益气化痰法治疗小儿哮喘缓解期虚实夹杂证的研究

发布时间：2018-01-26 15:58

本文关键词： 哮喘缓解期中医药治疗虚实夹杂证益气化痰法　出处：《广州中医药大学》2012年硕士论文　论文类型：学位论文

【摘要】：背景哮喘是儿童期常见的呼吸道慢性疾病之一,其临床主要表现为反复发作性喘息、呼吸困难、胸闷或咳嗽。具有反复发作、迁延难愈的特点。现代医学认为哮喘的本质是气道慢性变态反应性炎症,随着吸入激素、B2受体激动剂、白三烯调节剂等新剂型、新药物的相继问世,哮喘的治疗较前更加完善。但长期应用仍存在一些不可忽视的问题,如：缓解期治疗效果欠佳、长期使用导致某些不可避免的副作用以及某些药物对儿童哮喘的疗效欠佳,很难达到预期的效果等等。在寻找新的更有效的治疗方法的过程中,中医中药逐渐凸显出了其特色。中医认为,伏痰为哮喘宿根,且小儿“成而未全,全而未壮”的脏腑功能决定了小儿脾胃虚弱的特点,“脾为生痰之源”,而小儿不合理的喂养方式,更易化生痰浊,损伤脾气,故临床上小儿哮喘缓解期多见肺脾气虚,痰浊内蕴之虚实夹杂症。因此研究益气化痰法治疗小儿哮喘缓解期的临床有效性具有重要意义。目的本研究采用益气化痰法中成药及安慰剂随机双盲对照治疗小儿哮喘缓解期虚实夹杂证,进行有效性及安全性比较,旨在为益气化痰法治疗小儿哮喘缓解期虚实夹杂证的有效性及安全性提供科学依据。方法本研究作为二期临床药物试验的一部分,采用随机对照的临床试验设计,选择2010年3月到2011年7月到广东省中医院儿科门诊就诊的,符合诊断和纳入标准的哮喘缓解期中医辨证为虚实夹杂证的儿童54例,并采用随机双盲法将其分为益气化痰中药组和安慰剂组,各治疗4周,并分别在治疗前,治疗后2周及4周后进行症状与舌脉分级量化表、C-ACT表的记录及控制情况的评估；治疗前后检测-般安全性项目,及记录不良反应的发生。结果 1.主症量表评分,治疗2周后,评分显著下降(由治疗前的5.72±3.29下降至2.48±3.43,p0.05),即两周后症状有改善并起效；治疗4周后降为0.64±1.11分(p0.05),通过统计得出治疗有效率92%,与安慰剂组比较(p0.05),统计学比较有显著异常。 2.肺功能在治疗4周后,评分显著下降(由治疗前0.72±1.51下降至0.04±0.20,p0.05),与安慰剂组相比较(p0.05),统计学比较有显著异常。 3.治疗前后通过C-ACT表评分比较,无论是孩童自测或者是家长测评,治疗4周后,评分显著上升(p0.05),且与安慰剂组相比较(p0.05),统计学比较有显著异常。结论益气化痰法对于缓解哮喘缓解期虚实夹杂证的主症(日间症状、夜间症状、受限及药物使用)及改善肺功能疗效显著。
[Abstract]:Background Asthma is one of the common chronic respiratory diseases in childhood. Its clinical manifestations are recurrent wheezing, dyspnea, chest tightness or cough. Modern medicine believes that the essence of asthma is chronic allergic inflammation of the airway. With the inhalation of hormone B _ 2 receptor agonist, leukotriene regulator and other new dosage forms, new drugs have emerged. The treatment of asthma is more perfect than before, but there are still some problems that can not be ignored in long-term application, such as: the effect of remission treatment is not good. Long-term use leads to certain unavoidable side effects and the poor efficacy of certain drugs in children's asthma, it is very difficult to achieve the desired results, etc. In the search for new and more effective treatment. Traditional Chinese medicine gradually highlights its characteristics. TCM believes that phlegm is the root of asthma, and the function of the viscera of children "complete but not complete, complete but not strong" determines the characteristics of weakness of the spleen and stomach in children, and "spleen is the source of sputum". But the unreasonable feeding way of children is more easy to degenerate phlegm turbid and injure the temper. Therefore the deficiency of lung and spleen qi is more common in the remission period of children asthma. Therefore, it is of great significance to study the clinical efficacy of tonifying qi and removing phlegm in the remission period of asthma in children. Purpose In this study, Chinese patent medicine and placebo were used to treat asthenia and excess of asthmatic children in remission period, and the efficacy and safety were compared. The aim is to provide scientific basis for the efficacy and safety of tonifying qi and removing phlegm in treating asthenia and deficiency syndrome in children with asthma in remission period. Method As part of the second phase clinical drug trial, this study selected the paediatric outpatients of Guangdong traditional Chinese Medicine Hospital from March 2010 to July 2011, using a randomized controlled clinical trial design. Fifty-four children with asthmatic remission syndrome were divided into two groups randomly by double blind method: the traditional Chinese medicine group and the placebo group. Before treatment, 2 weeks and 4 weeks after treatment, the records and control of C-ACT were evaluated. Pre-and pre-treatment testing-general safety items, and record adverse reactions. Results 1. After 2 weeks of treatment, the score of the main symptom scale decreased significantly (from 5.72 卤3.29 before treatment to 2.48 卤3.43 p0.05), that is, the symptoms improved and became effective two weeks later; After 4 weeks of treatment, it was reduced to 0.64 卤1.11 minutes (p 0.05). The effective rate of treatment was 92%, which was significantly abnormal compared with the placebo group. 2. Pulmonary function decreased significantly after 4 weeks of treatment (from 0.72 卤1.51 before treatment to 0.04 卤0.20 p0.05g, compared with placebo group). There were significant abnormalities in statistics. 3.Compared with the C-ACT scale before and after treatment, the scores of children were significantly increased after 4 weeks of treatment, no matter whether it was self-test or parents' evaluation (p 0.05). Compared with the placebo group, there was significant statistical abnormality. Conclusion The method of tonifying qi and resolving phlegm is effective in relieving the main symptoms (daytime symptom, nocturnal symptom, restriction and drug use) and improving lung function of asthmatic asthenia and solid inclusion syndrome.
【学位授予单位】：广州中医药大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R272.6

【参考文献】