儿童哮喘体质分型调查及咳喘平颗粒治疗的临床观察

发布时间：2018-10-16 14:32

【摘要】：1体质分型研究1.1目的:通过对哮喘患儿体质分型研究,观察哮喘儿童体质分布特点,为中医药干预哮喘提供依据。1.2方法:采用问卷调查方法,对数据进行汇总,归纳出中医证候的辨证要点,分析结果,以构成比描述。1.3结果:通过对118例哮喘患儿调查,结果显示哮喘患病率男性高于女性,男女比例1.3:1,冬春两季发病为主,呼吸道感染和天气变化为主要诱发因素。体质调查显示阳虚质34例,占(28.81%),气虚质30例,占(25.42%),特禀质28例,占(23.73%),痰湿质9例,占(7.63%),湿热质7例,占(5.93%),阴虚质5例,占(4.24%),平和体质3例,占(2.54%),血瘀质2例,占(1.69%)。1.4结论:哮喘患儿体质有明显倾向性,以阳虚质和气虚质为主。通过对哮喘患儿体质分型调查,了解哮喘患儿体质分布特点,可以有针对性的进行中医干预,减少哮喘发作。2.临床研究2.1目的:通过观察咳喘平颗粒治疗儿童哮喘急性发作期寒哮的临床症状、体征、综合疗效及对LTD4、LTE4的影响,探讨咳喘平颗粒治疗儿童哮喘急性发作期寒哮的临床疗效,为临床治疗儿童哮喘提供理论依据。2.2方法:将符合纳入标准的60例哮喘患儿,根据随机数字法分为两组,西药组30例,给予沙丁胺醇+布地奈德雾化基础治疗,中药+西药组30例,在西药组基础上加用咳喘平颗粒口服。疗程结束后,观察并比较两组患儿治疗前后综合疗效、中医证候积分及LTD4、LTE4的变化。2.3结果2.3.1综合疗效:中药+西药组临床痊愈10人,显效15人,有效3人,无效2人,有效率为93.3%。西药组临床痊愈9人,显效8人,有效5人,无效8人,有效率为73.3%。(P0.05),差异有统计学意义,说明两种治疗方法均有效,且中药+西药组优于西药组。2.3.2中医证候积分:两组治疗后中医证候总积分均较前降低,(P0.05),差异有统计学意义。说明两种治疗方法均能降低总积分,且中药+西药组优于西药组。在改善患儿咳嗽、气喘、胸闷、喉间痰鸣主要症状方面,两组单项积分均较前降低,(P0.05),两种治疗方法均能改善患儿哮喘症状,且中药+西药组优于西药组,(P0.05),差异有统计学意义。2.3.3实验室指标:经治疗两组LTD4、LTE4水平均较前降低,对于治疗后两组患儿LTD4、LTE4比较,(P0.05),差异有统计学意义,且中药+西药组优于西药组。2.4结论(1)咳喘平颗粒治疗寒性哮喘发作期,效果显著,能较好改善哮喘患儿咳嗽、气喘、胸闷、喉间痰鸣等症状,安全性好,无不良反应。(2)咳喘平颗粒能有效降低LTD4、LTE4水平,减少气道炎症反应。
[Abstract]:1. Objective: to observe the distribution characteristics of constitution in asthmatic children through the study of constitution classification of children with asthma, and to provide the basis for intervention of asthma by traditional Chinese medicine. 1.2 methods: questionnaire survey was used to collect the data. The main points of syndrome differentiation of TCM were summarized, and the results were described in terms of composition ratio. 1.3 results: by investigating 118 children with asthma, the results showed that the prevalence rate of asthma in men was higher than that in women, the ratio of male to female was 1.3: 1, and the incidence of asthma was mainly in winter and spring. Respiratory tract infection and weather change were the main predisposing factors. Physical investigation showed that there were 34 cases of Yang deficiency (28.81%), 30 cases of qi deficiency (25.42%), 28 cases of special nature (23.73%), 9 cases of phlegm dampness (7.63%), 7 cases of dampness and heat (5.93%), 5 cases of yin deficiency (4.24%), 3 cases of mild constitution (2.54%) and 2 cases of blood stasis. (1.69%) 1.4 conclusion: the physical constitution of asthmatic children has obvious tendency, mainly Yang deficiency and Qi deficiency. By investigating the constitution type of asthmatic children, we can know the distribution characteristics of asthmatic children's physique, and can carry on the Chinese medicine intervention to reduce the asthma attack. 2. Objective: to investigate the clinical effect of Kechuanping granule on acute asthma in children by observing its clinical symptoms, signs, comprehensive curative effect and effect on LTD4,LTE4. 2.2 methods: 60 asthmatic children who met the criteria were divided into two groups according to the random number method: the western medicine group (n = 30) was treated with basic atomization of salbutamol budesonide. 30 cases of western medicine group were treated with Kechuanping granule on the basis of western medicine group. After the course of treatment, we observed and compared the comprehensive curative effect, the score of TCM syndrome and the change of LTD4,LTE4 before and after the treatment. Results 2.3.1.Results the comprehensive curative effect was 2.3.1.Results in the Chinese medicine group, 10 patients were cured, 15 patients were significantly effective, 3 patients were effective and 2 patients were ineffective. The effective rate was 93.3gist. In the western medicine group, 9 patients were cured, 8 were effective, 5 were effective, 8 were ineffective, the effective rate was 73.33. (P0.05), the difference was statistically significant, indicating that the two treatment methods were effective. And the traditional Chinese medicine group is better than the western medicine group. 2.3.2 TCM syndrome integral: after treatment, the total score of TCM syndrome in the two groups were lower than before, (P0.05), the difference was statistically significant. These two methods can decrease the total integral, and the traditional Chinese medicine group is better than the western medicine group. In improving the main symptoms of cough, asthma, chest tightness and phlegm between the larynx, the single score of the two groups was lower than that of the former, (P0.05), the two treatment methods could improve the symptoms of asthma in children. And the Chinese medicine group is better than the western medicine group, (P0.05), the difference is statistically significant. 2.3.3 Laboratory index: after treatment, the level of LTD4,LTE4 in the two groups are lower than before, for the two groups after treatment, LTD4,LTE4 comparison, (P0.05), the difference is statistically significant. Conclusion (1) Kechuanping granule is effective in treating cold asthma in children with asthma, it can improve cough, asthma, chest tightness, phlegm between larynx and so on, and has good safety. No adverse reactions. (2) Kechuanping granule can effectively reduce the level of LTD4,LTE4 and reduce airway inflammation.
【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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