防哮冲剂治疗小儿慢性咳嗽（气阴两虚型）的临床研究
|
摘要
目的：旨在通过全面的临床观察,研究防哮冲剂的治疗效果,进而研制出一种有效治疗气阴两虚型慢性咳嗽的药物；同时希望本研究对今后中医药在治疗小儿慢性咳嗽的研究思路和方法上有所帮助。
方法：通过对文献的综合研究和导师的经验总结,制定临床研究方案,将60例符合小儿气阴两虚型慢性咳嗽纳入标准的门诊患儿随机分为治疗组和对照组,治疗组30例,对照组30例。对两组患儿的一般情况、病程、病因、症状和体征进行比较,依据患儿年龄大小,治疗组和对照组分别给予相应剂量的防哮冲剂及念慈庵蜜炼川贝枇杷膏,疗程30天,对两组治疗后在疾病疗效和症状改善上进行比较。
结果：
(1)疗程结束后,治疗组的疗效明显优于对照组(P<0.05)。
(2)治疗组患儿症状的改善明显优于对照组,差异显著(P<0.05)
(3)治疗组患儿的远期疗效明优于对照组,差异显著(P<0.05)。
结论：临床观察研究表明,防哮冲剂治疗小儿气阴两虚型慢性咳嗽,可明显改善慢性咳嗽患儿的症状,疗效确切,无毒副作用,充分发挥了中医药治疗慢性咳嗽的优势,具有临床研究及推广价值。
Objective:To observe through a comprehensive clinical study of treatment effect against Asthma granules,and then developed an effective treatment for chronic cough medicines Qi and Yin defieiency;also hope that this study on the future of Chinese medicine in the treatment of children with chronic cough helpful ideas and methods.
Methods:60 cases of patients with Qi and Yin defieiency was divided into two groups-30 in treating group and 30 in contrast group. Compare the general conditions,the course of disease,etiology of disease,symptoms and physical signs of the two group.According to the age of the kid patients, administer the Fangxiaochongji and niancian respectively to each group of proper dosage;the whole treating process is one month altogether, judging the clinical effect by comparing with the improment of the symptoms.
Results:
(1)after treatment,the efficacy of treatment group is better than the control group.
(2)in the treatment group improved significantly in children with symptoms than the control group,the difference is significant.
(3)long teem effect of treatment group children is better than the control group,the difference is significant.
Conclusion:Clinical studies have shown that Fangxiaochongji Qi and Yin Deficiency type in children with chronic cough,can significantly improve symptoms of chronic cough and effective,non-toxic side effects,make full use of the advantages of Chinese medicine treatment of chronic cough,with research and promotion value.
方法：通过对文献的综合研究和导师的经验总结,制定临床研究方案,将60例符合小儿气阴两虚型慢性咳嗽纳入标准的门诊患儿随机分为治疗组和对照组,治疗组30例,对照组30例。对两组患儿的一般情况、病程、病因、症状和体征进行比较,依据患儿年龄大小,治疗组和对照组分别给予相应剂量的防哮冲剂及念慈庵蜜炼川贝枇杷膏,疗程30天,对两组治疗后在疾病疗效和症状改善上进行比较。
结果：
(1)疗程结束后,治疗组的疗效明显优于对照组(P<0.05)。
(2)治疗组患儿症状的改善明显优于对照组,差异显著(P<0.05)
(3)治疗组患儿的远期疗效明优于对照组,差异显著(P<0.05)。
结论：临床观察研究表明,防哮冲剂治疗小儿气阴两虚型慢性咳嗽,可明显改善慢性咳嗽患儿的症状,疗效确切,无毒副作用,充分发挥了中医药治疗慢性咳嗽的优势,具有临床研究及推广价值。
Objective:To observe through a comprehensive clinical study of treatment effect against Asthma granules,and then developed an effective treatment for chronic cough medicines Qi and Yin defieiency;also hope that this study on the future of Chinese medicine in the treatment of children with chronic cough helpful ideas and methods.
Methods:60 cases of patients with Qi and Yin defieiency was divided into two groups-30 in treating group and 30 in contrast group. Compare the general conditions,the course of disease,etiology of disease,symptoms and physical signs of the two group.According to the age of the kid patients, administer the Fangxiaochongji and niancian respectively to each group of proper dosage;the whole treating process is one month altogether, judging the clinical effect by comparing with the improment of the symptoms.
Results:
(1)after treatment,the efficacy of treatment group is better than the control group.
