温肺化痰合剂治疗风寒闭肺型毛细支气管炎的临床观察

发布时间：2018-06-07 06:20

  本文选题：毛细支气管炎 + 风寒闭肺型　； 参考：《湖北中医药大学》2012年硕士论文

【摘要】：毛细支气管炎,是一种2岁以下婴幼儿时期常见的下呼吸道感染疾病,尤其以2-6个月最为多见,主要为病毒感染引起,80%左右系病毒感染,58%为呼吸道合胞病毒(RSV)感染。临床以喘憋、气促和呼吸困难为主要特征。其症状如肺炎,且喘憋更著,病变常累及肺泡与肺泡间壁,故国内认为是毛细支气管炎一种特殊的肺炎,有人又称之为喘憋性肺炎。祖国医学多将其纳入“肺炎喘嗽”或“哮病”的范畴。毛细支气管炎多为病毒感染,中药治疗具有优势,成为中医儿科研究方向之一。有研究证实,使用中药联合西药治疗方案治疗小儿毛细支气管炎,在症状缓解、治疗时间及病后恢复等方面,效果均优于单纯西医治疗,临床疗效满意。 目的： 采用中药联合西药常规治疗的方案,观察中药联合西药常规治疗(治疗组)与西药常规治疗(对照组),治疗毛细支气管炎(风寒闭肺型)的临床疗效、缓解临床症状体征、血清RSV抗体阳性转阴情况、T细胞亚群(CD4%、CD8%、CD41/CD8)、免疫球蛋白E(IgE)、嗜酸性粒细胞(EOS)计数水平变化,并探讨其可能的作用机制。 方法： 本研究60例患儿均为武汉市儿童医院呼吸科、中医科住院患儿,均符合毛细支气管炎的西医诊断标准和中医风寒闭肺证候诊断标准,采用随机、对照方法,将其分为治疗组和对照组,治疗组30例,对照组30例,两组均均给予痰热清(0.5ml/Kg.1次/d)静点抗病毒、普米克(布地奈德)雾化吸入止咳平喘、常规叩背吸痰、退热等对症处理,入院后根据痰细菌培养结果以及药敏结果,合理选用抗生素,根据患儿缺氧情况,必要时予吸氧治疗。治疗组在上述治疗的基础上,口服温肺化痰合剂,七天为一疗程,观察1个疗程,进行疗效评定,并于停药后士5天后随访。 结果： (1)两组治疗前后在症状、体征消失时间上治疗组明显优于对照组(P0.01)； (2)两组治疗前血清RSV抗体阳性情况无显著差异性(P0.05),具有可比性,治疗后两组RSV抗体转阴情况比较,有显著性差异,治疗组效果优于对照组(P0.05)； (3)两组疗前CD4%、CD8%、CD4/CD8无显著性差异(P0.05),经过治疗后,两组患儿CD4%及CD4/CD8均有不同程度的升高,CD8%均有不同程度的降低,治疗组与对照组比较有非常显著性差异,治疗组效果明显优于对照组(P0.01)； (4)两组治疗前实验室指标IgE、EOS计数无显著差异性(P0.05),具有可比性,治疗后实验室指标IgE、EOS计数变化有显著性差异,治疗组效果优于对照组(P0.05)； (5)两组治疗前后中医症候疗效对比,总有效率治疗组90%,对照组66.67%,治疗组优于对照组(P0.05)； (6)治疗1周后,两组疾病疗效对比,总有效率治疗组93.33%,对照组73.33%,治疗组优于对照组(P0.05)。 结论： 此次临床观察说明根据中医辨证论治的原则,对风寒闭肺型毛细支气管炎采用中药联合西药常规治疗的方法治疗,结果说明中药治疗组在临床疗效、缓解临床症状体征、促进血清RSV抗体阳性转阴、改善T细胞亚群(CD4%、CD8%、CD41/CD8)、IgE、EOS计数指标方面明显优于单纯西药疗法的对照组。
[Abstract]:Bronchiolitis is a common lower respiratory tract infection of children under 2 years of age, especially for 2-6 months, mainly caused by virus infection, about 80% of the virus infection, and 58% of the respiratory syncytial virus (RSV) infection. The disease often involves the alveoli and the alveolar wall, so it is considered as a special pneumonia of bronchiolitis in China, and some people call it asthma suffocating pneumonia. The Chinese medicine is mostly included in the category of "pneumonia asthma" or "asthma". The bronchiolitis is mostly infected by virus, and the treatment of Chinese medicine has advantages, and it has become one of the research directions of traditional Chinese medicine. It has been proved that the effect of traditional Chinese medicine combined with western medicine in the treatment of bronchiolitis of children's bronchiolitis is better than that of simple western medicine in the treatment of symptoms, treatment time and recovery after the disease.
Objective:
The traditional Chinese medicine combined with western medicine routine treatment was used to observe the clinical efficacy of traditional Chinese medicine combined with western medicine routine treatment (treatment group) and Western medicine routine treatment (control group) to treat bronchiolitis (wind cold closed lung type), relieve clinical symptoms and signs, serum RSV antibody positive conversion, T cell subgroup (CD4%, CD8%, CD41/CD8), and immunoglobulin E (IgE), Eosinophil (EOS) counts were measured and the possible mechanisms of action were discussed.
Method锛，

本文编号：1990156