加味薯蓣丸膏方治疗小儿哮喘缓解期的临床观察

发布时间：2018-04-02 13:02

本文选题：加味薯蓣丸　切入点：膏方　出处：《湖北中医药大学》2017年硕士论文

【摘要】：目的:本研究通过观察加味薯蓣丸膏方治疗中医哮喘缓解期患儿中医症状及体征、免疫功能、微量元素、外周血嗜酸性粒细胞的自身前后对比及安全性指标等,旨在客观评价加味薯蓣丸膏方治疗小儿哮喘缓解期的临床疗效及安全性。方法:通过自身前后对照的临床试验设计,观察37例符合本研究要求的病例,冬至开始服用加味薯蓣丸膏方,疗程3个月,并进行随访1年,观察患儿治疗前后的中医症状及体征、哮喘发病次数及平均发作时间,呼吸道感染发病次数、病程和病种,外周血嗜酸性粒细胞、免疫球蛋白(Ig M、Ig G、Ig A)、微量元素(钙、锌、铁、铅、镁)的变化情况,及血常规、尿常规、肝功能(AST、ALT、γ-GT、ALP、TBIL)、肾功能(BUN、SCR、e GFR)、心电图等安全性指标。结果:(1)37例患儿中临床治愈4例(10.81%),显效12例(32.43%),有效16例(43.24%),无效5例(13.51%),总有效率为86.49%。(2)治疗后患儿主症积分均较治疗前下降,其中咳嗽、神疲乏力改善较明显,其差异具有统计学意义,P0.05;(3)治疗后患儿次症积分均较治疗前有所下降,其中反复感冒、形寒肢冷、潮热盗汗、口干咽燥、便秘较治疗前改善明显,差异具有统计学意义,P0.05,自汗、食少纳呆较治疗前改善显著,P0.01;其他症状与治疗前比较,差异无统计学意义,P0.05;(4)治疗后各中医证型总积分均较前改善,差异具有统计学意义,P0.05;其中肺脾气虚证总积分改善显著,差异具有统计学意义,P0.01;(5)治疗后哮喘每3个月发病次数及平均发作持续时间均较治疗前改善,差异具有统计学意义,P0.05;(6)治疗后患儿呼吸道感染发病次数等级、单次发病病程等级及单次发病病种等级均较治疗前有所下降,差异有统计学意义,P0.05;(7)治疗后患儿免疫球蛋白Ig A、Ig G较治疗前升高,差异具有统计学意义,P0.05;其中Ig A升高较显著,差异具有显著性差异,P0.01;Ig M较治疗前降低,差异具有统计学意义,P0.05;(8)治疗前后患儿外周血嗜酸性粒细胞计数无明显差异,P0.05。(9)治疗后患儿外周血钙含量较治疗前升高,P0.05,差异不具有统计学意义;铁、锌、铅、镁均较治疗前降低,P0.05,差异不具有统计学意义;(10)治疗后患儿血常规、尿常规、肝功能(AST、ALT、γ-GT、ALP、TBIL)、肾功能(BUN、SCR、e GFR)、心电图均未出现异常。结论:冬令服用加味薯蓣丸膏方治疗小儿哮喘缓解期,能够改善中医证侯,减少呼吸道感染发病次数,缩短呼吸道感染单次发病病程,降低呼吸道感染病种等级方面疗效明显,提高患儿免疫功能,减轻哮喘发作程度,减少哮喘发作次数,缩短哮喘发作病程,且在治疗过程中均未出现不良反应。说明服用加味薯蓣丸膏方从补益肺脾肾、祛痰化瘀疏风等方面能够有效改善哮喘患儿临床症状及体质,提高免疫功能,且具有良好的安全性。
[Abstract]:Objective: to observe the effect of modified Dioscorea Zingiberensis Pill on symptoms and signs of TCM, immune function, trace elements, eosinophil in peripheral blood and safety index in children with asthma.Objective to evaluate the clinical efficacy and safety of modified Dioscorea zingiberensis Pill recipe in the remission of childhood asthma.Methods: according to the clinical trial design, 37 cases were observed. The Winter Solstice began to take Dioscorea zingiberensis pill ointment for 3 months and followed up for 1 year.The symptoms and signs of traditional Chinese medicine (TCM) before and after treatment, the incidence times and average attack time of asthma, the incidence of respiratory tract infection, the course of disease, the eosinophil in peripheral blood, the immunoglobulin Ig MU Ig G G G An, trace elements (Ca, Zn, Fe), were observed before and after treatment.The changes of lead, magnesium, blood routine, urine routine, liver function, liver function, liver function, liver function, liver function, liver function, liver function, liver function, liver function, liver function, liver function, liver function, liver function, liver function, liver function, liver function, liver function, liver function, liver function, liver function, liver function, liver function, liver function, liver function, liver function, liver function.The difference was statistically significant (P 0.05) after treatment, the scores of secondary symptoms were all decreased, including repeated colds, cold limbs, hot flashes and night sweating, dry mouth and dry pharynx, and constipation. The difference was statistically significant (P 0.05), and the difference was significant (P 0.05).The difference was statistically significant (P 0.01) after treatment, the incidence times and the mean attack duration of asthma were improved every 3 months compared with those before treatment, and the difference was statistically significant (P 0.05) after treatment, the incidence of respiratory tract infection in children was higher than that before treatment.The grade of single disease course and the grade of disease type of single attack were lower than those before treatment, and the difference was statistically significant (P 0.05) the level of immunoglobulin IgA in children after treatment was higher than that before treatment, and the difference was statistically significant (P0.05. among them, the increase of IgA was significant.The difference was significant (P 0.01) Ig M was lower than that before treatment.There was no significant difference in eosinophil count in peripheral blood of children before and after treatment (P 0.05. 9). The calcium content in peripheral blood of children after treatment was higher than that before treatment (P 0.05), and the difference was not statistically significant, iron, zinc, lead, lead, iron, zinc, lead, iron, zinc, lead, iron, zinc, lead, iron, zinc, lead, iron, zinc, lead,After the treatment, the blood routine, urine routine, liver function and liver function of the children were all lower than those before treatment (P 0.05, P 0.05, P < 0.05). There was no abnormal electrocardiogram (ECG) in the patients with liver function, liver function, liver function, liver function, liver function, renal function and renal function.Conclusion: Dongling Dioscorea zingiberensis Pill can improve TCM syndrome, reduce the incidence of respiratory tract infection, shorten the course of single respiratory infection, and reduce the grade of respiratory tract infection.It can improve the immune function, reduce the degree of asthma attack, reduce the frequency of asthma attack, shorten the course of asthma attack, and no adverse reactions occurred in the course of treatment.It is concluded that taking Dioscorea zingiberensis Pill ointment can effectively improve the clinical symptoms and physique, improve the immune function and have good safety in the aspects of tonifying lung, spleen and kidney, expelling phlegm and removing blood stasis and thinning wind.
【学位授予单位】：湖北中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R272

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