(2)in the treatment group improved significantly in children with symptoms than the control group,the difference is significant.
(3)long teem effect of treatment group children is better than the control group,the difference is significant.
Conclusion:Clinical studies have shown that Fangxiaochongji Qi and Yin Deficiency type in children with chronic cough,can significantly improve symptoms of chronic cough and effective,non-toxic side effects,make full use of the advantages of Chinese medicine treatment of chronic cough,with research and promotion value.
引文
[1]唐·王冰《黄帝内经素问》,人民卫生出版社1963年
[2]汉·张仲景《金匮要略方论》,人民卫生出版社1963年
[3]隋·巢元方《诸病源候论》,人民卫生出版社1982年
[4]清·沈清鳌《杂病源流犀烛》,人民卫生出版社1993生
[5]宋·陈言《三因极一病证方论》,上海古籍出版社1992年
[6]元·朱丹溪《丹溪心法》,上海科学技术出版社1959年
[7]明·李挺《医学入门》(上下),天津科学技术出版社1999年
[8]明·王肯堂《证治准绳》(全五册),上海古籍出版社1991年
[9]明·张介宾《景岳全书》上下册,上海科学技术出版社1984年
[10]明·赵献可《医贯》,人民卫生出版社1982年
[11]林东红,杨鸿,马香.辨证治疗小儿慢性咳30例[J].福建中医学院学报,2003,13(5)：12-13.
[12]张元兵.慢性咳嗽的辨证论治简析[J].中医药学刊,2003,21(7)：1198.
[13]李素云,曹世宏教授辨治久咳的经验[J].四川中医,2003,21(4)：3
[14]曲妮妮.马智教授应用加减止嗽散治疗咳嗽变异性哮喘经验[J].中医药学刊,2006,24(2)：212-213
[15]钱静华.辨证配伍活血化瘀药治疗慢性咳嗽52例[J].山东中医杂志,2007,26(2)：101-102
[16]潘正连,孙子凯.曹世宏教授治疗慢性咳嗽的经验.江苏中医,2000：21(4)：3-4。
[17]刘美珍.王蒲生教授治疗小儿久咳的经验.新中医,2001：33(n)：n-1.2
[18]邵长荣.久咳论治(J).江苏中医药,2002,23(10)：1
[19]崔红生.咳嗽的辨病与辨治(J)中医杂志,2006,7(47)：500-501
[20]李乃庚,小儿久咳辨治琐碎.江苏中医,2000：21(6)：13.
[21]郁晓维.不在邪多而在正虚-江育仁教授防治呼吸道复感儿的经验[J].现代中医药(陕西),2004(4)：2
[22]余霞,吴玉昌,白洁.桂枝加厚朴杏子汤治疗咳嗽变异型哮喘37例[J].中华实用中西医杂志,2005,18(20)：1319-1320.
[23]魏文周,杨会,双袁玉.理肺止咳汤治疗嗜酸细胞性支气管炎36例[J].国际中医中药杂志,2007,29(3)：177.
[24]王敬碧.,小柴胡汤加减治疗久咳55例.实用中医杂志,2002：18(8)：86.
[25]年云娜.银翘散加减治疗慢性咳嗽的体会[J].中华临床新医学,2004,4(1)：61-62.
[26]高志姝,朱春晖.养阴清肺汤化裁治疗小儿慢性咽炎50例[J].江苏中医药,2005,26(12)：28.12
[27]吴剑辉.中西医结合治疗小儿慢性咳嗽疗效分析[J].广州医药,2000,31(3)：71-72.
[28]吴巧玲.耳穴贴压加艾灸治疗顽固性咳嗽[J].中国针灸,2001,21(10)：585
[29]张继红,赵藏朵,张慧岭.针刺加闪罐治疗顽固性咳嗽62例[J].陕西中医,2003,24(10)：928
[30]黄映君,刁本恕,王静安.“内外合治法”在儿科运用举隅.四川中医,2007,(25)4：3-4
[31]Morice AH and eonnnittee members.The diagnosis and management of Chronic cough.Eur Respir J,2004,24(3):481-492
[32]Mc Garvey LPA.Which investigations are most useful in the Diagnosis of chronic cough?Thorax,2004,59(4):342-346
[33]Lalloo UG. The cough reflex and the healthy smoker.Chest,2003,123(3):660-620.
[34]Irwin RS,Madison JM.AM J Med,2000,108(4A):1265-1305
[35]张红霞,李元霞.鼻后滴注综合征与小儿慢性咳嗽的关系探讨(附60例报告).陕西医学杂志2006.35(6)：711.
