参蛤细辛散时间给药法治疗小儿哮喘缓解期肾虚证的临床研究
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摘要
哮喘是世界范围内的常见病、多发病,其患病率有逐年上升的趋势。全世界约有1.5亿哮喘患者,每年死于哮喘的人约18万之多,因此哮喘已成为严重威胁人类健康的一种主要慢性疾病。2000年调查结果显示,我国儿童平均累计哮喘患病率达到1.97%。因此,哮喘的防治引起了全世界的重视,世界卫生组织已将其列入全球防治战略。
本病可分为急性发作期、慢性持续期和缓解期。在缓解期进行积极治疗,可预防和减少哮喘发作,是治疗儿童哮喘的重要环节。中医药在辨证论治原则指导下进行多环节调治,未病先防,具有独特的优势。本文在回顾哮喘缓解期相关文献的基础上,研究时间给药法在本病中的应用。通过对68例哮喘缓解期肾虚证患儿的临床观察,研究参蛤细辛散时间服药法治疗本证的疗效。通过对临床症状、体征积分的统计,比较每日辰时用药与辰时、酉时同时用药的疗效差异,同时观察参蛤细辛散的用药安全性,为临床减少服药次数提供依据,可增加儿童及家长的依从性,具有一定的临床推广价值。
目的:在“子午流注”理论的指导下治疗小儿哮喘缓解期肾虚证,在不同时点给予参蛤细辛散,通过观察两组的临床疗效,说明时间给药法对疗效的影响。
方法:本文以新加坡中华医院门诊、自然中医诊所的68例哮喘缓解期肾虚证患儿为研究对象,按盲法、随机的原则按1:1的比例分为试验组和对照组,两组均给予参蛤细辛散1～3个疗程,每个疗程12周,试验组每日于辰时给药1次,对照组每日于辰时和酉时给药2次,观察疗程结束后两组患儿主症、次症积分的变化,进行统计学处理,评判两种给药方法的疗效与安全性。
结果:试验前两组患儿在年龄、性别、病程、病情均无显著性差异,两组具有可比性。研究结果显示:试验组经治疗后,在总积分、哮喘次数、哮喘发作程度、痰涎、汗出不温、气短、鼻痒喷嚏、鼻塞、面色、精神、惊恐、畏寒肢冷、夜尿、大便、舌象等情况改善方面明显优于治疗前,在感冒次数、过敏症情况改善方面无明显差异。对照组患儿在总积分、哮喘次数、哮喘发作程度、痰涎、汗出不温、气短、鼻痒喷嚏、鼻塞、面色、精神、惊恐、畏寒肢冷、夜尿、大便、舌象等情况改善方面明显优于治疗前,在感冒次数、过敏症改善情况方面无明显差异。两组间对比,经治疗后,对照组在畏寒肢冷情况改善方面优于试验组,在总积分、感冒次数、哮喘次数、哮喘发作程度、过敏症、痰涎、汗出不温、气短、鼻痒喷嚏、鼻塞、面色、精神、惊恐、夜尿、大便、舌象情况改善方面无明显差异。两组总疗效分析:试验组显效2例(5.9%)、有效21例(61.76%)、无效11例(32.35%),总有效率67.64%。B组显效2例(5.9%)、有效22例(64.10%)、无效10例(29.41%),总有效率70%。经统计学处理,两组有效率无明显差异。两组均未见临床不良反应。
结论:在“子午流注”理论指导下,辰时给药的治疗方案与辰时、酉时给药的治疗方案疗效相似,从而为临床减少小儿服药次数提供了依据。运用时间给药法增强了小儿服药的依从性,具有一定的实用价值和操作性,值得临床推广。
Asthma, a common medical condition, is on the rise. Globally, there are approximately 150 million asthmatic patients. Amongst which 180 thousand die from the illness each year. Based on these figures, it is clear that asthma is a chronic medical condition that threatens the well-being of human health. In the year 2000, asthmatic analytical research report had recorded that 1.97% of Singaporean children were asthmatic. Therefore, the prevention of asthma has become a global issue. World Health Organization (WHO) has also classified the fight against asthma on a global scale.
Asthma can be categorised into acute attack, chronic duration and the remission phase. It is crucial for asthmatic children to engage proactively in the various phases of the treatment. The treatment of asthma during the remission phase in order to prevent and reduce the attacks is deemed very important. The Chinese medicine is superior in regulating the overall health of a person. Depending on the principle of differentiation and treatment,it is very effective in the various stages of treatment as well as the prevention of asthma. Based on the existing knowledge on the remission phase of asthmatic treatment, this thesis analysed the effects of consuming the medicine at different timings of the day. Through close observation of 68 cases of child asthmatic patients with weak kidney function, detailed analysis on the effects of consuming "Shen Ge Xi Xin San" at different timings of the day was performed. The results that the medicine had on the patients were tabulated and analysed based on short-term and long-term recoveries. A point system was applied to classify and grade the effects of the administration of the medicine on 2 different sets of timing - Morning only ; Both morning and evening. During the study, the safety aspects of using the medicine was also closely followed and recorded. From the study, medical effects and the safety of the medicine was observed, analysed and recorded. In addition, other beneficial effects of the medicine was also noted.
