穴位敷贴辅助治疗小儿哮喘不同中医证型的临床疗效观察

发布时间：2018-05-06 21:21

本文选题：穴位敷贴 + 支气管哮喘　；参考：《广州中医药大学》2012年硕士论文

【摘要】：支气管哮喘是一种慢性气道炎症性疾病,呈反复发作,近年来哮喘患病率有所上升,影响患儿缺课率升高、活动受到限制、影响社交能力等,对儿童的发育和成长十分不利。临床上穴位敷贴在防治支气管哮喘方面历史悠久,用于哮喘慢性持续期、临床缓解期,预防哮喘的复发有明确的疗效。研究目的：本研究旨在应用许华教授临床经验方(穴位敷贴I方)配合西医治疗方案,治疗支气管哮喘慢性持续期分属不同中医证型(冷哮、热哮)的患儿,观察治疗前后的临床症状与体征,以评估临床疗效,探讨穴位敷贴治疗支气管哮喘的不同证型的针对性,为支气管哮喘慢性持续期进行穴位敷贴的选药、选穴的进一步研究提供客观依据。方法：将冷哮30例患儿按1：1随机分为治疗组和对照组。冷哮治疗组、冷哮对照组各15例；热哮30例患儿按以上方法,分为热哮治疗组、热哮对照组各15例。治疗组给予穴位敷贴隔天一次,每次2-4小时,并每天给予西医治疗；对照组每天给予西医治疗。疗程3周。比较各组治疗前后哮喘主要症状和体征积分,并进行组间比较；评估治疗第3周哮喘控制水平；记录敷贴后皮肤不良反应。所有的研究数据输入计算机,运用SPSS19.0统计软件统计分析结果。结果： 1、自身前后对比,四组症状、体征积分治疗第3周较治疗前明显下降,差异均有统计学意义(P0.05)。说明各组治疗均可减轻哮喘慢性持续期症状及特征。 2、组间对比,治疗第1周,冷哮治疗组症状、体征积分较冷哮对照组明显下降,差异有统计学意义(P0.05)；热哮治疗组积分较热哮对照组明显下降,差异有统计学意义(P0.05)；冷哮治疗组积分与热哮治疗组差异无统计学意义。治疗第2周及第3周,各组症状、体征积分无显著性差异(P0.05)。说明穴位敷贴辅助治疗缓解症状时间更迅速；而长期效果趋于相近,该穴位敷贴对冷哮、热哮均有效。 3、治疗第3周各组有效率比较,差异无统计学意义(P0.05)。 4、治疗第3周比较各组的哮喘控制水平,冷哮治疗组、热哮治疗组分别与对照组比较,控制的例数明显多,但各组差异无统计学意义(P0.05)。 5、60例患儿使用穴位敷贴,未发现所贴皮肤处疼痛、水泡及皮肤过敏等严重不良反应。结论：在哮喘长期治疗方案基础上,穴位敷贴配合相应穴位,能有效、迅速的减轻慢性持续期哮喘患儿的主要临床症状,帮助哮喘慢性持续期患儿更快达到控制水平,且对冷哮、热哮患儿有相近疗效。穴位敷贴有效、安全、方便、依从性好,值得在临床推广应用。
[Abstract]:Bronchial asthma is a kind of chronic airway inflammatory disease. In recent years, the prevalence rate of asthma has increased, which affects children's absenteeism rate, limited activities, social ability and so on, which is very unfavorable to the development and growth of children. Acupoint application has a long history in the prevention and treatment of bronchial asthma. It is used in the chronic duration, clinical remission and prevention of asthma recurrence. Objectives of the study: The purpose of this study was to apply Professor Xu Hua's clinical experience prescription (acupoint application of I prescription) in combination with western medicine to treat children with bronchial asthma of chronic duration belonging to different TCM syndromes (cold asthma, heat asthma). The clinical symptoms and signs before and after treatment were observed in order to evaluate the clinical efficacy, to explore the pertinence of different syndrome types of bronchial asthma treated by acupoint application, and to select the drugs for the chronic duration of bronchial asthma. The further study on the selection of acupoints provides an objective basis. Methods: Thirty children with cold asthma were randomly divided into treatment group and control group according to 1:1. There were 15 cases in the cold asthma group and 15 cases in the cold asthma control group, and the 30 cases in the heat asthma group were divided into the heat asthma treatment group and the heat asthma control group according to the above methods. The treatment group was given acupoint application every other day for 2-4 hours, and the control group was treated with western medicine every day. The course of treatment was 3 weeks. The main symptoms and signs of asthma before and after treatment were compared and compared between groups; the control level of asthma was evaluated at the 3rd week of treatment; adverse skin reactions were recorded after application. All the research data were input into the computer and the statistical results were analyzed by SPSS19.0 statistical software. Results: 1. Compared with before and after treatment, the scores of symptoms and signs in the four groups decreased significantly in the third week compared with those before treatment, and the differences were statistically significant (P 0.05). The results showed that the symptoms and characteristics of chronic duration of asthma could be alleviated by the treatment of each group. 2, comparison between groups, in the first week of treatment, the scores of symptoms and signs in the cold asthma treatment group were significantly lower than those in the cold asthma control group, the difference was statistically significant (P 0.05), and the score in the heat asthma treatment group was significantly lower than that in the heat asthma control group. The difference was statistically significant (P 0.05), but there was no significant difference between the cold asthma treatment group and the heat asthma treatment group. At week 2 and week 3, there was no significant difference in the scores of symptoms and signs in each group (P 0.05). The results showed that the treatment of acupoint application was more rapid in relieving symptoms, but the long-term effect tended to be similar. The acupoint application was effective for cold wheezing and heat wheezing. 3. There was no significant difference in the effective rate of each group at the third week of treatment (P 0.05). 4. At the 3rd week of treatment, the control level of asthma in each group was compared. Compared with the control group, the cases of cold asthma treatment group and heat asthma treatment group were significantly higher than that of control group, but there was no significant difference in each group (P 0.05). There were no severe adverse reactions such as skin pain, blisters and skin allergies. Conclusion: On the basis of long-term treatment of asthma, acupoint application combined with corresponding acupoints can effectively and rapidly alleviate the main clinical symptoms of children with chronic persistent asthma, and help children with chronic asthma to reach the level of control faster, and to cold asthma. Children with heat wheezing have similar curative effect. Acupoint application is effective, safe, convenient and good compliance. It is worth popularizing in clinic.
【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

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