固本平哮汤治疗支气管哮喘非急性发作期肺肾两虚型临床疗效观察

发布时间：2018-01-04 20:06

本文关键词：固本平哮汤治疗支气管哮喘非急性发作期肺肾两虚型临床疗效观察　出处：《湖北中医药大学》2017年硕士论文　论文类型：学位论文

【摘要】：导师根据文献研究及丰富的临床经验将哮喘非急性发作期病机关键总结为“肺肾两虚,痰邪伏肺”,并确立“补肺益肾,化痰平喘”的治疗法则,以固本平哮汤为基础方辨证加减后运用于临床哮喘非急性发作期的治疗。为了对固本平哮汤疗效做进一步客观评价,本研究采用随机对照法,探讨固本平哮汤对支气管哮喘非急性发作期肺肾两虚型患者的症状、肺功能、哮喘控制情况的影响。目的:观察固本平哮汤治疗支气管哮喘非急性发作期肺肾两虚型的临床疗效。方法:根据中医辨证要点,选取支气管哮喘非急性发作期辨证属肺肾两虚型患者共68例,随机分为治疗组和对照组,每组各34例患者。两组患者治疗前对性别、年龄、病程长短、病情轻重程度方面进行比较,经统计学处理无显著差异性(P0.05),可以进行比较。治疗组患者给于固本平哮汤(黄芪20g,党参15g,灵芝10g,补骨脂15g,肉苁蓉10g,五味子6g,磁石18g,苏子15g,蜜紫菀12g,款冬花12g,法半夏12g,橘红6g)联合沙美特罗氟替卡松(舒利迭葛兰素史克50ug/250ug,每次1吸,每天2次)治疗,对照组仅给于沙美特罗氟替卡松(舒利迭葛兰素史克50ug/250ug,每次1吸,每天2次)常规治疗。治疗30天后停中药固本平哮汤,两组患者继续予以沙美特罗氟替卡松常规吸入。观察并记录治疗前后两组患者中医症候总积分、各单项症状积分、肺功能、哮喘控制测试(ACT)评分的变化情况。对记录的数据使用SPSS19.0软件进行统计分析。结果:(1)总有效率比较:治疗30天后治疗组总有效率为91.17%,对照组为85.29%,经统计学处理,有显著性差异(P0.05),治疗组疗效明显优于对照组。(2)总体症候积分及单项症状积分比较:两组治疗后组内及组间总体症候积分改善上,经统计学处理P0.05,具有显著性差异,两组均可以改善总体症候积分,治疗组明显优于对照组。两组在喘息、咳嗽、咳痰、乏力、畏寒肢冷等主要、次要单项症状改善上,经统计学处理,具有显著性差异P0.05,治疗组疗效明显优于对照组。两组均可改善胸膈满闷症状,但无显著差异,P0.05。治疗组可有效改善自汗、腰膝酸软的症状,对照组对自汗、腰膝酸软则无明显改善。(3)肺功能比较:两组治疗后肺功能FEV1%,PEF均有显著提高,经统计学处理P0.05,治疗组改善程度优于对照组。(4)哮喘控制水平方面:两组均可提高哮喘控制ACT评分,经统计学处理P0.05,具有显著差异性。治疗组优于对照组。结论:固本平哮汤与沙美特罗氟替卡松有很好的协同作用,比单纯使用沙美特罗氟替卡松更能有效控制哮喘,改善症状、提高肺功能。因此固本平哮汤联合沙美特罗氟替卡松在哮喘非急性发作期的治疗上比单纯运用沙美特罗氟替卡松具有一定的优势。
[Abstract]:According to the literature research and abundant clinical experience, the tutor summarized the key of pathogenesis of asthma in non-acute attack period as "deficiency of lung and kidney, accumulation of phlegm and evil", and established the treatment principle of "tonifying the lung and tonifying the kidney, resolving phlegm and relieving asthma". Guben Pingxiao decoction is used in the treatment of clinical asthma during non-acute attack after differentiation of symptoms and signs. In order to make further objective evaluation of the curative effect of Guben Pingxiao decoction, this study adopts a randomized controlled method. To explore the symptoms and pulmonary function of Gubenping decoction in patients with deficiency of both kidney and lung in non-acute stage of bronchial asthma. Objective: to observe the clinical effect of Gubenping Xiao decoction in treating asthmatic patients with deficiency of lung and kidney in non-acute attack period. Methods: according to the main points of TCM syndrome differentiation. A total of 68 patients with lung and kidney deficiency syndrome were randomly divided into treatment group and control group with 34 patients in each group. The two groups had sex, age and course of disease before treatment. Compared with the severity of the disease, there is no significant difference between the treatment group and the treatment group (Astragalus, 20g, Codonopsis 15g), the treatment group patients were given Guben Ping Xiao Tang (Astragalus 20g, Codonopsis 15g). Ganoderma lucidum 10g, psoralen 15g, Cistanche 10g, Schisandra Schisandra 6g, magnetite 18g, Perilla 15g, Aster honey 12g, Flos lucifera 12g, Pternata ternata 12g. Orange red 6g) combined with salmeterol fluticasone (Schuliday GlaxoSmithKline 50ugr / 250ugg, 1 inhalation at a time, twice a day). The control group was treated with routine therapy only with salmeterol fluticasone (Schuliday GlaxoSmithKline 50ugr / 250ugg, once a time, twice a day). After 30 days of treatment, Guben Pingxiao decoction was stopped. Two groups of patients continue to receive salmeterol fluticasone routine inhalation. Observe and record the two groups of patients before and after treatment of TCM symptoms total score, each single symptom score, pulmonary function. Changes in the ACT score of Asthma Control Test. Statistical analysis of recorded data using SPSS19.0 software. Results: 1). Comparison of the total effective rate: after 30 days of treatment, the total effective rate of the treatment group was 91.17%. The control group was 85.29 (P 0.05). The curative effect of the treatment group was significantly better than that of the control group. 2) overall symptom score and single symptom score were compared: after treatment, the overall symptom score of the two groups was improved, which was treated by statistics (P0.05). There was significant difference, both groups can improve the overall symptom score, the treatment group is significantly better than the control group. The two groups in asthma, cough, expectoration, fatigue, cold chills and other major, secondary single symptoms improved. After statistical treatment, there was significant difference (P0.05). The curative effect of the treatment group was significantly better than that of the control group. Both groups can improve the symptoms of chest and diaphragm fullness, but there is no significant difference (P0.05. the treatment group can effectively improve self-sweating. The comparison of lung function in the control group and in the control group showed that the pulmonary function of the two groups was significantly higher than that of the control group (P < 0.01). After statistical treatment P0.05, the treatment group improved better than the control group. 4) Asthma control level: both groups can improve asthma control ACT score, by statistical treatment P0.05. The treatment group is superior to the control group. Conclusion: Guben Ping Xiao Tang and salmeterol fluticasone have very good synergistic effect, which can effectively control asthma and improve symptoms than using salmeterol fluticasone alone. Therefore Guben Ping Xiao Tang combined with salmeterol fluticasone has some advantages over salmeterol fluticasone alone in the treatment of asthma in non-acute stage.
【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】：R256.12

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