Objective: To investigate the time administration effect of "Shen Ge Xi Xin San" on the remission phase of asthma affecting children with weak kidney function based on the "Zi Wu Liu Zhu" logic.
Method: The experimental subjects to this research were 68 asthmatic children with weak kidney function. They were the patients at the Singapore Chung Hwa Medical Institution and Natural TCM Clinic. Based on the concept of a blocked and randomized statistical model with a ratio of 1:1, the subjects were divided into 2 groups, namely the experimental group and the control group. Each group of patients was administered with the "Shen Ge Xi Xin San" with 1 to 3 courses at 12 weeks duration for each course. The experimental group was administered with the medicine each morning whereas the control group was administered both mornings and evenings. The results were obtained by applying a point system. The findings were concluded by analysing the points using specific statistical models, thus commenting on the effect of the different methods of administering the medicine as well as the safety aspects.
Result: Based on the concept of a randomized statistical model with a ratio of 1:1, 68 sick children were administered with "Shen Ge Xi Xin San". The experimental group was administered with the medicine each morning whereas the control group was administered both mornings and evenings. Results of the 2 groups were analysed. The analysis between the 2 groups was plausible because both groups observed similar characteristics in age, sex,condition and course of the illness.
Post-treatment results displayed significant improvements for most of the symptoms of the illness. However for both groups, no significant improvements were observed for flu and allergic symptoms. Post-treatment analysis displayed better results for the control group than the experimental group in the tolerance to cold. For the rest of the symptoms, both groups displayed similar results. The experimental group concluded with 2 significant success cases (5.9%), 21 success cases (61.76%) and 11 status-quo cases (32.35%) resulting an overall success rate of 67.64%. The control group concluded with 2 significant success cases (5.9%), 22 success cases (64.10%) and 10 status-quo cases (29.41%) resulting an overall success rate of 90%. There were no significant differences between the results of both groups and it was possible to achieve a success rate of 70.59%. In addition, no side-effects were noted.
Conclusion:Under the concept of "Zi Wu Liu Zhu", the administering of the medicine only in the morning or both morning and evening displayed similar results. Therefore it provided the basis for the reduction of the frequency of consuming the medicine. By applying the time administration of the medicine, it enhanced the compliance and medicinal effect on the patient. This method is thus effective and worth to be implemented clinically.
本病可分为急性发作期、慢性持续期和缓解期。在缓解期进行积极治疗,可预防和减少哮喘发作,是治疗儿童哮喘的重要环节。中医药在辨证论治原则指导下进行多环节调治,未病先防,具有独特的优势。本文在回顾哮喘缓解期相关文献的基础上,研究时间给药法在本病中的应用。通过对68例哮喘缓解期肾虚证患儿的临床观察,研究参蛤细辛散时间服药法治疗本证的疗效。通过对临床症状、体征积分的统计,比较每日辰时用药与辰时、酉时同时用药的疗效差异,同时观察参蛤细辛散的用药安全性,为临床减少服药次数提供依据,可增加儿童及家长的依从性,具有一定的临床推广价值。
目的:在“子午流注”理论的指导下治疗小儿哮喘缓解期肾虚证,在不同时点给予参蛤细辛散,通过观察两组的临床疗效,说明时间给药法对疗效的影响。
方法:本文以新加坡中华医院门诊、自然中医诊所的68例哮喘缓解期肾虚证患儿为研究对象,按盲法、随机的原则按1:1的比例分为试验组和对照组,两组均给予参蛤细辛散1～3个疗程,每个疗程12周,试验组每日于辰时给药1次,对照组每日于辰时和酉时给药2次,观察疗程结束后两组患儿主症、次症积分的变化,进行统计学处理,评判两种给药方法的疗效与安全性。
结果:试验前两组患儿在年龄、性别、病程、病情均无显著性差异,两组具有可比性。研究结果显示:试验组经治疗后,在总积分、哮喘次数、哮喘发作程度、痰涎、汗出不温、气短、鼻痒喷嚏、鼻塞、面色、精神、惊恐、畏寒肢冷、夜尿、大便、舌象等情况改善方面明显优于治疗前,在感冒次数、过敏症情况改善方面无明显差异。对照组患儿在总积分、哮喘次数、哮喘发作程度、痰涎、汗出不温、气短、鼻痒喷嚏、鼻塞、面色、精神、惊恐、畏寒肢冷、夜尿、大便、舌象等情况改善方面明显优于治疗前,在感冒次数、过敏症改善情况方面无明显差异。两组间对比,经治疗后,对照组在畏寒肢冷情况改善方面优于试验组,在总积分、感冒次数、哮喘次数、哮喘发作程度、过敏症、痰涎、汗出不温、气短、鼻痒喷嚏、鼻塞、面色、精神、惊恐、夜尿、大便、舌象情况改善方面无明显差异。两组总疗效分析:试验组显效2例(5.9%)、有效21例(61.76%)、无效11例(32.35%),总有效率67.64%。B组显效2例(5.9%)、有效22例(64.10%)、无效10例(29.41%),总有效率70%。经统计学处理,两组有效率无明显差异。两组均未见临床不良反应。
结论:在“子午流注”理论指导下,辰时给药的治疗方案与辰时、酉时给药的治疗方案疗效相似,从而为临床减少小儿服药次数提供了依据。运用时间给药法增强了小儿服药的依从性,具有一定的实用价值和操作性,值得临床推广。