[36]张玉荣,王坚.鼻窦炎引起的儿童慢性咳嗽临床诊疗体会.中国当代儿科杂志.2008.10(1)：77-78.
[37]Brlghtling CE,et al.AM J Respir Crit Care Med,1999,160:406-410
[38]Brlghtling CE,Pavord ID.Cin Exp Allergy,2000,30:4-6
[39]Gamey IK,et al.AM J Respir Crit Care Med,1997,156:211-216
[40]Diepinigaitis PV.Cough in asthma and eosinophilic bronchitis.Thorax,2004, 59(1):71-72.
[41]Holinger LD,Sande～AD.Chronic cough in infants and children:all update(J).Laryngoseope,1991,101(6Pt1):596-605.
[42]赵顺英,任亦欣,江载芳.慢性孤立性咳嗽息儿50例病因和诊断程序(J).中国实用儿科杂志,2006,21(2)：109-111.
[43]刘峰,江米足,周雪莲等.小儿慢性咳嗽与胃食管反流的关系(J).临床儿科杂志,2007,25(6)：442-444.
[44]Irwin RS.AM J.Gastroenterol,2000,95:9
[45]Harding SM, Riehter JE.Chest.1997,111:1398
[46]Pitlanish ML,Sandatore JC,Wolford RW.Severe coughing and gagging episode in an adolescent with a chronie laryngotracheal foreign body.Cin Pediatr,1997,36(6)357-359
[47]Charles WC.Primary tracheomalacia and gastroesophageal reflux ininfants with cough.Clin Pediatr,1998,37(12):725-731
[48]陆权.非典型微生物感染与慢性咳嗽[J].中国实用儿科杂志,2004,19(2)：708-710.
[49]常健,鲁继荣,梁东等.肺炎支原体、肺炎衣原体感染与儿童慢性咳嗽相关性分析[J].临床儿科杂志,2007,25(6)：439-441.
[50]蒋玲珍,庞黎华,庞福珍.小儿慢性咳嗽与支原体感染[J].江西医药,2006,4l(8)：584-585.
[51]全国儿科哮喘防治协作组.儿童哮喘防治常规.中华儿科杂志,1998,(12)：747-751.
[52]张淑霞,李丽,王素丽等.89例小儿慢性咳嗽变应原检测的临床意义.中国优生与遗传杂志2008.16(1)121-122.
[53]董传莉,潘家华.儿童慢性咳嗽的研究进展.实用全科医学.2008.6(4)409-410.(胃食管返流病有一个)
[54]祝筱姬.咳嗽变异性哮喘的诊治进展[J].实用医药吸杂志,2005,22(4)：368-369.
[55]中华医学会呼吸病学分会哮喘学组.咳嗽的诊断与治疗指南(草案).中华结核和呼吸杂志.2006,29：96-99.
[56]Iehimura K,Sugimura H, Naito A,etal.How to manage patients with hard-to-reeognize postnasal drip[J].Rhinology,1999,37(4):164-167
[57]Evansk L Recognition and management of sinusitis[J].Dxugs,1998,56(1):59-71.
[58]Brightling CE,Pavord IDI Eosinoplic bronchitis 2 what is it andwhy is it important?Chin ExPAllergy,2000,30:4-1
[59]Birring SS,Berry M,Brightling CE,et al.Eosinophilic bronchitis:clinical features, Management and Pathogenesis[J].Am J ResPir Med,2003, 2(2):169-173,
[60]万莉雅.儿童慢性咳嗽与肺结核.临床儿科杂志.2007,25(6)：435-436.
[61]Tokar B,Ozkan R,Ilhan H.Traeheobronehial foreign bodies in children:impo～ ance of aeeurate history and plain chest radiography in delayed presentation[J].Clin Radiology,2004,59(7):609-615.
[62]胡又兰,雍燕.儿童慢性咳嗽的常见病因及其特异性治疗.上海医学2005.28(8)：717-718.
[63]丁国芳,万琳等,小儿慢性咳嗽.国外医学儿科学分册.1995,22(1)：16-18.
[64]马海燕,宫桂芳等,2327例小儿住院病人相关流行病学因素调查.中国民政医学杂志.1996,9(6)：340-342.
[65]黄沁.免疫药物学,上海：上海科技出版社,1988,第1版：145-146.
