辅舒酮联合参苓白术散加减治疗小儿哮喘临床观察
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摘要
目的:观察辅舒酮联合参苓白术散加减对小儿哮喘缓解期肺脾气虚证患儿的临床疗效。方法:选取缓解期小儿哮喘脾肺气虚证102例,随机分为治疗组(51例)和对照组(51例),两组均维持予辅舒酮基础治疗,治疗组联合中药参苓白术散加减,治疗1个月后,评价患儿的中医证候积分、哮喘症状控制水平、哮喘控制测试(C-ACT)评分以及肺通气功能。结果:①中医证候积分:治疗后两组患儿中医证候积分均较前降低(P<0.01),其中治疗组改善情况优于对照组(P<0.05);②哮喘症状控制水平:治疗组总有效率为84.3%,优于对照组的总有效率72.5%(P<0.05);③哮喘控制测试(C-ACT)评分:治疗后两组患儿C-ACT评分均较前增加(P<0.01),但两组间差异无统计学意义(P>0.05);④肺功能:治疗后,两组患儿肺功能PEF、FVC、FEV1、FEV1/FVC均较前改善(P<0.05或P<0.01),且治疗组疗效优于对照组(P<0.05)。结论:辅舒酮联合参苓白术散加减可明显改善哮喘缓解期患儿的临床症状及肺通气功能。
Objective: To study the effect of Flixotide combined with Shenling Baizhu powder on children with lung spleen Qi deficiency during the s table asthma period. Methods: 102 children who met the criteria were randomly divided into the treatment group(51 cases) and the control group(51 cases), which were treated with Flixotide. The treatment group were treated whit Shenling Baizhu powder as well. Observing and analyzing the changes of TCM symptom scores, asthma control, C-ACT scores, and pulmonary function tests of the two groups of patients after treatment for 1 months. Results:(1)TCM syndrome scores: After treatment, the TCM syndrome scores of the two groups were lower than before(P<0.01), and the improvement of the treatment group was better than that of the control group(P<0.01);(2) Asthma symptoms Control level: The total effective rate was 84.3% in the treatment group, which was higher than the control group in 72.5%(P<0.05).(3) Asthma control test(C-ACT) score: The C-ACT scores in the two groups were both increased after treatment(P<0.01),which had no statistically significant difference between the two groups(P>0.05).(4) Pulmonary function: After treatment,the lung function in both groups, such as PEF, FVC, FEV1, FEV1/FVC, were all better than before(P<0.05 or P<0.01),and the treatment group played a better effect than the control group(P<0.05). Conclusion: Flixotide combined with Shenling Baizhu Powder can significantly improve the clinical symptoms and pulmonary ventilation function of children with wind phlegm inside and lung spleen Qi deficiency during the stable asthma period.
Objective: To study the effect of Flixotide combined with Shenling Baizhu powder on children with lung spleen Qi deficiency during the s table asthma period. Methods: 102 children who met the criteria were randomly divided into the treatment group(51 cases) and the control group(51 cases), which were treated with Flixotide. The treatment group were treated whit Shenling Baizhu powder as well. Observing and analyzing the changes of TCM symptom scores, asthma control, C-ACT scores, and pulmonary function tests of the two groups of patients after treatment for 1 months. Results:(1)TCM syndrome scores: After treatment, the TCM syndrome scores of the two groups were lower than before(P<0.01), and the improvement of the treatment group was better than that of the control group(P<0.01);(2) Asthma symptoms Control level: The total effective rate was 84.3% in the treatment group, which was higher than the control group in 72.5%(P<0.05).(3) Asthma control test(C-ACT) score: The C-ACT scores in the two groups were both increased after treatment(P<0.01),which had no statistically significant difference between the two groups(P>0.05).(4) Pulmonary function: After treatment,the lung function in both groups, such as PEF, FVC, FEV1, FEV1/FVC, were all better than before(P<0.05 or P<0.01),and the treatment group played a better effect than the control group(P<0.05). Conclusion: Flixotide combined with Shenling Baizhu Powder can significantly improve the clinical symptoms and pulmonary ventilation function of children with wind phlegm inside and lung spleen Qi deficiency during the stable asthma period.
引文
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[9]沈华浩,应英华.新版全球哮喘防治创议(GINA)方案的评价和解读[J].临床内科杂志,2007(04):221-223.
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[12]黄文哲,柳燕,秦民坚,窦昌贵.太子参提取物对小鼠免疫功能的影响[J].现代中药研究与实践,2005(06):35-37.
[13]杜永成,许建英,秦芳,等.黄芪对致敏大鼠气道壁转化生长因子-β1、Ⅲ型胶原蛋白和纤维连接蛋白表达的影响[J].中国中西医结合杂志,2005,25(S 1):29-32.
[2]Holgate ST.Innate and adaptive immune responses in asthma[J].Nat Med.2012,18(5):673-83.
[3]Sundel Jan,李百战,张寅平.中国家庭环境污染与儿童健康调查[J].科学通报,2013,58(25):2501-2503.
[4]Reddel HK,Bateman ED,Becker A,Boulet LP,Cruz AA,Drazen JM,Haahtela T,Hurd SS,Inoue H,de Jongste JC,Lemanske RF Jr,Levy ML,O'Byrne PM,Paggiaro P,Pedersen SE,Pizzichini E,Soto-Quiroz M,Szefler SJ,Wong GW,FitzGerald JM.A summary of the new GINA straegy:a roadmap to asthma control[J].European Respiratory Journal,2015,46(3):622-639.
[5]刘嘉君,任现志.补肾健脾方配合中药穴位敷贴治疗小儿哮喘缓解期临床研究[J].长春中医药大学学报,2011,27(3):380-381.
[6]鲍一笑.儿童支气管哮喘诊断与防治指南(2016年版)[A].中国中西医结合学会儿科专业委员会.第二十次全国儿科中西医结合学术会议资料汇编[C].中国中西医结合学会儿科专业委员会:,2016:16.
[7]马融.中医儿科学[M].北京:中国中医药出版社,2016:82-88.
[8]国家中医药管理局.ZY/T001.1~001.9-94中医病证诊断疗效标准[S].南京:南京大学出版社,1994:286-288.
[9]沈华浩,应英华.新版全球哮喘防治创议(GINA)方案的评价和解读[J].临床内科杂志,2007(04):221-223.
[10]王雪峰.哮喘中医病机“宿痰伏肺”与现代研究“气道炎症”学说的关系探讨”[A].中华中医药学会儿科分会、全国中医药高等教育学会儿科分会.第23届全国中医儿科学术研讨会暨儿科名中医讲习班论文汇编[C].中华中医药学会儿科分会、全国中医药高等教育学会儿科分会:中华中医药学会,2006:4.
[11]蒋建英,章可谓,葛丹枫,俞景茂.俞景茂教授治疗小儿哮喘经验[J].中国中医急症,2018,27(01):162-164.
[12]黄文哲,柳燕,秦民坚,窦昌贵.太子参提取物对小鼠免疫功能的影响[J].现代中药研究与实践,2005(06):35-37.
[13]杜永成,许建英,秦芳,等.黄芪对致敏大鼠气道壁转化生长因子-β1、Ⅲ型胶原蛋白和纤维连接蛋白表达的影响[J].中国中西医结合杂志,2005,25(S 1):29-32.