加味沙参麦冬汤治疗咳嗽变异性哮喘的临床研究
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摘要
目的观察加味沙参麦冬汤治疗咳嗽变异性哮喘(CVA)的临床效果。方法选择2011年1月~2013年12月北京市房山区中医院收治的CVA发作期患者120例,按照随机数字表法将其分为治疗组和对照组。对照组60例给予孟鲁司特钠片10 mg口服,1次/d,必要时吸入短效激素(布地奈德),2周为1个疗程。治疗组60例在对照组治疗基础上给予加味沙参麦冬汤口服,1剂/d,2次/d,2周为1个疗程。治疗后观察患者主要症状、证候积分情况,测定患者呼气峰流量变异率(PEFR)和血清白细胞介素-2(IL-2)、白细胞介素-6(IL-6)和肿瘤坏死因子-α(TNF-α)的含量。结果 1个疗程后,治疗组与对照组CVA治疗有效率分别为91.67%和53.33%,差异有高度统计学意义(P<0.01)。单项症状改善方面,咳嗽症状治疗组有效率为95.00%,对照组为63.33%;咽痒症状治疗组有效率为91.67%,对照组为55.00%;气急症状治疗组有效率为98.33%,对照组为55.00%;咳痰症状治疗组有效率为86.67%,对照组为56.67%。两组差异均有统计学意义(均P<0.05)。治疗组治疗后PEFR为(10.41±1.45)%,显著低于对照组[(17.22±2.18)%],差异有统计学意义(P<0.05)。治疗组治疗后IL-2为(12.18±2.28)μg/m L,显著高于对照组[(9.46±1.12)μg/m L],差异有高度统计学意义(P<0.01)。治疗组治疗后IL-6为(43.22±14.29)μg/m L,显著低于对照组[(62.64±15.21)μg/m L],差异有高度统计学意义(P<0.01)。治疗组治疗后TNF-α为(0.59±0.24)μg/m L,显著低于对照组[(0.89±0.23)μg/m L],差异有统计学意义(P<0.05)。结论加味沙参麦冬汤治疗CVA可显著提高疗效,值得临床推广。
Objective To observe the clinical efficacy of Modified Shashen Maidong Decoction in the treatment of patients with cough variant asthma(CVA). Methods One hundred and twenty cases of patients with CVA at the stage of attack admitted to Fangshan Traditional Medical Hospital of Beijing from January 2011 to December 2013 were selected. According to random number table, patients were divided into treatment group and control group. 60 cases of control group were given 10 mg Montelukast Sodium Tablets orally, once a day, a short-acting hormone(Budesonide) was added when necessary, 2 weeks was as a course. 60 cases of treatment group were given Modified Shashen Maidong Decoction on basis of control group, one dose a day, twice a day, 2 weeks was as a course. After treatment, the main symptoms and syndrome scores were observed, the contents of peak expiratory flow rate variability(PEFR), serum interleukin-2(IL-2), interleukin-6(IL-6) and tumor necrosis factor-α(TNF-α) were detected. Results After a course of treatment, the efficacy rate of treatment group and control group was 91.67%, 53.33%, the difference was highly statistically significant(P < 0.01). On aspect of single symptom improvement, cough symptoms: efficiency of the treatment group was 95.00%, which of control group was 63.33%; throat itching symptoms: efficiency of the treatment group was98.33%, which of control group was 55.00%; shortness of breath symptoms: efficiency of the treatment group was91.67%, which of control group was 55.00%; expectoration symptoms: efficiency of the treatment group was 86.67%,which of control group was 56.67%. The differences between the two groups were all statistically significant(all P <0.05). After treatment, PEFR of treatment group [(10.41 ±1.45)% ] was significantly lower than that of control group[(17.22 ±2.18)% ], the difference was statistically significant(P < 0.05). The level of IL-2 in treatment group was(12.18±2.28) μg/m L, which was significantly higher than that of control group [(9.46±1.12) μg/m L], the difference was highly statistically significant(P < 0.01). The level of IL-6 in treatment group was(43.22±14.29) μg/m L,which was significantly lower than that of control group [(62.64±15.21) μg/m L], the difference was highly statistically significant(P < 0.01). The level of TNF-α in treatment group was(0.59±0.24) μg/m L, which was significantly lower than that of control group [(0.89±0.23) μg/m L], the difference was statistically significant(P < 0.05). Conclusion Modified Shashen Maidong Decoction in the treatment CVA can obviously improve clinical efficacy, which is worthy of clinical promotion.
