加减小青龙汤对老年外寒内饮型支气管哮喘患者的干预作用
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摘要
目的:分析加减小青龙汤对老年外寒内饮型支气管哮喘患者的干预作用。方法:选取2015年3月至2017年2月海南省中医院收治的老年外寒内饮型支气管患者80例作为研究对象,采用数字随机表法分为对照组和观察组,每组40例,对照组采取西医常规治疗并予以氨茶碱片,观察组在对照组基础上加小青龙汤加减治疗。观察患者治疗前后的临床治疗效果,患者临床症状的积分变化及哮喘控制问卷6(ACQ)评分、哮喘生活治疗问卷(AQLQMAEKS)评分、肺功能等方面指标变化。疗效标准参照《中药新药临床研究指导原则》。结果:观察组总有效率为95. 00%,对照组总有效率为72. 50%,2组临床疗效比较,差异有统计学意义(P <0. 05)。观察组治疗前后中医证候积分及各单项症状积分(咳嗽、咯痰、喘息、哮鸣、气短)的差值明显大于对照组(P <0. 05),治疗后各单项症状积分及中医证候总积分显著下降。观察组经治疗后AQCQ6及AQLQMARKS评分明显低于对照组(P <0. 05)。观察组治疗后第1秒用力呼气量(FEV1)、第1秒用力呼气量占用力肺活量比率(FEV1/FVC)、最大呼气中段平均流速(MMEF)呈上升趋势,且观察组治疗后FEV1、FEV1/FVC、MMEF明显高于对照组(P <0. 05)。结论:加减小青龙汤治疗老年外寒内饮型支气管哮喘患者疗效确切,能显著改善患者中医临床症状及其肺功能。
Objective: To analyze the intervention effects of modified Xiaoqinglong Decoction on the elderly patients with external cold and internal fluid retention syndrome of bronchial asthma. Methods: A total of 80 cases of bronchial asthma with external cold and internal fluid retention syndrome in our hospital from March 2015 to February 2017 were selected as the research objects,and divided into control group and observation group by random number table,with 40 cases in each group. The control group was treated with routine treatment of Western medicine and Aminophylline Tablets,while the observation group was treated with modified Xiaoqinglong Decoction on the basis of Western medicine. The clinical effects of patients before and after treatment,the integral changes of clinical symptoms,asthma control questionnaire( ACQ6) score,asthma quality of life questionnaire( AQLQMAEKS) score,lung function and other indicators were observed. The standard of curative effects referred to The guiding principles of clinical research of new drugs of Chinese medicine. Results: The total effective rate of the observation group was 95%,and the total effective rate of the control group was 72. 50%. The difference between the 2 groups was statistically significant( P < 0. 05). The difference in TCM syndrome integral and individual symptoms( cough,phlegm,wheezing,shortness of breath) of the observation group before and after treatment was significantly higher than the control group( P < 0. 05). Each individual symptom scores and the total score of TCM syndrome decreased significantly after treatment. The score of AQCQ6 and AQLQMARKSin the observation group was significantly lower than that of the control group( P < 0. 05). The forced expiratory volume In 1 s( FEV1),FEV1/forced vital capacity ratio( FEV1/FVC),maximal midexpiratory mean velocity( MMEF) of the observation group after treatment showed an upward trend.FEV1,FEV1/FVC and MMEF of the observation group after treatment were significantly higher than that of control group( P <0. 05). Conclusion: The effects of modified Xiaoqinglong Decoction in the treatment of elderly patients with external cold and internal fluid retention syndrome of bronchial asthma is certain,which can significantly improve the TCM clinical symptoms and lung function of patients.
