脱敏平喘颗粒治疗过敏性鼻炎—哮喘综合征临床疗效研究

发布时间：2018-03-06 08:15

本文选题：过敏性鼻炎-哮喘综合征　切入点：脱敏平喘颗粒　出处：《北京中医药大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:过敏性鼻炎-哮喘综合征发病率逐年升高,已成为全球性健康问题,目前现有中西医治疗方法仍存在诸多弊端,导致病情反复发作,迁延不愈。脱敏平喘颗粒是国医大师王琦教授治疗过敏性鼻炎-哮喘综合征的经验性用方,本研究旨在通过设立随机对照试验,研究脱敏平喘颗粒治疗过敏性鼻炎-哮喘综合征有效性及安全性,为进一步临床推广提供确证性证据。方法:收集2016年5月至2017年2月就诊于北京中医药大学第三附属医院呼吸科门诊,西医诊断符合过敏性鼻炎-哮喘综合征,支气管哮喘属于急性发作期(轻、中度)或慢性持续期(轻、中度持续),过敏性鼻炎属季节性或持续性(轻或中-重度),中医辨证分型符合肺热怫郁证患者60例。采用随机、对照研究方法,按1:1比例分成治疗组和对照组。对照组给予吸入布地奈德福莫特罗粉吸入剂和口服孟鲁司特钠片治疗。治疗组在此基础上加服脱敏平喘配方颗粒。疗程均为2周。分别于治疗前、后采集两组患者中医证候评分、肺功能检查以及各项安全性指标。并于治疗前及4周后采集两组ACT评分。数据结果使用Microsoft Excel建立数据库,采用SPSS 21.0进行统计分析。结果:中医总体疗效,治疗组总有效率为92.86%,对照组总有效率为73.08%,两组比较具有显著性差异(P0.05)。中医单项症状积分,治疗组降低喘息、胸闷、鼻塞、鼻痒、喷嚏、咽痒、眼痒单项积分优于对照组,差异具有统计学意义(P0.05);两组在咳嗽、流涕、咳痰症状积分无明显差异(P0.05)。鼻炎疗效,治疗组有效率为96.43%,对照组有效率为50%,治疗组显著高于对照组(P0.05)。ACT评分,治疗组治疗后完全控制病例2例,部分控制病例21例,未控制病例5例,对照组无完全控制病例,部分控制病例15例,未控制病例11例。治疗后两组数据进行组间比较,差异具有统计学意义(P0.05)。肺功能结果,对照组 PEF(%)显著增加(P0.05),FEV1(%)、FVC(%)、FEV1/FVC与治疗前比较无显著性差异(P0.05);治疗组FEV1(%)、PEF(%)显著增加(P0.05),FVC(%)、FEV1/FVC与治疗前比较无明显差异(P0.05)。治疗后两组间比较,治疗组FEV1(%)优于对照组(P0.05),FVC(%)、PEF(%)、FEV1/FVC与对照组无显著性差异(P0.05)。结论:脱敏平喘颗粒颗可有效缓解过敏性鼻炎及哮喘症状,改善肺功能,提高ACT评分,改善患者生活质量,提高综合疗效。同时治疗前后血常规、尿常规、肝肾功能检查未见明显变化,治疗过程中无不良反应事件,可广泛应用于临床。
[Abstract]:Objective: the incidence of allergic rhinitis and asthma syndrome has been increasing year by year and has become a global health problem. Desensitized Pingchuan granule is an empirical prescription for allergic rhinitis and asthma syndrome treated by Professor Wang Qi, a master of Chinese medicine. The purpose of this study was to establish a randomized controlled trial. To study the efficacy and safety of desensitized Pingchuan granule in the treatment of allergic rhinitis asthma syndrome. Methods: from May 2016 to February 2017, the clinic of respiratory department of the third affiliated Hospital of Beijing University of traditional Chinese Medicine was collected. The diagnosis of western medicine was consistent with allergic rhinitis and asthma syndrome. Bronchial asthma belongs to acute attack (mild, moderate) or chronic persistent (mild, moderate persistent), allergic rhinitis is seasonal or persistent (mild or moderate to severe). Comparative study methods, The control group was treated with inhaled budesonide formoterol powder inhalation and oral montelukast sodium tablets. The treatment group was treated with desensitized antiasthmatic granules on this basis. The course of treatment was 2 weeks. Before treatment, The scores of TCM syndromes, pulmonary function and various safety indexes were collected from two groups of patients. The scores of ACT were collected before and 4 weeks after treatment. The data were established by Microsoft Excel. Results: the total effective rate of the treatment group was 92.86, the total effective rate of the control group was 73.08, the difference between the two groups was significant (P 0.05). The single score of sneeze, pharyngoitch and eye itching was better than that of the control group, the difference was statistically significant (P 0.05), and there was no significant difference in the score of cough, runny and expectoration between the two groups (P 0.05). The effective rate of the treatment group was 96.43 and the effective rate of the control group was 50. The effective rate of the treatment group was significantly higher than that of the control group (P 0.05N. ACT score). After treatment, 2 cases were completely controlled in the treatment group, 21 cases were partially controlled cases, 5 cases were uncontrolled cases, and the control group had no complete control cases. There were 15 cases of partially controlled cases and 11 cases of uncontrolled cases. After treatment, the difference between the two groups was statistically significant (P 0.05). There was no significant difference in FEV1 / FVC between before and after treatment in the control group (P 0.05), but there was no significant difference in FEV1 / FVC between before and after treatment in the treatment group (P 0.05). There was no significant difference in FEV1 / FVC between the two groups after treatment. There was no significant difference between the treatment group and the control group in FEV1 / FVC. Conclusion: desensitized Pingchuan granule can effectively relieve allergic rhinitis and asthma symptoms, improve lung function, improve ACT score, and improve the quality of life of the patients. At the same time, blood routine, urine routine, liver and kidney function before and after treatment were not obviously changed, and there were no adverse events in the course of treatment, so they can be widely used in clinical practice.
【学位授予单位】：北京中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R276.1;R256.12

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