[66]于辉,李春香,宫凌涛,等.甘草的药理作用概述.现代生物医学进展,2006；6,(4)：77-79
[67]Haraguchi H,Tanimoto K,Tanmura Y,etal.Mode of antibacterial action of retrochalcones from Glycyrrhiza Inflata.Phyto-chemistry,1998,48(1):125-129.
[2]汉·张仲景《金匮要略方论》,人民卫生出版社1963年
[3]隋·巢元方《诸病源候论》,人民卫生出版社1982年
[4]清·沈清鳌《杂病源流犀烛》,人民卫生出版社1993生
[5]宋·陈言《三因极一病证方论》,上海古籍出版社1992年
[6]元·朱丹溪《丹溪心法》,上海科学技术出版社1959年
[7]明·李挺《医学入门》(上下),天津科学技术出版社1999年
[8]明·王肯堂《证治准绳》(全五册),上海古籍出版社1991年
[9]明·张介宾《景岳全书》上下册,上海科学技术出版社1984年
[10]明·赵献可《医贯》,人民卫生出版社1982年
[11]林东红,杨鸿,马香.辨证治疗小儿慢性咳30例[J].福建中医学院学报,2003,13(5)：12-13.
[12]张元兵.慢性咳嗽的辨证论治简析[J].中医药学刊,2003,21(7)：1198.
[13]李素云,曹世宏教授辨治久咳的经验[J].四川中医,2003,21(4)：3
[14]曲妮妮.马智教授应用加减止嗽散治疗咳嗽变异性哮喘经验[J].中医药学刊,2006,24(2)：212-213
[15]钱静华.辨证配伍活血化瘀药治疗慢性咳嗽52例[J].山东中医杂志,2007,26(2)：101-102
[16]潘正连,孙子凯.曹世宏教授治疗慢性咳嗽的经验.江苏中医,2000：21(4)：3-4。
[17]刘美珍.王蒲生教授治疗小儿久咳的经验.新中医,2001：33(n)：n-1.2
[18]邵长荣.久咳论治(J).江苏中医药,2002,23(10)：1
[19]崔红生.咳嗽的辨病与辨治(J)中医杂志,2006,7(47)：500-501
[20]李乃庚,小儿久咳辨治琐碎.江苏中医,2000：21(6)：13.
[21]郁晓维.不在邪多而在正虚-江育仁教授防治呼吸道复感儿的经验[J].现代中医药(陕西),2004(4)：2
[22]余霞,吴玉昌,白洁.桂枝加厚朴杏子汤治疗咳嗽变异型哮喘37例[J].中华实用中西医杂志,2005,18(20)：1319-1320.
[23]魏文周,杨会,双袁玉.理肺止咳汤治疗嗜酸细胞性支气管炎36例[J].国际中医中药杂志,2007,29(3)：177.
[24]王敬碧.,小柴胡汤加减治疗久咳55例.实用中医杂志,2002：18(8)：86.
[25]年云娜.银翘散加减治疗慢性咳嗽的体会[J].中华临床新医学,2004,4(1)：61-62.
[26]高志姝,朱春晖.养阴清肺汤化裁治疗小儿慢性咽炎50例[J].江苏中医药,2005,26(12)：28.12
[27]吴剑辉.中西医结合治疗小儿慢性咳嗽疗效分析[J].广州医药,2000,31(3)：71-72.
[28]吴巧玲.耳穴贴压加艾灸治疗顽固性咳嗽[J].中国针灸,2001,21(10)：585
[29]张继红,赵藏朵,张慧岭.针刺加闪罐治疗顽固性咳嗽62例[J].陕西中医,2003,24(10)：928
[30]黄映君,刁本恕,王静安.“内外合治法”在儿科运用举隅.四川中医,2007,(25)4：3-4
[31]Morice AH and eonnnittee members.The diagnosis and management of Chronic cough.Eur Respir J,2004,24(3):481-492
[32]Mc Garvey LPA.Which investigations are most useful in the Diagnosis of chronic cough?Thorax,2004,59(4):342-346
[33]Lalloo UG. The cough reflex and the healthy smoker.Chest,2003,123(3):660-620.
[34]Irwin RS,Madison JM.AM J Med,2000,108(4A):1265-1305
[35]张红霞,李元霞.鼻后滴注综合征与小儿慢性咳嗽的关系探讨(附60例报告).陕西医学杂志2006.35(6)：711.
[36]张玉荣,王坚.鼻窦炎引起的儿童慢性咳嗽临床诊疗体会.中国当代儿科杂志.2008.10(1)：77-78.