Objective: To analyze the intervention effects of modified Xiaoqinglong Decoction on the elderly patients with external cold and internal fluid retention syndrome of bronchial asthma. Methods: A total of 80 cases of bronchial asthma with external cold and internal fluid retention syndrome in our hospital from March 2015 to February 2017 were selected as the research objects,and divided into control group and observation group by random number table,with 40 cases in each group. The control group was treated with routine treatment of Western medicine and Aminophylline Tablets,while the observation group was treated with modified Xiaoqinglong Decoction on the basis of Western medicine. The clinical effects of patients before and after treatment,the integral changes of clinical symptoms,asthma control questionnaire( ACQ6) score,asthma quality of life questionnaire( AQLQMAEKS) score,lung function and other indicators were observed. The standard of curative effects referred to The guiding principles of clinical research of new drugs of Chinese medicine. Results: The total effective rate of the observation group was 95%,and the total effective rate of the control group was 72. 50%. The difference between the 2 groups was statistically significant( P < 0. 05). The difference in TCM syndrome integral and individual symptoms( cough,phlegm,wheezing,shortness of breath) of the observation group before and after treatment was significantly higher than the control group( P < 0. 05). Each individual symptom scores and the total score of TCM syndrome decreased significantly after treatment. The score of AQCQ6 and AQLQMARKSin the observation group was significantly lower than that of the control group( P < 0. 05). The forced expiratory volume In 1 s( FEV1),FEV1/forced vital capacity ratio( FEV1/FVC),maximal midexpiratory mean velocity( MMEF) of the observation group after treatment showed an upward trend.FEV1,FEV1/FVC and MMEF of the observation group after treatment were significantly higher than that of control group( P <0. 05). Conclusion: The effects of modified Xiaoqinglong Decoction in the treatment of elderly patients with external cold and internal fluid retention syndrome of bronchial asthma is certain,which can significantly improve the TCM clinical symptoms and lung function of patients.
引文
[1]隋艾凤,隋月娇,邓虎,等.中西医结合治疗支气管哮喘患者临床观察[J].世界中西医结合杂志,2014,9(11):1209-1211.
[2]王丙天.小青龙汤加减配合穴位敷贴治疗老年支气管哮喘急性发作期的疗效[J].世界临床医学,2016,10(9):182.
[3]曹芬芬,万丽玲,刘美年,等.小青龙汤联合中药封包治疗外寒里饮型支气管哮喘的临床研究[J].中医药通报,2017,16(4):39-42.
[4]Maltais F,Decramer M,Casaburi R,et al. An official American Thoracic Society/European Respiratory Society statement:update on limb muscle dysfunction in chronic obstructive pulmonary disease[J]. Am J Respir Crit Care Med,2014,189(9):e15-62.
[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)[J].中国实用内科杂志,2013,33(8):615-622.
[6]刘芳.小青龙汤治疗支气管哮喘寒哮型疗效观察[J].临床医学研究与实践,2016,1(10):70-70.
[7]孔庆活,唐兴荣,冯玉莲,等.小青龙汤加减对支气管哮喘慢性持续期患者PEF的影响[J].湖南中医药大学学报,2017,37(5):530-532.
[8]Lynch DA,Austin JH,Hogg JC,et al. CT-Definable Subtypes of Chronic Obstructive Pulmonary Disease:A Statement of the Fleischner Society[J]. Radiology,2015,277(1):192-205.
[9]夏清华,程继荣,程科,等.小青龙汤联合西药治疗支气管哮喘的疗效观察[J].沈阳医学院学报,2015,17(2):89-90,102.
[10]林立元,李成,林坤,等.小青龙汤加减治疗外寒内饮型支气管哮喘急性发作的临床疗效[J].临床合理用药杂志,2017,10(15):88-89.
[11]Putcha N,Drummond MB,Wise RA,et al. Comorbidities and Chronic Obstructive Pulmonary Disease:Prevalence,Influence on Outcomes,and Management[J]. Semin Respir Crit Care Med,2015,36(4):575-591.
[12]闻昌华.小青龙汤加减辅助治疗支气管哮喘急性发作期的疗效观察[J].临床合理用药杂志,2016,9(17):39-40.
[13]Gea J,Pascual S,Casadevall C,et al. Muscle dysfunction in chronic obstructive pulmonary disease:update on causes and biological findings[J]. J Thorac Dis,2015,7(10):E418-438.
[14]孔静,蔡懂,田梅,等.小青龙汤治疗支气管哮喘临床研究[J].世界中西医结合杂志,2017,12(3):390-393.