Asthma, a common medical condition, is on the rise. Globally, there are approximately 150 million asthmatic patients. Amongst which 180 thousand die from the illness each year. Based on these figures, it is clear that asthma is a chronic medical condition that threatens the well-being of human health. In the year 2000, asthmatic analytical research report had recorded that 1.97% of Singaporean children were asthmatic. Therefore, the prevention of asthma has become a global issue. World Health Organization (WHO) has also classified the fight against asthma on a global scale.
Asthma can be categorised into acute attack, chronic duration and the remission phase. It is crucial for asthmatic children to engage proactively in the various phases of the treatment. The treatment of asthma during the remission phase in order to prevent and reduce the attacks is deemed very important. The Chinese medicine is superior in regulating the overall health of a person. Depending on the principle of differentiation and treatment,it is very effective in the various stages of treatment as well as the prevention of asthma. Based on the existing knowledge on the remission phase of asthmatic treatment, this thesis analysed the effects of consuming the medicine at different timings of the day. Through close observation of 68 cases of child asthmatic patients with weak kidney function, detailed analysis on the effects of consuming "Shen Ge Xi Xin San" at different timings of the day was performed. The results that the medicine had on the patients were tabulated and analysed based on short-term and long-term recoveries. A point system was applied to classify and grade the effects of the administration of the medicine on 2 different sets of timing - Morning only ; Both morning and evening. During the study, the safety aspects of using the medicine was also closely followed and recorded. From the study, medical effects and the safety of the medicine was observed, analysed and recorded. In addition, other beneficial effects of the medicine was also noted.
Objective: To investigate the time administration effect of "Shen Ge Xi Xin San" on the remission phase of asthma affecting children with weak kidney function based on the "Zi Wu Liu Zhu" logic.
Method: The experimental subjects to this research were 68 asthmatic children with weak kidney function. They were the patients at the Singapore Chung Hwa Medical Institution and Natural TCM Clinic. Based on the concept of a blocked and randomized statistical model with a ratio of 1:1, the subjects were divided into 2 groups, namely the experimental group and the control group. Each group of patients was administered with the "Shen Ge Xi Xin San" with 1 to 3 courses at 12 weeks duration for each course. The experimental group was administered with the medicine each morning whereas the control group was administered both mornings and evenings. The results were obtained by applying a point system. The findings were concluded by analysing the points using specific statistical models, thus commenting on the effect of the different methods of administering the medicine as well as the safety aspects.
Result: Based on the concept of a randomized statistical model with a ratio of 1:1, 68 sick children were administered with "Shen Ge Xi Xin San". The experimental group was administered with the medicine each morning whereas the control group was administered both mornings and evenings. Results of the 2 groups were analysed. The analysis between the 2 groups was plausible because both groups observed similar characteristics in age, sex,condition and course of the illness.
Post-treatment results displayed significant improvements for most of the symptoms of the illness. However for both groups, no significant improvements were observed for flu and allergic symptoms. Post-treatment analysis displayed better results for the control group than the experimental group in the tolerance to cold. For the rest of the symptoms, both groups displayed similar results. The experimental group concluded with 2 significant success cases (5.9%), 21 success cases (61.76%) and 11 status-quo cases (32.35%) resulting an overall success rate of 67.64%. The control group concluded with 2 significant success cases (5.9%), 22 success cases (64.10%) and 10 status-quo cases (29.41%) resulting an overall success rate of 90%. There were no significant differences between the results of both groups and it was possible to achieve a success rate of 70.59%. In addition, no side-effects were noted.
