力克喘雾化吸入剂治疗哮喘急性发作的临床分析
|
摘要
背景：支气管哮喘急性发作期的治疗尚无理想中药吸入剂。
目的：观察中药力克喘雾化吸入剂在支气管哮喘急性发作治疗中的临床疗效。
方法：60例哮喘急性发作期患者，用简单随机方法分为治疗组、对照组各30例，两组性别、年龄、病情均有可比性(P＞0.05)，并按中医辨证分为寒哮和热哮，两组均按哮喘严重程度分级予西药常规综合治疗，治疗组加用力克喘雾化吸入剂雾化吸入，每日1次，疗程10天。对照组加用生理盐水10ml雾化吸入，每日1次，疗程10天。根据中华医学会哮喘病疗效判定标准进行临床疗效评价，并对比两组治疗前、后肺功能(PEF、FEV_1)和外周血嗜酸粒细胞计数(EOS)变化。
结果：治疗组：临床控制7例，显效13例，有效6例，无效4例，控显率66.67％。对照组：临床控制3例，显效8例，有效12例，无效7例，控显率36.67％。两组经统计学处理(P＜0.05)，差异显著，说明治疗组疗效明显优于对照组，且疗效稳定。治疗组寒哮13例，经治疗1疗程后，临床控制3例，显效6例，有效2例，无效2例。治疗组热哮17例，经治疗1疗程后，临床控制4例，显效7例，有效4例，无效2例。经统计学检验两者间无显著性差异(P＞0.05)。对照组治疗前第1秒呼气肺容积(FEV_1)：1.68±0.31，最大呼气流速(PEF)：3.70±1.27，治疗后FEV_1：1.87±0.32；PEF：3.97±1.24。治疗组治疗前FEV_1：1.60±0.30，PEF：3.60±1.34，治疗后FEV_1：2.06±0.31；PEF：4.83±1.35。对照组与治疗组治疗前的(FEV_1)、(PEF)相比无显著差异(P＞0.1)；两组治疗后的(FEV_1)、(PEF)相比差异显著(P＜0.05)；两组治疗前后(FEV_1)及(PEF)变化经统计学检验差异非常显著(P＜0.01)。两组治疗前嗜酸粒细胞计数(EOS)分别为0.244±0.049、0.249±0.059，治疗后为0.156±0.051、0.126±0.045，两组EOS治疗前无显著差异P＞0.1，两组EOS治疗后与治疗前相比P＜0.01差异非常显著，两组间治疗后比较治疗组减少明显P＜0.05显著差异。
结论：治疗组疗效明显优于对照组，力克喘雾化吸入剂对哮喘急性发作疗效确切，且对热哮寒哮均有效，说明力克喘对支气管哮喘急性发作的疗效与证型无明显联系。
Background:There is lack of an idea Chinese medicine aerosol in treating acute asthma.
Objective: To inventigate curative effect on acut asthma with Chinese medidine,aerosol of LiKeChuan.
Methods:Sixty bronchial asthma patients were divided randomly into 2 groups, who was attribute to cold syndrome and heat syndrome. The control group (30 cases) was treated with NS by spray inhalation on the basis of routine therapy, while treatment group (30 cases) was treated with LiKeChuan.by spray inhalation on the basis of routine therapy.According to the decisive criterion curative effection for asthma, we evaluate the clinic curative effection and compare pulmonary function (PEF^ FEVi) of two group between prior to and after the procedures.
Result: In treatment group, the curative effect is better than that of control group there are significant differences between them (P>0.05). The PEF in control group was (3. 70+1.27)L/S before, while in treatment group was (3. 60 + 1. 34) L/S, there are no obvious chang between them (P>0.1).. The FEV1 in control group was (1. 68 + 0. 31) L before, while in treatment group was (1.60 + 0. 30)L , there are no obvious chang between them (P>0.1).. The PEF in contrpl group was (3. 97 + 1. 24) L/S after, while in treatment group was (4. 83 + 1. 35)L/S, there are obviously difference between them (P<0.05). The FEV1 in control group was (1.87 + 0. 32) L after, while in treatment group was (2. 06 + 0. 31) L, there are obviously difference between them (P<0.05). The pulmonary fuction of the treatment group have significant differences comparable with that of control group (P<0.05).In treatment group , the curative effect have no significant differences between cold syndrome and heat syndrome.