[15]郭洁,武蕾,梁亚飞,等.小青龙汤加味联合西医治疗支气管哮喘寒哮证疗效及对肺功能的影响[J].现代中西医结合杂志,2017,26(10):1037-1039,1045.
[16]张天灵.小青龙汤联合西药治疗重度支气管哮喘临床疗效观察[J].现代诊断与治疗,2016,27(8):1417-1418.
[17]祁华琼,何泮,黄伟明,等.小青龙汤治疗支气管哮喘寒哮证患者的临床效果观察[J].中医临床研究,2017,9(11):56-57.
[18]沈利春.小青龙汤对慢性支气管哮喘患者肺功能的影响[J].医药前沿,2016,6(26):346-347.
[19]张浩,池雷霆,郭锦晨,等.小青龙汤在支气管哮喘中的临床应用[J].亚太传统医药,2017,13(13):70-71.
[2]王丙天.小青龙汤加减配合穴位敷贴治疗老年支气管哮喘急性发作期的疗效[J].世界临床医学,2016,10(9):182.
[3]曹芬芬,万丽玲,刘美年,等.小青龙汤联合中药封包治疗外寒里饮型支气管哮喘的临床研究[J].中医药通报,2017,16(4):39-42.
[4]Maltais F,Decramer M,Casaburi R,et al. An official American Thoracic Society/European Respiratory Society statement:update on limb muscle dysfunction in chronic obstructive pulmonary disease[J]. Am J Respir Crit Care Med,2014,189(9):e15-62.
[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)[J].中国实用内科杂志,2013,33(8):615-622.
[6]刘芳.小青龙汤治疗支气管哮喘寒哮型疗效观察[J].临床医学研究与实践,2016,1(10):70-70.
[7]孔庆活,唐兴荣,冯玉莲,等.小青龙汤加减对支气管哮喘慢性持续期患者PEF的影响[J].湖南中医药大学学报,2017,37(5):530-532.
[8]Lynch DA,Austin JH,Hogg JC,et al. CT-Definable Subtypes of Chronic Obstructive Pulmonary Disease:A Statement of the Fleischner Society[J]. Radiology,2015,277(1):192-205.
[9]夏清华,程继荣,程科,等.小青龙汤联合西药治疗支气管哮喘的疗效观察[J].沈阳医学院学报,2015,17(2):89-90,102.
[10]林立元,李成,林坤,等.小青龙汤加减治疗外寒内饮型支气管哮喘急性发作的临床疗效[J].临床合理用药杂志,2017,10(15):88-89.
[11]Putcha N,Drummond MB,Wise RA,et al. Comorbidities and Chronic Obstructive Pulmonary Disease:Prevalence,Influence on Outcomes,and Management[J]. Semin Respir Crit Care Med,2015,36(4):575-591.
[12]闻昌华.小青龙汤加减辅助治疗支气管哮喘急性发作期的疗效观察[J].临床合理用药杂志,2016,9(17):39-40.
[13]Gea J,Pascual S,Casadevall C,et al. Muscle dysfunction in chronic obstructive pulmonary disease:update on causes and biological findings[J]. J Thorac Dis,2015,7(10):E418-438.
[14]孔静,蔡懂,田梅,等.小青龙汤治疗支气管哮喘临床研究[J].世界中西医结合杂志,2017,12(3):390-393.
[15]郭洁,武蕾,梁亚飞,等.小青龙汤加味联合西医治疗支气管哮喘寒哮证疗效及对肺功能的影响[J].现代中西医结合杂志,2017,26(10):1037-1039,1045.
[16]张天灵.小青龙汤联合西药治疗重度支气管哮喘临床疗效观察[J].现代诊断与治疗,2016,27(8):1417-1418.
[17]祁华琼,何泮,黄伟明,等.小青龙汤治疗支气管哮喘寒哮证患者的临床效果观察[J].中医临床研究,2017,9(11):56-57.
[18]沈利春.小青龙汤对慢性支气管哮喘患者肺功能的影响[J].医药前沿,2016,6(26):346-347.
[19]张浩,池雷霆,郭锦晨,等.小青龙汤在支气管哮喘中的临床应用[J].亚太传统医药,2017,13(13):70-71.