Conclusion:Under the concept of "Zi Wu Liu Zhu", the administering of the medicine only in the morning or both morning and evening displayed similar results. Therefore it provided the basis for the reduction of the frequency of consuming the medicine. By applying the time administration of the medicine, it enhanced the compliance and medicinal effect on the patient. This method is thus effective and worth to be implemented clinically.
引文
[1]许建中.中西医结合哮喘病学[M].北京:人民卫生出版社.第1版.
[2]陈颢珠.实用内科学[M].北京:人民卫生出版社.第11版.
[3]中华医学会儿科学分会呼吸学组.儿童支气管哮喘防治常规(试行)[J].中华儿科杂志,2004;42(2):100.
[4]杜永成.哮喘的现代诊断与治疗[M].中国医药科技出版社,第1版.
[5]Program and Abstracts in the Fith International Conference of Chronopharmacology.Biological Rhythms and Medication.Ameha Island.Florida,USA.1992
[6]Remberg A,Labrecque G,Smolensky MH.Chronobiologie et chrono therapeutique[J].Paris;Flammarion Mdicine Sciences.1991.200
[7]麻仲学主编.中国医学疗法大全[M].济南:山东科学技术出版社,1990,327,771
[8]刘璐.哮喘遗传学研究进展[J].山西医药杂志,2004,33(1):45.
[9]陈贵廷,杨思澍主编.实用中西医结合诊断治疗学[M].中国医药科技出版社.1991.262
[10]Daian CM,Wolff All,Bielory 1.The role of atypical or-ganisms in asthma[J].Allergy Asthma Proe,2000,21(2):107.
[11]Einarsson S,Sigurdsson HK,Magnusdottir,etal.Age nspecific prevalence of antiboties against chlamydia pneumonia in iceland[J1 ·Seand J Infeet Dis,2002,14(8):245.
[12]Behrman RE,Klegman RM,Arivn AM.Nelson testbook of Pediatries[M].15~(th) ed.phi]adelphia:Saunders,1999,507.
[13]中华呼吸病学汇编(试行方案)[J].中华结核和呼吸杂志,1993,165:6-8,10-12.
[14]中华医学呼吸病学会编制[J].中华结核和呼吸杂志,1997,20(10):261-267.
[15]Edelman JM,Turpin JA,Bronsky EA,etal.Oral montelukast eomPared with inhaled salmeterol to prevent exercise induced bron- choeonstrietion[J].Ann Intem Med 2000,132:97-104.
[16]Riehter K,Jorres RA,Magnussen H.Effieaey and duration of aetion of the antileukotriene zafirlukas on cold air induced bronchoeonstrietion [J].EurResPir J,2000,15:693-699.
[17]Dahen SE,Malmstr MK,Nizankowska E,etal.Improvemen of aspirin intolerant asthma by montelukast,a leukotriene antagonist[J].Am J Respir Crit Care Med,2002,165:9-14.
[18]梅丹,郭翠玲.色甘酸钠的药理及应用新进展[J1.中国药房,1998,9(3):135-136.
[19]程兆忠,秦筱梅.BZ受体激动剂在哮喘治疗中的应用[J].山东医药,1999,39(20)44-45.
[20]赵文利.茶碱在哮喘防治中免疫调节作用[1].重庆医学,2003,(2):234-237.
[21]崔振泽,李晓辉.茶碱在哮喘治疗中的应用[1].中国临床医生,1999,27(7):33.
[22]Bames PJ.Histamine and Serotonin[J].Pulmonary Pharmaeology &Theraputies,2001,14:329-339.
[23]吕小华.支气管哮喘的现代治疗物[J].临床肺科杂志,2005,10(4):514-515.
[24]李明华.哮喘病的新概念和治疗研究进展[J].中国临床医生,2004,32(2):2.
[25]张颖.哮喘缓解期运用中医扶正固本法的临床探索[J].中医文献杂志,2004,(3):34-35.
[26]吴福玲,冯学斌,蒋少锋,等.支气管哮喘相关因子的研究进展[J].滨州医学院学报,2004,27(2):122.
[27]姜晓峰,梁红艳.哮喘发病机制研究的现状与展望[J].中华检验医学杂志,2004,27(1):7.
[28]李森,尚云晓.呼吸道合胞病毒诱发哮喘机制[M].国外医学儿科学分册,2004,31(2):80.
[29]李睿,杨锡强.婴儿呼吸道合胞病毒感染与儿童哮喘[M].国外医学儿科学分册,2004,31(1):47.
[30]殷凯生.支气管哮喘的现代诊断与治疗[M].国外医学呼吸系统分册,2004,24(1):54.
