加味麻杏石甘汤治疗小儿急性支气管炎风热犯肺证的临床研究

发布时间：2018-03-29 19:37

本文选题：加味麻杏石甘汤　切入点：小儿急性支气管炎　出处：《北京中医药大学》2012年硕士论文

【摘要】：急性支气管炎是小儿时期常见的一种呼吸道疾病,是病毒或细菌感染,物理化学刺激或过敏反应等对气管-支气管粘膜所造成的急性炎症。临床以咳嗽、咯痰为主要症状,双肺可闻及干罗音或不固定的湿罗音。本病可发生于任何季节,多见于寒冷季节,冬春季发病率明显增高。本病常继发于上呼吸道感染,并为麻疹、百日咳及其他急性传染病的一种临床表现。以婴幼儿时期发病较多、较重。根据本病临床表现,属中医“咳嗽”“喘证”等范畴,病因多为外感。风热犯肺多因小儿养护过温,衣着太厚,热伤于肺,兼感温热之邪,加之饮食调护不当,以致火热熏灼肺金。王俊宏主任医师从清热宣肺,止咳化痰的治疗原则入手,以加减麻杏石甘汤为基本方进行加减,用以治疗风热犯肺之肺热重症小儿急性支气管炎临床取得明显疗效。小儿急性支气管炎一般病程较短,但其严重影响患儿及其家长的日常生活,若治疗、调护不当,易于导致病情迁延或反复发作,从而影响患儿生长发育。本次临床研究主要为观察王俊宏主任运用加味麻杏石甘汤治疗风热犯肺之肺热重症小儿急性支气管炎的临床疗效。本论文包括文献综述和临床研究两部分内容。 1.文献综述分两部分：第一部分论述了祖国传统医学对小儿急性支气管炎的认识及研究概况,其中从小儿生理病理特点与小儿急性支气管炎的关系、古代中医医家对小儿急性支气管炎的认识、现代中医医家对小儿急性支气管炎的研究概况三部分进行阐述；第二部分论述了现代医学对小儿急性支气管炎的认识及研究概况。 2.临床研究目的：观察王俊宏主任医师运用加味麻杏石甘汤治疗风热犯肺型小儿急性支气管炎的临床疗效。方法：对符合纳入标准的65例风热犯肺型小儿急性支气管炎的病例随机分为治疗组31例,对照组34例。治疗组采用临证加减中药免煎颗粒剂治疗,对照组采用麻杏止咳糖浆治疗,观察并对比两组药物在用药后72小时、用药后7天患儿的症状、体征及证候表现改善情况,采用SPSS13.0统计软件进行统计学分析。结果： (1)治疗组在用药72小时、7天对咳嗽、咯痰的疗效均明显优于对照组(P0.05) (2)治疗组在缩短咳嗽、咯痰症状的病程上明显优于对照组(P0.05)； (3)治疗组在用药72小时、7天主症积分、次症积分及总积分改善方面均优于对照组(P0.05)： (4)治疗组在用药72小时、7天临床总疗效均明显优于对照组(P0.05)； (5)两组用药7天临床总疗效均优于用药72小时(P0.05)。结论：采用加味麻杏石甘汤治疗风热犯肺型小儿急性支气管炎在改善症状、缩短病程方面疗效显著,值得临床推广
[Abstract]:Acute bronchitis is a common respiratory disease in childhood. It is caused by viral or bacterial infection, physical and chemical stimulation or allergic reaction to the tracheobronchial mucosa. Both lungs can hear dry rales or wet rales. The disease can occur in any season and is more common in cold seasons. The incidence of this disease in winter and spring is significantly increased. The disease is usually secondary to upper respiratory tract infections and measles. A clinical manifestation of pertussis and other acute infectious diseases. The infantile period is more and more serious. According to the clinical manifestation of pertussis, it belongs to the category of TCM "cough" and "asthma syndrome", and the etiology is mostly exogenous. Most of the wind-heat offenses of the lungs are caused by the children's maintenance of excessive temperature, their clothing too thick, their injuries to the lungs, and the evil of feeling warm and hot, as well as the improper diet and nursing, which results in the burning heat and burning of the lungs. Chief physician Wang Junhong starts with the treatment principles of clearing away heat and dissipating the lungs, stopping coughing and resolving phlegm. To add and subtract maxingshigan decoction as the basic prescription for the treatment of severe acute bronchitis of children with lung fever caused by wind and heat, the clinical curative effect is obvious. The course of acute bronchitis in children is generally short, but it seriously affects the daily life of children and their parents. The main purpose of this clinical study was to observe the clinical effect of modified maxing Shigan decoction on acute bronchitis in children with severe pulmonary fever caused by wind and heat. This paper includes literature review. And clinical research. 1. Literature review. It is divided into two parts: the first part discusses the understanding and research of acute bronchitis in children in traditional Chinese medicine, including the relationship between the physiological and pathological characteristics of children and acute bronchitis in children. The understanding of acute bronchitis in children by ancient Chinese medicine doctors and the research survey of acute bronchitis in children by modern TCM doctors are described in three parts. The second part discusses the understanding and research situation of acute bronchitis in children in modern medicine. 2. Clinical studies. Objective: to observe the clinical effect of modified maxing Shigan decoction on acute bronchitis in children with wind and heat invasion. Methods: 65 children with acute bronchitis of wind-heat infantile pulmonary type were randomly divided into treatment group (n = 31) and control group (n = 34). The control group was treated with Maxingzhike syrup. The symptoms, signs and syndromes of the two groups were improved at 72 hours and 7 days after treatment. The statistical analysis was carried out by SPSS13.0 software. Results:. 1) the curative effect of cough and sputum in the treatment group was obviously better than that in the control group in 72 hours and 7 days. 2) the course of cough and sputum in the treatment group was significantly better than that in the control group (P 0.05); 3) the improvement of the main symptom score, the secondary symptom score and the total score in the treatment group were better than that in the control group in 72 hours and 7 days. 4) the total clinical efficacy of the treatment group was significantly better than that of the control group in 72 hours and 7 days. 5) the total curative effect of the two groups in 7 days was better than that in 72 hours (P 0.05). Conclusion: modified maxing Shigan decoction is effective in improving symptoms and shortening the course of disease in children with acute bronchitis of wind-heat infantile pulmonary type. It is worth popularizing in clinic.
【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】：2012
【分类号】：R272

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