咳喘平颗粒对风寒闭肺型毛细支气管炎的临床疗效和安全性观察

发布时间：2018-08-04 10:54

【摘要】：目的:本研究旨在观察咳喘平颗粒治疗风寒闭肺型毛细支气管炎患儿的临床疗效及安全性,主要对中医证候积分和综合疗效进行评估,同时对患儿外周血血清I L-4、I L-1 7水平进行检测,初步探讨咳喘平颗粒治疗小儿毛细支气管炎的作用机制,为毛细支气管炎的临床治疗提供理论依据。方法:选取符合本研究标准的毛细支气管炎患儿6 0例,运用随机数字法分为观察组和对照组,每组各3 0例,两组均予以西医常规治疗,其中观察组在西医常规治疗的基础上加予咳喘平颗粒口服。两组均以7天为1个疗程,1个疗程结束后,观察两组患儿中医证候积分、综合疗效及药物不良反应;同时两组在治疗前1天和治疗最后1天分别检测患儿外周血血清I L-4水平、I L-1 7水平、血常规、肝功能、肾功能、尿常规及大便常规,旨在观察咳喘平颗粒治疗风寒闭肺型毛细支气管炎患儿的临床疗效、安全性及初步探讨其作用机制。结果:1.总疗效比较:观察组的总有效率为9 6.6 7%,对照组的总有效率为8 0.0 0%,两组的总有效率相比较,差异有统计学意义(p0.0 5),提示两组治疗后均能显著提高风寒闭肺型毛细支气管炎患儿的临床疗效,且观察组优于对照组。2.中医证候总积分比较:两组患儿中医证候总积分治疗后均较治疗前低,差异均有统计学意义(p0.0 5)。治疗后两组组间中医证候总积分相比较,差异有统计学意义(p0.0 5)。提示两组治疗后均可显著改善风寒闭肺型毛细支气管炎患儿的临床症状和体征,且观察组优于对照组。3.中医各主要证候积分比较:两组患儿中医各主要证候积分治疗后均较治疗前低,差异均有统计学意义(p0.0 1或p0.0 5);且两组组间气喘、咳嗽、痰鸣三个主要证候积分相比较,观察组优于对照组(p0.0 5)。4.中医各次要证候积分比较:两组患儿中医各次要证候积分治疗后均较治疗前低,差异均有统计学意义(p0.0 1或p0.0 5);且两组组间鼻翼煽动、口唇青紫两个次要证候积分相比较,观察组优于对照组(p0.0 5)。5.外周血血清I L-4和I L-1 7比较:治疗前后两组组内患儿血清I L-4、I L-1 7水平相比较,差异均有统计学意义(p0.0 5),提示两组均可降低患儿血清I L-4、I L-1 7水平;治疗后两组组间患儿血清I L-4、I L-1 7水平相比较,观察组优于对照组(p0.0 5)。6.安全性观察:本研究过程中,6 0名患儿未出现严重的不良反应,仅对照组有2例患儿出现一过性腹泻、呕吐,未予处理后症状很快消失。同时两组在治疗前后对患儿进行安全性指标的检测,结果提示血常规、肝功能、肾功能、尿常规及大便常规均未见异常。本研究表明咳喘平颗粒在治疗风寒闭肺型毛细支气管炎患儿的过程中安全可靠。结论:1.咳喘平颗粒可明显改善风寒闭肺型毛细支气管炎患儿中医证候积分、增强患儿体质,提高临床综合疗效。2.咳喘平颗粒能降低患儿外周血血清I L-4、I L-1 7水平,提示咳喘平颗粒治疗风寒闭肺型毛细支气管炎患儿的机制可能是调节T h 1/T h 2平衡失调、减轻气道炎症。3.咳喘平颗粒安全性好,值得在临床上推广应用。
[Abstract]:Objective: the purpose of this study was to observe the clinical efficacy and safety of Ke Chuan Ping granules in the treatment of children with wind cold and pulmonary bronchiolitis, mainly to evaluate the TCM syndrome integral and comprehensive effect, and to detect the level of I L-4 and I L-1 7 in the peripheral blood serum of the children, and discuss the effect of Ke Chuan Ping Granule on the treatment of bronchiolitis in children. The mechanism is to provide theoretical basis for the clinical treatment of bronchiolitis. Methods: 60 children with bronchiolitis were selected in accordance with the standard of this study, and were divided into the observation group and the control group by random number method, 30 cases in each group, and the two groups were treated with western medicine routine treatment. The observation group was added to the cough and asthma Granule on the basis of the routine treatment of Western medicine. The two groups were treated with 7 days as 1 courses. After the 1 course of treatment, the scores of TCM syndromes, comprehensive curative effect and drug adverse reaction were observed in the two groups. At the same time, the level of I L-4 in the peripheral blood serum, the level of I L-1 7, the blood routine, the liver function, the renal function, the routine urine and the routine stool routine were observed in the two groups in the 1 days before the treatment and the last 1 days of treatment. The clinical efficacy, safety and preliminary discussion of the effect mechanism of CHD Chan Ping granule in the treatment of children with bronchiolitis with wind cold and closed pulmonary bronchitis. Results: 1. total effective effect was compared: the total effective rate of the observation group was 96.67%, the total effective rate of the control group was 80%, the total effective rate of the two groups was compared, the difference was