizing inhalation of decoction of three crude drugs and external application of Chinese medicine treatment for cough in children,has a very good therapeutic effect,featured with simple medical equipment requirement,low price,simple operation,high compliance,shortened expected course of disease,which can significantly reduce the economic and psychological burden of the children' s family and is a good clinical treatment option with broad prospects,thus is worthy to be popularized.
引文
[1]Chang AB,Glomb WB.Guidelines for evaluating chronic cough in pediatrics:ACCT'evidence-based clinical practice guidelines[J].Chest,2006,129(1 Suppl):260-283S.
[2]Morice AH,Fontana GA,Sovijarvi AR,et al.The diagnosis and management of chronic cough[J].Eur Respir J,2004,24(3):481-492.
[3]陆权,董晓燕.中国儿童慢性咳嗽病因构成比多中心研究[J].中华儿科杂志,2012,50(2):83-92.
[4]周仁金.三拗汤合止嗽散治疗喉源性咳嗽52例的临床疗效探讨[J].内蒙古中医药,2013,32(24):14-15.
[5]白月双,施益农,高艳.三拗汤救治儿童支气管哮喘急性发作的临床机理与应用探讨[J].四川中医,2014,32(9):26-27.
[6]国家中医药管理局.中医病证诊断疗效标准(ZY/T001 1-94)[S].南京:南京大学出版社,1999.
[7]刘建.三拗片辅助治疗急慢性支气管炎的临床疗效及安全性分析[J].现代中西医结合杂志,2012,21(34):3796-3798.
[8]苏咏梅,李艳.三拗汤合止嗽散治疗小儿外感风寒袭肺证体会[J].实用中医药杂志,2014,30(5):463-463.
[9]李伟.三拗汤合杏苏二陈汤配合西药治疗慢性支气管炎疗效观察[J].陕西中医,2012,33(11):1478-1479.
[10]陈慧,马融.三拗汤对支气管哮喘大鼠Th1,Th2转录调节机制的研究[J].中国中药杂志,2012,37(9):1324-1326.
[11]赵建国,程冬梅.止嗽散合三拗汤治疗肺炎支原体感染后期咳嗽疗效观察[J].中国医药导报,2012,9(4):107-108.
[12]林剑荣.加味三拗汤联合西医治疗慢性支气管炎急性期风邪犯肺证124例的临床观察[J].内蒙古中医药,2014,33(34):56.
[13]李国华.三拗汤合止嗽散治疗上气道咳嗽综合征36例[J].浙江中医杂志,2014,49(4):249.
[14]李芳,马忠金,刘东楠,等.小儿咳喘糖浆治疗呼吸道感染所致咳嗽60例[J].河南中医,2015,35(5):1168-1169.
[15]陈玉琴.三拗汤加味治疗治疗小儿支气管炎和肺炎[J].中外医药,2015,34(12):167-168.
[2]Morice AH,Fontana GA,Sovijarvi AR,et al.The diagnosis and management of chronic cough[J].Eur Respir J,2004,24(3):481-492.
[3]陆权,董晓燕.中国儿童慢性咳嗽病因构成比多中心研究[J].中华儿科杂志,2012,50(2):83-92.
[4]周仁金.三拗汤合止嗽散治疗喉源性咳嗽52例的临床疗效探讨[J].内蒙古中医药,2013,32(24):14-15.
[5]白月双,施益农,高艳.三拗汤救治儿童支气管哮喘急性发作的临床机理与应用探讨[J].四川中医,2014,32(9):26-27.
[6]国家中医药管理局.中医病证诊断疗效标准(ZY/T001 1-94)[S].南京:南京大学出版社,1999.
[7]刘建.三拗片辅助治疗急慢性支气管炎的临床疗效及安全性分析[J].现代中西医结合杂志,2012,21(34):3796-3798.
[8]苏咏梅,李艳.三拗汤合止嗽散治疗小儿外感风寒袭肺证体会[J].实用中医药杂志,2014,30(5):463-463.
[9]李伟.三拗汤合杏苏二陈汤配合西药治疗慢性支气管炎疗效观察[J].陕西中医,2012,33(11):1478-1479.
[10]陈慧,马融.三拗汤对支气管哮喘大鼠Th1,Th2转录调节机制的研究[J].中国中药杂志,2012,37(9):1324-1326.
[11]赵建国,程冬梅.止嗽散合三拗汤治疗肺炎支原体感染后期咳嗽疗效观察[J].中国医药导报,2012,9(4):107-108.
[12]林剑荣.加味三拗汤联合西医治疗慢性支气管炎急性期风邪犯肺证124例的临床观察[J].内蒙古中医药,2014,33(34):56.
[13]李国华.三拗汤合止嗽散治疗上气道咳嗽综合征36例[J].浙江中医杂志,2014,49(4):249.
[14]李芳,马忠金,刘东楠,等.小儿咳喘糖浆治疗呼吸道感染所致咳嗽60例[J].河南中医,2015,35(5):1168-1169.
[15]陈玉琴.三拗汤加味治疗治疗小儿支气管炎和肺炎[J].中外医药,2015,34(12):167-168.