[31]刘世琼,张全爱.中医药治疗支气管哮喘实验研究进展[J].甘肃中医学院学报,2004,21(1):57.
[32]http://www.hpb.gov.sg/hpb/default.asp?pg_id=865&aid=46.
[33]王明明,胡英同,汪受传.汪受传从肺论治小儿哮喘缓解期的经验[J].辽宁中医杂志,2001,28(8):466.
[34]闽亮,沈惠风.补虚三法防治哮喘[J].陕西中医,1998,19(4):191.
[35]王明明,汪受传.玉屏风散预防小儿哮喘临床效果及机理探讨[J].时珍国医国药,2001,12(5):457.
[36]牟慧琴,郑昱,李潮平,等.喘康丸防治哮喘的临床研究[J].光明中医,2004,(2):21.
[37]魏成功,全权.益肺汤对哮喘缓解期峰值呼气流速变化的研究[J].新中医,2000,32(8):38.
[38]殷莉波.自拟补肾益肺汤防治支气管哮喘42例[J].中医药临床杂志,2004,16(1):92.
[39]黄开珍,黄美杏,梁春才,等.补肺片防治缓解期支气管哮喘的临床研究[J].广西中医药,2001,24(6):15.
[40]韩芳华.中药治疗小儿哮喘缓解期67例[J].辽宁中医杂志,1998,25(10):474.
[41]于作洋,刘弼臣.治疗小儿哮喘的经验[J].山西中医,1998,14(2):6.
[42]张庆荣,谷峰,赵世芬,等.脾虚对哮喘氧化抗氧平衡改变的影响[J].辽宁中医杂志,1999,26(12):574.
[43]盛丽先,王艳.小儿哮喘缓解期中医病机认识和治疗[J].浙江中西医结合杂志,2007,17(1):1.
[44]周兆山,王燕青,姜洪玉,等.哮喘缓解期从肾虚体质辩证[J].中医研究,2005,18(9):22.
[45]王福霞,赵学诚.六味地黄丸防治支气管哮喘疗效观察[J].现代中西医结 合杂志,2000,9(21):2115.
[46]许建华,无敦序,方肇勤等.哮喘大鼠肺组织cAMP、cGMP的动态变化及补肾定喘汤对其的影响[J].中国中医药信息杂志,2000,7(1):26.
[47]李贵才,谢鹤.参蛤河车散防治小儿哮喘缓解期60例分析[J].福建医药杂志,2003,25(4):69.
[48]赵明元.防喘合剂防治缓解期支气管哮喘44例[J].江苏中医,2001,22(2):14.
[49]兰智慧,洪广祥,郭德华等.益气护卫汤对哮喘小鼠Th_1/Th_2型细胞因子水平的影响[J].江西中医药,2002,33(3):43.
[50]刘浩.六味地黄合苓桂术甘汤防治儿童哮喘65例疗效观察[J].实用中西医结合临床,2005,5(3):32.
[51]江霞,廖宝军.从痰瘀论治小儿哮喘116例分析[J].陕西中医函授,2000,(5):41.
[52]刘志宏,张桂菊,王明香,等.益气活血汤防治儿童哮喘复发120例临床观察[J].四川中医,2004,22(6):70.
[53]虞坚尔,李利清,张晓峰等.平喘方干预支气管哮喘模型大鼠Th_1/Th_2平衡的研究[J].中医儿科杂志,2006,2(1):23.
[54]郑翠娥,曲政军.喘舒颗粒治疗支气管哮喘缓解期40例临床观察[J].山东中医药大学学报,2003,27(3):183.
[55]白晓红,邵功利,王雪峰.伏九贴膏防治小儿哮喘的临床研究探要[J].中医药学刊,2004,22(9):1.
[56]徐磊.“辛日辛时贴辛穴”治疗哮喘197例[J].中医外治杂志.2006,15卷第(6):17-18.
[57]王翠真.清肺补肾汤配合穴位注射治疗支气管哮喘336例[J].中国民间疗法,2003,11(7):35.
[58]贾士荣.科学大众[M].第2版.上海:医学科学出版社,1963,37.
[59]崔允文.支气管哮喘的理论机理[J].百科知识,1987,26(11):15.
[60]马向东,徐秋菊.子午流注与支气管哮喘[J].包头医学.2001,25(3):124.
[61]胡伟勇.子午流注针法治疗支气管哮喘65例临床观察[J].江西中医学院学报.1995,7(6):11.
[62]陈松泉,章惠陵.择时针灸治疗哮喘的免疫指标观察及机理探讨[J].中国针灸.1994,增刊:160-162.