Conclusions:The therapetic efficacy of LiKeChuan in treating acute asthma by spray inhalation on the basis of routine therapy is superor to routine therapy alone. It suggests that
the curative effect have little relation with syndroms.
目的：观察中药力克喘雾化吸入剂在支气管哮喘急性发作治疗中的临床疗效。
方法：60例哮喘急性发作期患者，用简单随机方法分为治疗组、对照组各30例，两组性别、年龄、病情均有可比性(P＞0.05)，并按中医辨证分为寒哮和热哮，两组均按哮喘严重程度分级予西药常规综合治疗，治疗组加用力克喘雾化吸入剂雾化吸入，每日1次，疗程10天。对照组加用生理盐水10ml雾化吸入，每日1次，疗程10天。根据中华医学会哮喘病疗效判定标准进行临床疗效评价，并对比两组治疗前、后肺功能(PEF、FEV_1)和外周血嗜酸粒细胞计数(EOS)变化。
结果：治疗组：临床控制7例，显效13例，有效6例，无效4例，控显率66.67％。对照组：临床控制3例，显效8例，有效12例，无效7例，控显率36.67％。两组经统计学处理(P＜0.05)，差异显著，说明治疗组疗效明显优于对照组，且疗效稳定。治疗组寒哮13例，经治疗1疗程后，临床控制3例，显效6例，有效2例，无效2例。治疗组热哮17例，经治疗1疗程后，临床控制4例，显效7例，有效4例，无效2例。经统计学检验两者间无显著性差异(P＞0.05)。对照组治疗前第1秒呼气肺容积(FEV_1)：1.68±0.31，最大呼气流速(PEF)：3.70±1.27，治疗后FEV_1：1.87±0.32；PEF：3.97±1.24。治疗组治疗前FEV_1：1.60±0.30，PEF：3.60±1.34，治疗后FEV_1：2.06±0.31；PEF：4.83±1.35。对照组与治疗组治疗前的(FEV_1)、(PEF)相比无显著差异(P＞0.1)；两组治疗后的(FEV_1)、(PEF)相比差异显著(P＜0.05)；两组治疗前后(FEV_1)及(PEF)变化经统计学检验差异非常显著(P＜0.01)。两组治疗前嗜酸粒细胞计数(EOS)分别为0.244±0.049、0.249±0.059，治疗后为0.156±0.051、0.126±0.045，两组EOS治疗前无显著差异P＞0.1，两组EOS治疗后与治疗前相比P＜0.01差异非常显著，两组间治疗后比较治疗组减少明显P＜0.05显著差异。
结论：治疗组疗效明显优于对照组，力克喘雾化吸入剂对哮喘急性发作疗效确切，且对热哮寒哮均有效，说明力克喘对支气管哮喘急性发作的疗效与证型无明显联系。
Background:There is lack of an idea Chinese medicine aerosol in treating acute asthma.
Objective: To inventigate curative effect on acut asthma with Chinese medidine,aerosol of LiKeChuan.
Methods:Sixty bronchial asthma patients were divided randomly into 2 groups, who was attribute to cold syndrome and heat syndrome. The control group (30 cases) was treated with NS by spray inhalation on the basis of routine therapy, while treatment group (30 cases) was treated with LiKeChuan.by spray inhalation on the basis of routine therapy.According to the decisive criterion curative effection for asthma, we evaluate the clinic curative effection and compare pulmonary function (PEF^ FEVi) of two group between prior to and after the procedures.
Result: In treatment group, the curative effect is better than that of control group there are significant differences between them (P>0.05). The PEF in control group was (3. 70+1.27)L/S before, while in treatment group was (3. 60 + 1. 34) L/S, there are no obvious chang between them (P>0.1).. The FEV1 in control group was (1. 68 + 0. 31) L before, while in treatment group was (1.60 + 0. 30)L , there are no obvious chang between them (P>0.1).. The PEF in contrpl group was (3. 97 + 1. 24) L/S after, while in treatment group was (4. 83 + 1. 35)L/S, there are obviously difference between them (P<0.05). The FEV1 in control group was (1.87 + 0. 32) L after, while in treatment group was (2. 06 + 0. 31) L, there are obviously difference between them (P<0.05). The pulmonary fuction of the treatment group have significant differences comparable with that of control group (P<0.05).In treatment group , the curative effect have no significant differences between cold syndrome and heat syndrome.
