肃肺调脾饮治疗儿童咳嗽变异性哮喘（肺脾不调型）疗效观察

发布时间：2018-05-23 10:28

本文选题：咳嗽变异性哮喘 + 儿童　；参考：《山西医科大学》2017年硕士论文

【摘要】：目的:观察肃肺调脾饮治疗儿童咳嗽变异性哮喘(肺脾不调型)的临床疗效、远期疗效及复发率。方法:将符合儿童咳嗽变异性哮喘的西医诊断标准和肺脾不调型的中医证候标准,并且符合纳入标准和排除标准的60例咳嗽变异性哮喘(肺脾不调型)患儿,随机分为治疗组和对照组,两组均为30例,两组均给予健康教育。治疗组给予肃肺调脾饮,每次150ml,饭后温服,一日2次;对照组给予普米克都保(有效成分主要为布地奈德粉吸入剂),1次200ug,一日2次。两组的疗程均为8周。在临床研究过程中,两组均不服用与肃肺调脾饮作用相同或相近的中草药、中成药等。治疗前及治疗后,两组均行肺功能检查(肺通气功能、支气管激发试验),并记录咳嗽症状评分、中医证候评分及安全性观察指标(一般体检项目、血尿便常规、肝肾功能及临床不良反应、不良事件等);经统计学分析,评价肃肺调脾饮的疗效。治疗结束后,两组均剔除咳嗽疗效为无效的病例,随访3个月后行支气管激发试验并记录咳嗽症状评分及复发率。结果:疗效性评价:(1)对治疗组治疗前后咳嗽症状疗效和咳嗽症状积分进行比较,差异具有统计学意义。(2)中医证候疗效比较:治疗组总有效率为90.00%,对照组为73.33%,两组差异有统计学意义。(3)咳嗽症状疗效比较:治疗组总有效率为86.67%,对照组为90.00%,两组差异无统计学意义。(4)随访3个月后咳嗽疗效:治疗组总有效率为76.67%,对照组为50.00%,两组差异有统计学意义。(5)两组复发率:治疗组复发率为11.54%,对照组为37.04%,两组差异有统计学意义。(6)两组治疗前后肺功能指标比较(组内比较),差异均具有统计学意义;治疗后两组肺功能指标PEF、PD20FEV1.0水平差异无统计学意义,而FEV1.0及FVC水平差异具有统计学意义。安全性评价:治疗过程中,两组患儿的一般体检、血尿便常规、肝肾功能等检查项目未见异常,也未出现临床不良反应。结论:(1)肃肺调脾饮对儿童咳嗽变异性哮喘(肺脾不调型)治疗有效,且未发现临床不良反应;(2)肃肺调脾饮在改善咳嗽变异性哮喘(肺脾不调型)患儿中医证候、提高远期疗效及降低复发率上优于普米克都保;(3)肃肺调脾饮在改善咳嗽变异性哮喘(肺脾不调型)患儿的咳嗽症状上与普米克都保相当;(4)肃肺调脾饮可有效改善儿童咳嗽变异性哮喘(肺脾不调型)的肺功能,在降低气道高反应性和改善PEF水平上与普米克都保相当;但在改善FEV1.0及FVC的水平上,肃肺调脾饮劣与普米克都保。
[Abstract]:Objective: to observe the clinical effect, long-term effect and recurrence rate of Sufei Tiaopi decoction in treating cough variant asthma in children. Methods: 60 children with cough variant asthma (lung and spleen irregularity) were divided into two groups: the western medicine diagnostic criteria and the TCM syndromes of lung and spleen disorder, and 60 children with cough variant asthma (lung and spleen irregular) who were included in the criteria and excluded. Two groups were randomly divided into treatment group and control group, both groups were 30 cases, both groups were given health education. The treatment group was given Sufei Tiaopi decoction, 150 ml per time, 2 times a day after meals, and the control group was treated with budesonide powder inhaler (budesonide powder inhaler, 200ug1, 2 times a day). The course of treatment was 8 weeks in both groups. In the course of clinical study, the two groups did not take the same or similar effects of Sufei Tiaopi Yin, Chinese herbal medicine, Chinese patent medicine and so on. Before and after treatment, both groups underwent pulmonary function examination (pulmonary ventilation function, bronchial provocation test, cough symptom score, TCM syndromes score and safety observation index (general physical examination items, hematuria routine, etc.) Liver and kidney function, clinical adverse reactions, adverse events, etc. The curative effect of Sufei Tiaopi Yin was evaluated by statistical analysis. At the end of the treatment, the two groups were treated with bronchial provocation test and the cough symptom score and recurrence rate were recorded after 3 months follow-up. Results: the curative effect and the score of cough symptom were compared before and after treatment in the treatment group. Comparison of the curative effect of TCM Syndrome: the total effective rate in the treatment group was 90.00,73.33 in the control group, and the difference between the two groups was statistically significant. 3) comparison of cough symptom efficacy: the total effective rate of the treatment group was 86.67 and that of the control group was 90.00B. the difference between the two groups was poor. After 3 months follow-up, the total effective rate of cough was 76.67 in the treatment group and 50.00in the control group. The difference between the two groups was statistically significant. The recurrence rate was 11.54 in the treatment group and 37.04 in the control group. The difference between the two groups was statistically significant. There were significant differences in pulmonary function between the two groups before and after treatment. After treatment, there was no significant difference in pulmonary function between the two groups, but there was a significant difference in FEV1.0 and FVC levels between the two groups. Safety evaluation: in the course of treatment, the general physical examination, hematuria routine, liver and kidney function of the two groups were not abnormal, and there were no clinical adverse reactions. Conclusion Sufei Tiaopi Yin is effective in the treatment of children's cough variant asthma (lung and spleen irregular type), and no clinical adverse reaction is found in the treatment of children with cough variant asthma (lung and spleen irregular type). It can improve TCM syndromes of cough variant asthma (lung and spleen irregular type). To improve the long-term effect and reduce the recurrence rate is better than that of Pumike du Bao Pao (3) Sufei Tiaopi Yin can effectively improve the cough symptoms of children with cough variant asthma (lung and spleen non-regulation type) compared with Pumike du Bao Pao 4) Sufei Tiaopi Yin can effectively improve the cough symptoms of children with cough variant asthma (lung and spleen non-regulation type) Sufei Tiaopi Yin can be effectively improved. Lung function of cough variant Asthma in Children In reducing airway hyperresponsiveness and improving the level of PEF, Pulmicort is comparable to Pumike, but in improving the level of FEV1.0 and FVC, Sufei regulating spleen drink is inferior to Pumike.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R272

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