[63]吕建强.时辰药理学和时辰治疗学的研究进展[J].中华医学杂志,1994;74(2):121
[64]陈克正等.编著.叶天士诊治大全[M].中国中医药出版社.1995.177.
[65]潘华信等.主编.叶天士医案大全[M].上海中医药大学出版社.1994.217.
[66]夏质彬.子午流注学说临床辩证施治[J].中华现代中西医杂志,2003,1(3)
[67]张根妹.时辰医学在临床护理中的应用[J].辽宁中医杂志,2002,7(29):7.
[68]刘逢军.医学养生医家论道,2007,34.
[69]李树森.http://www.chinaasthma.cn/World-asthma-day/2910.html.
[70]韩红红,李丽萍.子午流注辩证用药体会[J].中国中医药信息杂志,2002,9(9):67.
[71]顾燕.论子午流注学说在咳喘症护理中的运用[J].解放军护理杂志,2002,19(6):48.
[72]徐叔云,临床药理学[M].第二版,北京:人民卫生出版社2003.18.
[73]永山治.药物奏效方式与昼夜节律[J].姜煜普译.日本医药介绍,1988:9(6):261
[74]赵贵铭.“培本哮喘散”治疗哮喘108例[J].中医药研究,1996,(6):1.
[75]张惠勇.健脾温肾膏治疗治疗支气管哮喘65例[J].新中医,1996,28(10):42.
[76]赖祥林.扶正固本法治疗肺源性哮喘缓解期的临床观察[J].实用中西医结合杂志,1995,8(10):588.
[77]张镜人等.中西医结合治疗哮喘病[J].中西医结合杂志,1983,3(1):8.
[78]庄金星.参蛤散佐治小儿支气管哮喘29例临床分析[J].福建医药杂志.1995,17(6):60.
[79]刘杰著.中国八卦本草[M].青岛出版社.2005.5.
[80]汪受传,赵霞主编.中医儿科学难点解析[M].中国中医药出版社.2007.1.
[81]汪受传主编.全国普通高等教育中医药类精编教材·中医儿科学[M].上海科技出版社.2006.8.
[82]王琦主编.中医体质学[M].中国中医药科技出版社.1995.151.
[83]陈华主编.中医的科学原理[M].商务印书馆.1998.65.
[84]胡剑北编著.中医时间治疗学应用全书[M].华夏出版社.1993.96.
[85]梅全喜,毕焕新主编.现代中药药理手册[M].中国中医药出版社.1998.37.
[86]苏永安著.十二经脉时间养生法[M].风行馆能量医学远流出版社.1997.137
[87]孟景春,王新华主编.黄帝内经素文译释[M].上海科学技术出版社.1997.
[2]陈颢珠.实用内科学[M].北京:人民卫生出版社.第11版.
[3]中华医学会儿科学分会呼吸学组.儿童支气管哮喘防治常规(试行)[J].中华儿科杂志,2004;42(2):100.
[4]杜永成.哮喘的现代诊断与治疗[M].中国医药科技出版社,第1版.
[5]Program and Abstracts in the Fith International Conference of Chronopharmacology.Biological Rhythms and Medication.Ameha Island.Florida,USA.1992
[6]Remberg A,Labrecque G,Smolensky MH.Chronobiologie et chrono therapeutique[J].Paris;Flammarion Mdicine Sciences.1991.200
[7]麻仲学主编.中国医学疗法大全[M].济南:山东科学技术出版社,1990,327,771
[8]刘璐.哮喘遗传学研究进展[J].山西医药杂志,2004,33(1):45.
[9]陈贵廷,杨思澍主编.实用中西医结合诊断治疗学[M].中国医药科技出版社.1991.262
[10]Daian CM,Wolff All,Bielory 1.The role of atypical or-ganisms in asthma[J].Allergy Asthma Proe,2000,21(2):107.
[11]Einarsson S,Sigurdsson HK,Magnusdottir,etal.Age nspecific prevalence of antiboties against chlamydia pneumonia in iceland[J1 ·Seand J Infeet Dis,2002,14(8):245.
[12]Behrman RE,Klegman RM,Arivn AM.Nelson testbook of Pediatries[M].15~(th) ed.phi]adelphia:Saunders,1999,507.
[13]中华呼吸病学汇编(试行方案)[J].中华结核和呼吸杂志,1993,165:6-8,10-12.
[14]中华医学呼吸病学会编制[J].中华结核和呼吸杂志,1997,20(10):261-267.
[15]Edelman JM,Turpin JA,Bronsky EA,etal.Oral montelukast eomPared with inhaled salmeterol to prevent exercise induced bron- choeonstrietion[J].Ann Intem Med 2000,132:97-104.
