六君子汤合玉屏风散治疗哮喘迁延期的临床研究
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摘要
目的观察六君子汤合玉屏风散治疗对哮喘迁延期风痰内蕴、肺脾气虚证患儿中医证候积分、哮喘控制测试(C-ACT)评分及肺通气功能的影响。方法选择2016年5月至2017年5月上海交通大学医学院附属上海儿童医学中心呼吸科、复旦大学附属儿科医院及上海中医药大学附属市中医医院儿科门诊哮喘迁延期(风痰内蕴、肺脾气虚证)患儿共100例,随机分为观察组和对照组各50例。对照组给予布地奈德吸入剂治疗6个月,观察组在对照组治疗基础上,联合应用六君子汤合玉屏风散治疗3个月。分析治疗3个月和6个月后两组患儿中医证候积分、C-ACT评分及肺功能参数的变化情况。结果 (1)治疗3、6个月后观察组中医证候积分显著低于对照组,差异有统计学意义(P<0.05)。(2)治疗3个月后两组C-ACT评分比较差异无统计学意义(P>0.05)。治疗6个月后观察组C-ACT评分显著高于对照组,差异有统计学意义(P<0.05)。(3)治疗3、6个月后观察组PEF、FVC、FEV1、FEF50及FEF75均显著高于对照组,差异有统计学意义(P<0.05)。结论六君子汤合玉屏风散具有改善哮喘迁延期风痰内蕴、肺脾气虚证患儿的中医证候,提高哮喘控制测试评分,改善肺通气功能的作用。
Objective To study the effect of Liujunzi decoction and Yupingfeng powder on the TCM syndrome score, the C-ACT score and the pulmonary function in asthma children in remission with wind-phlegm inside and lung-spleen Qi-deficiency.Methods Totally 100 children who met the asthma diagnostic standards were selected and randomly divided into the control group and the treatment, with each group having 50 cases. In the control group, budesonide was given for 6 months, while in the treatment group, pulmicort was given for 6 months, combined with the Liujunzi decoction and Yupingfeng powder for 3 months. After 3 months and 6 months of treatment, TCM syndrome score, asthma control test(C-ACT) and pulmonary function were revalued.Results(1)TCM syndrome scores: after 3 months and 6 months of treatment, the improvement of TCM syndrome score in the treatment group were lower than that of the control group(P<0.05).(2)C-ACT score: after 3 months of treatment, C-ACT was similar in the two groups(P>0.05). At 6 months of treatment, the improvement in the treatment group was superior to that in the control group(P<0.05).(3)Pulmonary function: after 3 months and 6 months of treatment, the improvement of PEF, FVC, FEV1, FEF50 and FEF75 in the treatment group was better than that in the control group(P<0.05).Conclusion Liujunzi decoction and Yupingfeng powder can improve the symptoms of TCM syndrome, the asthma control test(C-ACT) score, and the function of lung ventilation in the children with asthma in remission period with wind-phlegm inside and lung-spleen Qi-deficiency.
Objective To study the effect of Liujunzi decoction and Yupingfeng powder on the TCM syndrome score, the C-ACT score and the pulmonary function in asthma children in remission with wind-phlegm inside and lung-spleen Qi-deficiency.Methods Totally 100 children who met the asthma diagnostic standards were selected and randomly divided into the control group and the treatment, with each group having 50 cases. In the control group, budesonide was given for 6 months, while in the treatment group, pulmicort was given for 6 months, combined with the Liujunzi decoction and Yupingfeng powder for 3 months. After 3 months and 6 months of treatment, TCM syndrome score, asthma control test(C-ACT) and pulmonary function were revalued.Results(1)TCM syndrome scores: after 3 months and 6 months of treatment, the improvement of TCM syndrome score in the treatment group were lower than that of the control group(P<0.05).(2)C-ACT score: after 3 months of treatment, C-ACT was similar in the two groups(P>0.05). At 6 months of treatment, the improvement in the treatment group was superior to that in the control group(P<0.05).(3)Pulmonary function: after 3 months and 6 months of treatment, the improvement of PEF, FVC, FEV1, FEF50 and FEF75 in the treatment group was better than that in the control group(P<0.05).Conclusion Liujunzi decoction and Yupingfeng powder can improve the symptoms of TCM syndrome, the asthma control test(C-ACT) score, and the function of lung ventilation in the children with asthma in remission period with wind-phlegm inside and lung-spleen Qi-deficiency.
引文
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[19] 刘双利,姜程曦,赵岩,等.防风化学成分及其药理作用研究进展[J].中草药,2017,48(10):2146-2152.
[2] 中华医学会呼吸病学分会哮喘学组.支气管哮喘控制的中国专家共识[J].中华内科杂志,2013,52(5):440-443.
[3] Anderson WJ,Zajda E,Lipworth BJ.Are we overlooking persistent small airways dysfunction in community-managed asthma[J].Ann Allergy Asthma Immunol,2012,109(3):185-189.
[4] Bourdin A,Paganin F,Préfaut C,et al.Nitrogen washout slope in poorly controlled asthma[J].Allergy,2006,61(1):85-89.
[5] Thien F.Measuring and imaging small airways dysfunction in asthma[J].Asia Pac Allergy,2013,3(4):224-230.
[6] 中华医学会儿科学分会呼吸学组,《中华儿科杂志》编辑委员会.儿童支气管哮喘诊断与防治指南(2016年版)[J].中华儿科杂志,2016,54(3):167-181.
[7] 汪受传,虞坚尔.中医儿科学[M].北京:中国中医药出版社,2012:92-95.
[8] 郑筱萸.中药新药临床研究指导原则[M].北京:中国医药科技出版社,2002:60-66.
[9] Ko FW,Leung TF,Hui DS,et al.Asthma Control Test correlates well with the treatment decisions made by asthma specialists[J].Respirology,2009,14(4):559-566.
[10] 张皓,邬宇芬,黄剑峰,等.儿童肺功能检测及评估专家共识[J].临床儿科杂志,2014,32(2):104-114.
[11] 何国文,朱利永.肺功能检查在支气管哮喘急性发作期、缓解期的变化及意义[J].临床合理用药杂志,2011,4(17):72-73.
[12] 李玮,刘璐,孙丽平,等.中医药防治小儿哮喘临床研究进展[J].中国中西医结合儿科学,2017,9(3):191-194.
[13] 白明学.白术的现代药理研究与临床新用[J].中国中医药现代远程教育,2008,6(6):609-610.
[14] 宋保兰.陈皮药理作用[J].实用中医内科杂志,2014,28(8):132-133.
[15] 刘亚平,邢素芳.半夏的药理作用研究[J].基层医学论坛,2014,18(32):4446-4447.
[16] 刘华平.史锁芳教授应用大剂量甘草治疗支气管哮喘探讨经验[J].中医学报,2010,25(2):230-231.
[17] 朱盼,杨程,李泽庚.黄芪治疗支气管哮喘研究进展[J].亚太传统医药,2017,13(12):59-61.
[18] 彭成,万丽,余浩成,等.四君子汤[M].北京:人民卫生出版社,2012:53.
[19] 刘双利,姜程曦,赵岩,等.防风化学成分及其药理作用研究进展[J].中草药,2017,48(10):2146-2152.