statistically significant (p0.0 5), suggesting the two groups of treatment. The latter can significantly improve the clinical efficacy of the children with bronchiolitis of wind cold and pulmonary bronchiolitis, and the observation group is better than the control group.2. TCM syndrome total score: the two groups of children's TCM syndromes after total integral treatment are lower than before the treatment, the difference is statistically significant (p0.0 5). After the treatment of the two groups of TCM syndromes, the difference is statistically significant. Study significance (p0.0 5). The clinical symptoms and signs of the children with wind cold and bronchiolitis were significantly improved after the treatment of two groups, and the observation group was better than the control group.3.. The scores of the main syndromes in the two groups were lower than those before the treatment, the difference was statistically significant (p0.0 1 or p0.0 5). And the two groups of asthma, cough, phlegm, three main syndrome scores compared, the observation group was better than the control group (p0.0 5).4. traditional Chinese medicine syndrome score comparison: the two groups of children's secondary syndrome scores after treatment were lower than before the treatment, the difference was statistically significant (p0.0 1 or p0.0 5); and two groups of nasal alar incitement, lip and purple two times. To compare the syndrome score, the observation group was better than the control group (p0.0 5).5. peripheral blood serum I L-4 and I L-1 7. The difference of serum I L-4 and I L-1 7 in the two groups of children before and after treatment was statistically significant (p0.0 5), suggesting that the two groups could reduce the serum I levels and 7 levels of the children. Compared with the 7 level, the observation group was better than the control group (p0.0 5).6. safety observation: in the course of this study, 60 children had no serious adverse reactions, only 2 cases in the control group had an excessive diarrhea, vomiting, and the symptoms disappeared quickly after the treatment. At the same time, the safety indexes were detected in the two groups before and after treatment, and the results were suggested. Blood routine, liver function, renal function, urine routine and stool routine are not abnormal. This study shows that the cough and asthma granule is safe and reliable in the treatment of children with wind cold and pulmonary bronchiolitis. Conclusion: 1. cough and Chuan Ping granules can obviously improve the TCM syndrome score of wind cold closed pulmonary bronchiolitis, enhance the physique of the children and improve the prognosis. The comprehensive therapeutic effect of.2. Ke Chuan Ping granule can reduce the serum serum I L-4 and I L-1 7 level in the peripheral blood of the children. It is suggested that the mechanism of the cough and Chuan Ping granule in treating the children with wind cold closed pulmonary bronchiolitis may be the regulation of T h 1/T H 2 balance imbalance, the safety of the airway inflammation.3. cough and asthma granule, and it is worthy of clinical application.
【学位授予单位】：安徽中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R272

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