[16]Riehter K,Jorres RA,Magnussen H.Effieaey and duration of aetion of the antileukotriene zafirlukas on cold air induced bronchoeonstrietion [J].EurResPir J,2000,15:693-699.
[17]Dahen SE,Malmstr MK,Nizankowska E,etal.Improvemen of aspirin intolerant asthma by montelukast,a leukotriene antagonist[J].Am J Respir Crit Care Med,2002,165:9-14.
[18]梅丹,郭翠玲.色甘酸钠的药理及应用新进展[J1.中国药房,1998,9(3):135-136.
[19]程兆忠,秦筱梅.BZ受体激动剂在哮喘治疗中的应用[J].山东医药,1999,39(20)44-45.
[20]赵文利.茶碱在哮喘防治中免疫调节作用[1].重庆医学,2003,(2):234-237.
[21]崔振泽,李晓辉.茶碱在哮喘治疗中的应用[1].中国临床医生,1999,27(7):33.
[22]Bames PJ.Histamine and Serotonin[J].Pulmonary Pharmaeology &Theraputies,2001,14:329-339.
[23]吕小华.支气管哮喘的现代治疗物[J].临床肺科杂志,2005,10(4):514-515.
[24]李明华.哮喘病的新概念和治疗研究进展[J].中国临床医生,2004,32(2):2.
[25]张颖.哮喘缓解期运用中医扶正固本法的临床探索[J].中医文献杂志,2004,(3):34-35.
[26]吴福玲,冯学斌,蒋少锋,等.支气管哮喘相关因子的研究进展[J].滨州医学院学报,2004,27(2):122.
[27]姜晓峰,梁红艳.哮喘发病机制研究的现状与展望[J].中华检验医学杂志,2004,27(1):7.
[28]李森,尚云晓.呼吸道合胞病毒诱发哮喘机制[M].国外医学儿科学分册,2004,31(2):80.
[29]李睿,杨锡强.婴儿呼吸道合胞病毒感染与儿童哮喘[M].国外医学儿科学分册,2004,31(1):47.
[30]殷凯生.支气管哮喘的现代诊断与治疗[M].国外医学呼吸系统分册,2004,24(1):54.
[31]刘世琼,张全爱.中医药治疗支气管哮喘实验研究进展[J].甘肃中医学院学报,2004,21(1):57.
[32]http://www.hpb.gov.sg/hpb/default.asp?pg_id=865&aid=46.
[33]王明明,胡英同,汪受传.汪受传从肺论治小儿哮喘缓解期的经验[J].辽宁中医杂志,2001,28(8):466.
[34]闽亮,沈惠风.补虚三法防治哮喘[J].陕西中医,1998,19(4):191.
[35]王明明,汪受传.玉屏风散预防小儿哮喘临床效果及机理探讨[J].时珍国医国药,2001,12(5):457.
[36]牟慧琴,郑昱,李潮平,等.喘康丸防治哮喘的临床研究[J].光明中医,2004,(2):21.
[37]魏成功,全权.益肺汤对哮喘缓解期峰值呼气流速变化的研究[J].新中医,2000,32(8):38.
[38]殷莉波.自拟补肾益肺汤防治支气管哮喘42例[J].中医药临床杂志,2004,16(1):92.
[39]黄开珍,黄美杏,梁春才,等.补肺片防治缓解期支气管哮喘的临床研究[J].广西中医药,2001,24(6):15.
[40]韩芳华.中药治疗小儿哮喘缓解期67例[J].辽宁中医杂志,1998,25(10):474.
[41]于作洋,刘弼臣.治疗小儿哮喘的经验[J].山西中医,1998,14(2):6.
[42]张庆荣,谷峰,赵世芬,等.脾虚对哮喘氧化抗氧平衡改变的影响[J].辽宁中医杂志,1999,26(12):574.
[43]盛丽先,王艳.小儿哮喘缓解期中医病机认识和治疗[J].浙江中西医结合杂志,2007,17(1):1.
[44]周兆山,王燕青,姜洪玉,等.哮喘缓解期从肾虚体质辩证[J].中医研究,2005,18(9):22.
[45]王福霞,赵学诚.六味地黄丸防治支气管哮喘疗效观察[J].现代中西医结 合杂志,2000,9(21):2115.
[46]许建华,无敦序,方肇勤等.哮喘大鼠肺组织cAMP、cGMP的动态变化及补肾定喘汤对其的影响[J].中国中医药信息杂志,2000,7(1):26.
[47]李贵才,谢鹤.参蛤河车散防治小儿哮喘缓解期60例分析[J].福建医药杂志,2003,25(4):69.
[48]赵明元.防喘合剂防治缓解期支气管哮喘44例[J].江苏中医,2001,22(2):14.
