益气疏风方治疗气虚风动证咳嗽变异性哮喘的临床疗效观察

发布时间：2018-01-01 16:33

本文关键词：益气疏风方治疗气虚风动证咳嗽变异性哮喘的临床疗效观察　出处：《北京中医药大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:咳嗽变异性哮喘(Cough variant asthma,CVA),是哮喘的一种特殊类型,而且是一种呼吸系统疾病的常见病。咳嗽是CVA的主要或唯一的临床表现,很多人由于咳嗽持续发生或者反复发作,导致咳嗽迁延不愈,最终引发咳嗽变异性哮喘。近年来咳嗽变异性哮喘的发病率持续增高的趋势。目前现代医学主要以抗炎药、支气管扩张药、抗过敏药物来应用对症治疗,但其疗效尚不理想,并且对人体的副作用较多,停药后容易复发。西医对于本病的治疗具有一定的局限性。而中医药的治疗根据审证论治,辨清证候,审明病因病机,采取针对性的治则从根本上治愈并改善患者的整体症状,提高生活质量。因此运用中医药治疗该病日益受到关注。导师杨道文教授在其二十多年的临床工作中,对于咳嗽变异性哮喘的认识及治疗积累了丰富的经验。"益气疏风方"为杨道文教授根据多年的临床经验所创,方药基本组成为黄芪、白术、蜂房、蝉蜕、僵蚕、炙麻黄、苦杏仁,本着益气扶正以治本,疏风祛邪以治标,标本兼治的治疗原则。本研究旨在观察运用益气疏风方加减治疗辨证为气虚风动证的咳嗽变异性哮喘患者,探讨益气疏风方治疗咳嗽变异性哮喘的临床疗效,以期为治疗本病提供一条新的诊治思路。方法:本论文第一部分通过文献检索、整理归纳的方式,总结古代医家以及现代医家对咳嗽变异性哮喘的相关研究,主要包括本病的中医病名,病因病机,不同的诊治方法和临床经验四大部分。第二部分是采用自身对照的方法,对20例辨证为气虚风动证的咳嗽变异性哮喘患者运用"益气疏风方"进行治疗,重点观察患者的咳嗽、咽痒、恶风、自汗、神疲乏力等症状与体征,分别记录于治疗前、治疗后评分,应用统计软件SPSS20.0对评分进行分析,观察并评估"益气疏风方"加减对咳嗽变异性哮喘的临床疗效。结果:运用益气疏风方治疗气虚风动证的咳嗽变异性哮喘患者,经治疗前与治疗后症状评分比较,有显著统计学意义(P0.01),可以明显改善患者的临床症状。其中临床治愈1例,显效4例,有效13例,无效2例,治疗总有效率为90%。结论:益气疏风方加减对改善咳嗽变异性哮喘气虚风动证患者的临床症状及体征疗效确切,取得了显著临床效果,具有重要的临床指导意义与使用价值。由此证实益气疏风法的有效性及适应范围,并为临床提供了一条新的诊治思路。
[Abstract]:Objective: cough variant asthma (Cough variant, asthma, CVA) is a special type of asthma, and is a common disease of respiratory system disease. The clinical manifestations of cough is mainly or only CVA, a lot of people because of persistent cough or recurrent cough, leading to delayed healing, eventually cause cough variant asthma in recent years. Cough variant asthma incidence trend. Modern medicine mainly anti-inflammatory drugs and bronchodilators, anti allergic drug application to symptomatic treatment, but the effect is not ideal, and more side effects on the human body, easy to relapse after drug withdrawal. Western medicine has limitations the treatment for the disease. The treatment of Chinese medicine according to the trial on the treatment of differentiating syndromes, etiology and pathogenesis of the Ming, take targeted treatment fundamentally cure and improve overall symptoms, improve the quality of life and therefore. The use of Chinese medicine treatment of the disease has been paid more and more attention. Professor Yang Daowen in the more than 20 years of clinical work, for the understanding and treatment of cough variant asthma has accumulated rich experience. "Qi Shufeng party" created by Professor Yang Daowen based on years of clinical experience, the basic recipe consists of Astragalus, Atractylodes, hive chantui, Jiangcan, ephedra, bitter almond, the spirit of Invigorating Qi to cure, dispelling wind expelling the symptoms, the treatment principle of tackling the problem. The purpose of this study is to observe the use of Yiqi Shufeng Decoction for treating the syndrome of qi deficiency and wind srirring cough variant asthma patients, to investigate the effects of Yiqi Shufeng Decoction in the treatment of the clinical curative effect of cough variant asthma, in order to provide a new treatment strategy for the treatment of this disease. Methods: in the first part, through literature retrieval, summarization method, summary of ancient physicians and modern medicine on cough variant asthma The related research of asthma, including TCM disease name of this disease, etiology and pathogenesis, diagnosis and treatment of different methods and clinical experience of four parts. The second part is the self control method, 20 cases of syndrome of qi deficiency syndrome of cough by supplementing qi and wind dispelling wind "for treatment of variant asthma patients, observed cough, throat itching, evil wind, sweating, fatigue and other symptoms and signs were recorded before treatment, after treatment scores, using statistical software SPSS20.0 to analyze the score, observe and evaluate" Yiqi Shufeng Decoction clinical curative effect of "cough variant asthma. Results: the use of Qi and dispelling wind. Treatment of pneumatic syndrome of cough variant asthma patients, the symptom scores before and after the treatment, there was statistical significance (P0.01), can significantly improve clinical symptoms. 1 cases were cured, 4 cases were cured, 13 cases were effective, no The effect of 2 cases, the total effective rate was 90%. conclusion: Yiqi Decoction on improving cough dispelling wind and clinical symptoms and signs of variant asthma of qi deficiency syndrome in patients with pneumatic exact, achieved significant clinical effect, and has important clinical significance and application value. The validity and the range of the gas expelling wind method. 4, and provides a new way for clinical diagnosis and treatment.

【学位授予单位】：北京中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R256.12

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