小青龙汤联合寒哮贴贴穴治疗小儿寒性哮喘的临床疗效研究

发布时间：2018-12-18 03:28

【摘要】：目的:本课题以小青龙汤联合寒哮贴贴穴治疗符合寒性哮喘的患儿,以观察小青龙汤联合寒哮贴贴穴治疗急性发作期小儿寒性哮喘的临床疗效和安全性,丰富小儿寒性哮喘的中医治法,为小青龙汤联合寒哮贴贴穴治疗小儿寒性哮喘提供临床依据。方法:本研究收集符合纳入标准的小儿寒性哮喘患儿120例,按照简单随机化原则,将120例将患儿按照就诊顺序进行编号,应用SPSS Transform程序对编号进行分组,分为小青龙汤组和小青龙汤联合寒哮贴贴穴组(联合组),其中,小青龙汤组60例患者,联合组60例患者。小青龙汤组单独使用小青龙汤口服治疗,联合组在小青龙汤组的基础上加用寒哮贴贴穴(生麻黄、丁香、细辛、白芥子、甘遂,按照1:1:1:2:1的比例研末,姜汁调匀,制蚕豆大小药饼贴肺腧穴、定喘穴、大椎穴、膏肓穴、膻中穴、脾腧穴、肾腧穴)治疗。观察治疗1周后患儿临床症状、体征、肺功能的改变,且持续观察对比两组治疗疗程,并观察血常规、肝肾功能等安全性指标。数据皆采用SPSS19.0统计方法进行统计分析。结果:1.小青龙汤组:临床控制6例、显效23例、有效19例、无效9例,总有效率达85.00%;联合组:临床控制10例、显效31例、有效13例、无效4例,总有效率达93.33%,差异具备统计学意义(P0.05);与小青龙汤组比较,联合组总有效率提升,差异具备统计学意义(P0.05)。2.中医症候疗效:小青龙汤组中临床治愈4例、显效36例、有效12例、无效5例,总有效率达91.22%;联合组中临床治愈9例、显效42例、有效6例、无效1例,总有效率达98.27%,差异有统计学意义(P0.05);与小青龙汤组比较,联合组总有效率升高,差异有统计学意义(P0.05)。3.治疗后,其患者肺功能PEF值改善情况明显优于治疗前,其中小青龙汤疗程大于联合组,其差异有统计学意义(P0.01)。与小青龙汤组比较,联合组总有效率提高,疗程缩短,差异有统计学意义(P0.05,P0.01)。4.治疗前后,两组患儿的血常规、肝肾功能检查无明显变化。治疗过程中无不良反应出现。结论:小青龙汤联合寒哮贴贴穴治疗小儿寒性哮喘较单独使用小青龙汤口服,疗效明显提高,且具有良好的安全性。通过以上临床研究佐证了内外结合治疗小儿寒性哮喘的科学价值,验证了小青龙汤联合寒哮贴贴穴在改善小儿寒性哮喘方面的确切作用,为临床医治小儿寒性哮喘提供了颇为有效的治疗思路。
[Abstract]:Objective: to observe the clinical efficacy and safety of Xiao Azure Dragon decoction combined with Cold Asthma paste in the treatment of children with cold asthma. It can provide clinical basis for treating children cold asthma with Xiao Azure Dragon decoction combined with cold plaster. Methods: in this study, 120 children with cold asthma were collected. According to the principle of simple randomization, 120 children with cold asthma were numbered according to the order of seeing a doctor, and the numbers were divided into groups by SPSS Transform program. It was divided into two groups: Xiao Azure Dragon decoction group and Xiao Azure Dragon decoction combined with Han Xiao tie point group (combined group). Among them, there were 60 patients in the small Azure Dragon decoction group and 60 patients in the combined group. The Xiao Azure Dragon decoction group was treated by oral administration of Xiaolai_person1# decoction alone, while the combined group was treated with Han Xiao tie points (raw ephedra, clove, Asarum, mustard, kansui) on the basis of the small Azure Dragon decoction group. At the rate of 1: 1: 1: 1: 2: 1, at the end of the study, Ginger juice blending, make broad bean size medicine cake paste lung acupoint, Dingchuan point, Dazhui point, Yan Zhong point, spleen acupoint, kidney acupoint) treatment. The changes of clinical symptoms, signs and lung function were observed after 1 week of treatment, and the safety indexes such as blood routine, liver and kidney function were observed and compared continuously. The data were analyzed by SPSS19.0 statistical method. Results: 1. In the group of Xiao Azure Dragon decoction, there were 6 cases of clinical control, 23 cases of remarkable effect, 19 cases of effective and 9 cases of ineffective. The total effective rate was 85.00%. In the combined group, 10 cases were clinically controlled, 31 cases were effective, 13 cases were effective, 4 cases were ineffective, the total effective rate was 93.33 and the difference was statistically significant (P0.05). Compared with Xiao Azure Dragon decoction group, the total effective rate of the combined group was improved, the difference was statistically significant (P0.05). In the group of Xiao Azure Dragon decoction, 4 cases were clinically cured, 36 cases were markedly effective, 12 cases were effective, 5 cases were ineffective, and the total effective rate was 91.22 cases. In the combined group, 9 cases were clinically cured, 42 cases were obviously effective, 6 cases were effective, and 1 case was ineffective. The total effective rate was 98.277.The difference was statistically significant (P0.05). Compared with Xiao Azure Dragon decoction group, the total effective rate of combined group increased, the difference was statistically significant (P0.05). After treatment, the improvement of PEF value of pulmonary function was better than that before treatment, and the course of treatment of Xiao Azure Dragon decoction was greater than that of combined group, and the difference was statistically significant (P0.01). Compared with Xiao Azure Dragon decoction group, the total effective rate of combined group was increased, the course of treatment was shortened, the difference was statistically significant (P0.05, P0.01). Before and after treatment, the blood routine, liver and kidney function of the two groups did not change significantly. No adverse reactions occurred during the treatment. Conclusion: the therapeutic effect of Xiao Azure Dragon decoction combined with cold plaster on children with cold asthma is better than that of Xiao Azure Dragon decoction alone, and it has good safety. The above clinical studies have proved the scientific value of the combination of internal and external treatment of cold asthma in children, and verified the exact role of Xiao Azure Dragon decoction combined with cold asthma paste in improving children's cold asthma. For the clinical treatment of cold asthma in children to provide a rather effective way of treatment.
【学位授予单位】：山东中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R272

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