[37]Brlghtling CE,et al.AM J Respir Crit Care Med,1999,160:406-410
[38]Brlghtling CE,Pavord ID.Cin Exp Allergy,2000,30:4-6
[39]Gamey IK,et al.AM J Respir Crit Care Med,1997,156:211-216
[40]Diepinigaitis PV.Cough in asthma and eosinophilic bronchitis.Thorax,2004, 59(1):71-72.
[41]Holinger LD,Sande～AD.Chronic cough in infants and children:all update(J).Laryngoseope,1991,101(6Pt1):596-605.
[42]赵顺英,任亦欣,江载芳.慢性孤立性咳嗽息儿50例病因和诊断程序(J).中国实用儿科杂志,2006,21(2)：109-111.
[43]刘峰,江米足,周雪莲等.小儿慢性咳嗽与胃食管反流的关系(J).临床儿科杂志,2007,25(6)：442-444.
[44]Irwin RS.AM J.Gastroenterol,2000,95:9
[45]Harding SM, Riehter JE.Chest.1997,111:1398
[46]Pitlanish ML,Sandatore JC,Wolford RW.Severe coughing and gagging episode in an adolescent with a chronie laryngotracheal foreign body.Cin Pediatr,1997,36(6)357-359
[47]Charles WC.Primary tracheomalacia and gastroesophageal reflux ininfants with cough.Clin Pediatr,1998,37(12):725-731
[48]陆权.非典型微生物感染与慢性咳嗽[J].中国实用儿科杂志,2004,19(2)：708-710.
[49]常健,鲁继荣,梁东等.肺炎支原体、肺炎衣原体感染与儿童慢性咳嗽相关性分析[J].临床儿科杂志,2007,25(6)：439-441.
[50]蒋玲珍,庞黎华,庞福珍.小儿慢性咳嗽与支原体感染[J].江西医药,2006,4l(8)：584-585.
[51]全国儿科哮喘防治协作组.儿童哮喘防治常规.中华儿科杂志,1998,(12)：747-751.
[52]张淑霞,李丽,王素丽等.89例小儿慢性咳嗽变应原检测的临床意义.中国优生与遗传杂志2008.16(1)121-122.
[53]董传莉,潘家华.儿童慢性咳嗽的研究进展.实用全科医学.2008.6(4)409-410.(胃食管返流病有一个)
[54]祝筱姬.咳嗽变异性哮喘的诊治进展[J].实用医药吸杂志,2005,22(4)：368-369.
[55]中华医学会呼吸病学分会哮喘学组.咳嗽的诊断与治疗指南(草案).中华结核和呼吸杂志.2006,29：96-99.
[56]Iehimura K,Sugimura H, Naito A,etal.How to manage patients with hard-to-reeognize postnasal drip[J].Rhinology,1999,37(4):164-167
[57]Evansk L Recognition and management of sinusitis[J].Dxugs,1998,56(1):59-71.
[58]Brightling CE,Pavord IDI Eosinoplic bronchitis 2 what is it andwhy is it important?Chin ExPAllergy,2000,30:4-1
[59]Birring SS,Berry M,Brightling CE,et al.Eosinophilic bronchitis:clinical features, Management and Pathogenesis[J].Am J ResPir Med,2003, 2(2):169-173,
[60]万莉雅.儿童慢性咳嗽与肺结核.临床儿科杂志.2007,25(6)：435-436.
[61]Tokar B,Ozkan R,Ilhan H.Traeheobronehial foreign bodies in children:impo～ ance of aeeurate history and plain chest radiography in delayed presentation[J].Clin Radiology,2004,59(7):609-615.
[62]胡又兰,雍燕.儿童慢性咳嗽的常见病因及其特异性治疗.上海医学2005.28(8)：717-718.
[63]丁国芳,万琳等,小儿慢性咳嗽.国外医学儿科学分册.1995,22(1)：16-18.
[64]马海燕,宫桂芳等,2327例小儿住院病人相关流行病学因素调查.中国民政医学杂志.1996,9(6)：340-342.
[65]黄沁.免疫药物学,上海：上海科技出版社,1988,第1版：145-146.
[66]于辉,李春香,宫凌涛,等.甘草的药理作用概述.现代生物医学进展,2006；6,(4)：77-79
[67]Haraguchi H,Tanimoto K,Tanmura Y,etal.Mode of antibacterial action of retrochalcones from Glycyrrhiza Inflata.Phyto-chemistry,1998,48(1):125-129.