儿童益肺膏治疗小儿哮喘缓解期脾肺气虚证的临床研究

发布时间：2018-10-31 18:19

【摘要】：本研究依照随机、对照的原则,在武汉市中医医院,对儿童益肺膏治疗小儿哮喘缓解期肺脾气虚证的有效性、安全性进行了系统观察,本研究目前仍在进行中,现将2015年12月至2017年2月间疗程满6周后并观察1年的病例进行统计分析,共80例哮喘缓解期脾肺气虚型患儿,治疗组40例、对照组40例。目的:采取随机、对照的临床研究方式,观察对比儿童益肺膏和西医对照药物两种不同治疗方案下的疗效,客观评价儿童益肺膏用于哮喘缓解期,在提高哮喘控制水平、减轻中医症候积分等方面的有效性和安全性。方法:采取随机、对照的研究方法,对80例哮喘缓解期脾肺气虚型患儿进行临床研究,治疗组采用儿童益肺膏口服治疗;对照组采用西医对照药物,疗程均为6周。疗程结束后对两组患儿哮喘控制水平、C-ACT评分、中医证候积分等进行评价,两组治疗前后相关实验室指标和治疗结束半年后及一年后有效率进行比较。采纳统计软件SPSS 17.0对数据结果进行分析,包括x~2检验、t检验、Kruskal Wallis H检验。结果:(1)治疗后治疗组、对照组总有效率分别为82.5%、62.5%,两组比较有统计学意义(P0.05);(2)治疗后两组C-ACT评分平均值均有上升,两组C-ACT评分治疗前后比较有统计学意义(P0.05),治疗组与对照组治疗后比较有统计学意义(P0.05);(3)两组治疗后中医症候积分平均值均有下降,治疗组治疗后中医症候积分评分与治疗前相比有统计学意义(P0.05),与对照组治疗后中医症候积分比较有统计学意义(P0.05);(4)两组对FEV1、PEF均有改善作用,每组治疗前后比较均有统计学意义(P0.05),且两组治疗后比较均有统计学意义(P0.05);(5)两组治疗后IgE水平均有下降,IgG、IgM水平均有上升,治疗组治疗前后比较有统计学意义(P0.05);(6)两组治疗后血嗜酸性粒细胞计数均有明显降低,与本组治疗前比较差异有统计学意义(P0.O5),治疗组与对照组治疗后比较差异有统计学意义(P0.O5);(7)两组在治疗半年后、一年后有效率均有上升,但是对照组治疗有效率与同期对照组比较有统计学意义(P0.O5)。结论:小儿哮喘缓解期脾肺气虚证应用儿童益肺膏,减轻哮喘发作程度,减低哮喘C-ACT评分,提高哮喘控制水平,调节患儿免疫功能,改善其肺功能,说明儿童益肺膏可以达到防治哮喘缓解期脾肺气虚证的目的,具有极高的临床应用价值,值得推广。
[Abstract]:According to the principle of randomness and control, this study made a systematic observation on the efficacy and safety of children's Yifei ointment in treating asthmatic patients with deficiency of lung and spleen qi in the hospital of traditional Chinese medicine of Wuhan City, and this study is still in progress. From December 2015 to February 2017, 80 children with spleen and lung qi deficiency in remission of asthma were statistically analyzed, 40 in treatment group and 40 in control group after 6 weeks of treatment from December 2015 to February 2017. Objective: to observe and compare the therapeutic effects of children's Yifei ointment and western medicine in different therapeutic schemes, and to evaluate objectively the therapeutic effect of children's Yifei ointment in asthma remission period, and to improve the asthma control level. Reduce the effectiveness and safety of TCM symptom score. Methods: a randomized, controlled study was carried out in 80 children with asthmatic remission of spleen and lung qi deficiency. The treatment group was treated with Yifei ointment orally, while the control group was treated with western medicine for 6 weeks. The asthma control level, C-ACT score, TCM syndrome score and so on were evaluated after the course of treatment. The laboratory indexes before and after treatment and the effective rate six months after treatment and one year after treatment were compared between the two groups. The statistical software SPSS 17.0 was used to analyze the data, including x2 test and t-test, Kruskal Wallis H test. Results: (1) in the treatment group, the total effective rate of the control group was 82.5 and 62.5, respectively. There was statistical significance between the two groups (P0.05). (2) after treatment, the average C-ACT scores of the two groups increased, the C-ACT scores of the two groups were statistically significant before and after treatment (P0.05), the treatment group and the control group after treatment had statistical significance (P0.05); (3) the mean scores of TCM symptom scores in the two groups were decreased after treatment, and the scores of TCM symptom scores in the treatment group were significantly higher than those before treatment (P0.05). Compared with the control group after treatment, TCM symptom score had statistical significance (P0.05). (4) FEV1,PEF was improved in both groups, there was significant difference before and after treatment (P0.05), and there was significant difference after treatment (P0.05). (5) the level of IgE decreased and the level of IgG,IgM increased after treatment in both groups. There was statistical significance before and after treatment in treatment group (P0.05). (6) after treatment, the eosinophil count in the two groups was significantly lower than that before treatment (P0.O5), and there was a significant difference (P0.O5) between the treatment group and the control group after treatment. (7) after six months of treatment, the effective rate of the two groups increased after one year, but the effective rate of the control group was significantly higher than that of the control group (P0.O5). Conclusion: children with asthmatic patients with deficiency of spleen and lung qi were treated with Yifei ointment to reduce the severity of asthma attack, reduce the C-ACT score of asthma, improve the level of asthma control, regulate the immune function of children, and improve their lung function. It is suggested that the children's Yifei ointment can prevent and cure the deficiency of spleen and lung qi in the asthmatic remission period, which has high clinical application value and is worth popularizing.
【学位授予单位】：湖北中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R272

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