Objective To observe the clinical efficacy of Modified Shashen Maidong Decoction in the treatment of patients with cough variant asthma(CVA). Methods One hundred and twenty cases of patients with CVA at the stage of attack admitted to Fangshan Traditional Medical Hospital of Beijing from January 2011 to December 2013 were selected. According to random number table, patients were divided into treatment group and control group. 60 cases of control group were given 10 mg Montelukast Sodium Tablets orally, once a day, a short-acting hormone(Budesonide) was added when necessary, 2 weeks was as a course. 60 cases of treatment group were given Modified Shashen Maidong Decoction on basis of control group, one dose a day, twice a day, 2 weeks was as a course. After treatment, the main symptoms and syndrome scores were observed, the contents of peak expiratory flow rate variability(PEFR), serum interleukin-2(IL-2), interleukin-6(IL-6) and tumor necrosis factor-α(TNF-α) were detected. Results After a course of treatment, the efficacy rate of treatment group and control group was 91.67%, 53.33%, the difference was highly statistically significant(P < 0.01). On aspect of single symptom improvement, cough symptoms: efficiency of the treatment group was 95.00%, which of control group was 63.33%; throat itching symptoms: efficiency of the treatment group was98.33%, which of control group was 55.00%; shortness of breath symptoms: efficiency of the treatment group was91.67%, which of control group was 55.00%; expectoration symptoms: efficiency of the treatment group was 86.67%,which of control group was 56.67%. The differences between the two groups were all statistically significant(all P <0.05). After treatment, PEFR of treatment group [(10.41 ±1.45)% ] was significantly lower than that of control group[(17.22 ±2.18)% ], the difference was statistically significant(P < 0.05). The level of IL-2 in treatment group was(12.18±2.28) μg/m L, which was significantly higher than that of control group [(9.46±1.12) μg/m L], the difference was highly statistically significant(P < 0.01). The level of IL-6 in treatment group was(43.22±14.29) μg/m L,which was significantly lower than that of control group [(62.64±15.21) μg/m L], the difference was highly statistically significant(P < 0.01). The level of TNF-α in treatment group was(0.59±0.24) μg/m L, which was significantly lower than that of control group [(0.89±0.23) μg/m L], the difference was statistically significant(P < 0.05). Conclusion Modified Shashen Maidong Decoction in the treatment CVA can obviously improve clinical efficacy, which is worthy of clinical promotion.
引文
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[14]陈潮,余容,叶秀,等.苓甘五味姜辛汤合二陈汤加减治疗咳嗽变异性哮喘125例[J].四川中医,2008,26(1):58-59.
[15]李杰,苏惠萍,王琦,等.清热润肺止咳法对咳嗽变异性哮喘患者临床疗效及纠正Th1/Th2失衡状态作用的研究[J].北京中医药大学学报,2010,33(10):709-712.
[16]夏海波.射干麻黄汤加减治疗小儿咳嗽变异性哮喘84例临床观察[J].中医药导报,2008,14(9):49-50.
[17]伍德军.小柴胡汤加味治疗咳嗽变异性哮喘56例[J].河北中医,2000,22(6):455.
[18]刘光西.桃红四物汤加减治疗儿童咳嗽变异性哮喘疗效观察[J].山东中医杂志,2006,25(2):93-94.
[19]帅明华,郭春香.中西医结合治疗小儿咳嗽变异性哮喘65例[J].中国中医药信息杂志,2001,8(7):64-65.
[20]樊茂蓉,张燕萍,苗青,等.润肺咳喘胶囊对咳嗽变异性哮喘豚鼠气道反应性及血清IL-5、IL-6及TNF-α水平的影响[J].时珍国医国药,2013,24(7):1619-1622.
[2]郑筱萸.中药新药临床研究指导原则[S].北京:中国医药科技出版社,2002:1-5.
[3]陈灏珠.实用内科学[M].北京:人民卫生出版社,1997.
[4]王志红,陈晓军,李威,等.孟鲁司特治疗成人咳嗽变异型哮喘的临床观察[J].临床肺科杂志,2012,17(20):2164-2165.
[5]樊长征,张燕萍.润肺止咳法治疗肺热阴虚型咳嗽变异型哮喘临床研究[J].北京中医药,2011,30(9):679.
[6]苗青,王书臣,张燕萍,等.广济止咳方治疗咳嗽变异型哮喘30例临床疗效观察[J].新中医,2006,38(2):25-37.
[7]侍鑫杰.王霞芳辨治咳嗽变异型哮喘经验[J].上海中医药杂志,2008,42(3):20-21.
[8]康立媛.辨证论治小儿咳嗽变异型哮喘98例[J].广西中医学院学报,2005,8(1):37-38.
[9]冯晓纯,孙丽平,许冰,等.王烈教授关于小儿咳嗽变异性哮喘证治经验[J].世界中西医结合杂志,2007,2(12):690-691.
[10]苗青,樊茂蓉,张燕萍,等.咳嗽变异性哮喘的中医治法探讨[J].时珍国医国药,2009,20(11):2841-2842.
[11]罗社文,晁恩祥.治疗咳嗽变异型哮喘经验[J].中医杂志,2002,43(1):74-75.
[12]林振暻.史锁芳教授运用祛风宣肺、疏肝止痉法治疗咳嗽变异性哮喘的经验[J].甘肃中医学院学报,2009,26(1):1-2.
[13]余晓琪,干磊,程德华.润燥祛风法治疗咳嗽变异性哮喘的随机对照研究[J].上海中医药杂志,2011,45(5):58-89.
[14]陈潮,余容,叶秀,等.苓甘五味姜辛汤合二陈汤加减治疗咳嗽变异性哮喘125例[J].四川中医,2008,26(1):58-59.
[15]李杰,苏惠萍,王琦,等.清热润肺止咳法对咳嗽变异性哮喘患者临床疗效及纠正Th1/Th2失衡状态作用的研究[J].北京中医药大学学报,2010,33(10):709-712.
[16]夏海波.射干麻黄汤加减治疗小儿咳嗽变异性哮喘84例临床观察[J].中医药导报,2008,14(9):49-50.
[17]伍德军.小柴胡汤加味治疗咳嗽变异性哮喘56例[J].河北中医,2000,22(6):455.
[18]刘光西.桃红四物汤加减治疗儿童咳嗽变异性哮喘疗效观察[J].山东中医杂志,2006,25(2):93-94.
[19]帅明华,郭春香.中西医结合治疗小儿咳嗽变异性哮喘65例[J].中国中医药信息杂志,2001,8(7):64-65.
[20]樊茂蓉,张燕萍,苗青,等.润肺咳喘胶囊对咳嗽变异性哮喘豚鼠气道反应性及血清IL-5、IL-6及TNF-α水平的影响[J].时珍国医国药,2013,24(7):1619-1622.