Conclusions:The therapetic efficacy of LiKeChuan in treating acute asthma by spray inhalation on the basis of routine therapy is superor to routine therapy alone. It suggests that
the curative effect have little relation with syndroms.
引文
[1] 许建中，吴银根，李明华，中西医结合哮喘病学．北京：人民卫生出版社，2001．2
[2] 李明华，殷凯生，朱栓立，哮喘病学．北京：人民卫生出版社，1998，369
[3]、[4] 中华医学会呼吸病分会，支气管哮喘防治指南 中华结核和呼吸杂志，1997，20，(5)：261—264。
[5] 姜静，尚宁，范欣生．中药辛夷雾化吸入治疗支气管哮喘[J]．临床肺科杂志，2001(2)：17．
[6] 朱文翔，孙洪维．中药超声雾化吸入治疗支气管哮喘临床观察[J]．中国中医急症，1998，7(1)：3-5．
[7] 邵凤扬，顾成光，敛肺清热平喘方雾化吸入治疗支气管哮喘的研究 中国实验方剂杂志，2002，8(5)：10
[8] 秦东风，吸入性中药平喘剂研究思路 中国中医急症 2003，12(5)：477
[9] 余传星，朱玲．藿香正气水阻断肥大细胞颗粒的实验研究[J]．中医药研究，1994，(4)：60．
[10] 余传星，朱玲．藿香正气水阻断肥大细胞颗粒的实验研究[J]．中医药研究，1994，(4)：60．
[11] 谭峰源．藿香正气水治疗Ⅰ型变态反应性疾病45例临床观察[J]．中医药研究，1995，(2)：16．
[12] 刘中煜，袁美娟，聂正慧，等．藿香正气水解痉、镇痛和抗菌作用实验研究[J]．中草药，1984，12(15)：15-18．
[13] 许环淑．厚朴酚药效学及其作用机理的研究[J]．北京中医．1993，12(3)：51．
[14] 何权赢，林江涛，现代呼吸系统疾病诊断学．北京：中国协和医科大学出版社，2002(3)：240
[2] 李明华，殷凯生，朱栓立，哮喘病学．北京：人民卫生出版社，1998，369
[3]、[4] 中华医学会呼吸病分会，支气管哮喘防治指南 中华结核和呼吸杂志，1997，20，(5)：261—264。
[5] 姜静，尚宁，范欣生．中药辛夷雾化吸入治疗支气管哮喘[J]．临床肺科杂志，2001(2)：17．
[6] 朱文翔，孙洪维．中药超声雾化吸入治疗支气管哮喘临床观察[J]．中国中医急症，1998，7(1)：3-5．
[7] 邵凤扬，顾成光，敛肺清热平喘方雾化吸入治疗支气管哮喘的研究 中国实验方剂杂志，2002，8(5)：10
[8] 秦东风，吸入性中药平喘剂研究思路 中国中医急症 2003，12(5)：477
[9] 余传星，朱玲．藿香正气水阻断肥大细胞颗粒的实验研究[J]．中医药研究，1994，(4)：60．
[10] 余传星，朱玲．藿香正气水阻断肥大细胞颗粒的实验研究[J]．中医药研究，1994，(4)：60．
[11] 谭峰源．藿香正气水治疗Ⅰ型变态反应性疾病45例临床观察[J]．中医药研究，1995，(2)：16．
[12] 刘中煜，袁美娟，聂正慧，等．藿香正气水解痉、镇痛和抗菌作用实验研究[J]．中草药，1984，12(15)：15-18．
[13] 许环淑．厚朴酚药效学及其作用机理的研究[J]．北京中医．1993，12(3)：51．
[14] 何权赢，林江涛，现代呼吸系统疾病诊断学．北京：中国协和医科大学出版社，2002(3)：240