[49]兰智慧,洪广祥,郭德华等.益气护卫汤对哮喘小鼠Th_1/Th_2型细胞因子水平的影响[J].江西中医药,2002,33(3):43.
[50]刘浩.六味地黄合苓桂术甘汤防治儿童哮喘65例疗效观察[J].实用中西医结合临床,2005,5(3):32.
[51]江霞,廖宝军.从痰瘀论治小儿哮喘116例分析[J].陕西中医函授,2000,(5):41.
[52]刘志宏,张桂菊,王明香,等.益气活血汤防治儿童哮喘复发120例临床观察[J].四川中医,2004,22(6):70.
[53]虞坚尔,李利清,张晓峰等.平喘方干预支气管哮喘模型大鼠Th_1/Th_2平衡的研究[J].中医儿科杂志,2006,2(1):23.
[54]郑翠娥,曲政军.喘舒颗粒治疗支气管哮喘缓解期40例临床观察[J].山东中医药大学学报,2003,27(3):183.
[55]白晓红,邵功利,王雪峰.伏九贴膏防治小儿哮喘的临床研究探要[J].中医药学刊,2004,22(9):1.
[56]徐磊.“辛日辛时贴辛穴”治疗哮喘197例[J].中医外治杂志.2006,15卷第(6):17-18.
[57]王翠真.清肺补肾汤配合穴位注射治疗支气管哮喘336例[J].中国民间疗法,2003,11(7):35.
[58]贾士荣.科学大众[M].第2版.上海:医学科学出版社,1963,37.
[59]崔允文.支气管哮喘的理论机理[J].百科知识,1987,26(11):15.
[60]马向东,徐秋菊.子午流注与支气管哮喘[J].包头医学.2001,25(3):124.
[61]胡伟勇.子午流注针法治疗支气管哮喘65例临床观察[J].江西中医学院学报.1995,7(6):11.
[62]陈松泉,章惠陵.择时针灸治疗哮喘的免疫指标观察及机理探讨[J].中国针灸.1994,增刊:160-162.
[63]吕建强.时辰药理学和时辰治疗学的研究进展[J].中华医学杂志,1994;74(2):121
[64]陈克正等.编著.叶天士诊治大全[M].中国中医药出版社.1995.177.
[65]潘华信等.主编.叶天士医案大全[M].上海中医药大学出版社.1994.217.
[66]夏质彬.子午流注学说临床辩证施治[J].中华现代中西医杂志,2003,1(3)
[67]张根妹.时辰医学在临床护理中的应用[J].辽宁中医杂志,2002,7(29):7.
[68]刘逢军.医学养生医家论道,2007,34.
[69]李树森.http://www.chinaasthma.cn/World-asthma-day/2910.html.
[70]韩红红,李丽萍.子午流注辩证用药体会[J].中国中医药信息杂志,2002,9(9):67.
[71]顾燕.论子午流注学说在咳喘症护理中的运用[J].解放军护理杂志,2002,19(6):48.
[72]徐叔云,临床药理学[M].第二版,北京:人民卫生出版社2003.18.
[73]永山治.药物奏效方式与昼夜节律[J].姜煜普译.日本医药介绍,1988:9(6):261
[74]赵贵铭.“培本哮喘散”治疗哮喘108例[J].中医药研究,1996,(6):1.
[75]张惠勇.健脾温肾膏治疗治疗支气管哮喘65例[J].新中医,1996,28(10):42.
[76]赖祥林.扶正固本法治疗肺源性哮喘缓解期的临床观察[J].实用中西医结合杂志,1995,8(10):588.
[77]张镜人等.中西医结合治疗哮喘病[J].中西医结合杂志,1983,3(1):8.
[78]庄金星.参蛤散佐治小儿支气管哮喘29例临床分析[J].福建医药杂志.1995,17(6):60.
[79]刘杰著.中国八卦本草[M].青岛出版社.2005.5.
[80]汪受传,赵霞主编.中医儿科学难点解析[M].中国中医药出版社.2007.1.
[81]汪受传主编.全国普通高等教育中医药类精编教材·中医儿科学[M].上海科技出版社.2006.8.
[82]王琦主编.中医体质学[M].中国中医药科技出版社.1995.151.
[83]陈华主编.中医的科学原理[M].商务印书馆.1998.65.
[84]胡剑北编著.中医时间治疗学应用全书[M].华夏出版社.1993.96.
[85]梅全喜,毕焕新主编.现代中药药理手册[M].中国中医药出版社.1998.37.
[86]苏永安著.十二经脉时间养生法[M].风行馆能量医学远流出版社.1997.137
[87]孟景春,王新华主编.黄帝内经素文译释[M].上海科学技术出版社.1997.