宁哮畅中颗粒剂配合穴位贴敷治疗儿童哮喘迁延期的疗效观察

发布时间：2018-01-15 10:06

  本文关键词：宁哮畅中颗粒剂配合穴位贴敷治疗儿童哮喘迁延期的疗效观察　出处：《河北医科大学》2017年硕士论文　论文类型：学位论文

  更多相关文章： 儿童哮喘 迁延期 宁哮畅中 穴位贴敷 疗效观察

【摘要】：目的:支气管哮喘(bronchial asthma)简称哮喘,是儿童时期最常见的一种慢性呼吸道疾病。其发病原因是痰伏于肺,并在肺、脾、肾相对不足的基础上,外邪侵袭、饮食失节、情志失调、接触异味异物等因素共同作用的结果,具有反复发作的特点,在严重使患儿的身心健康受到影响的同时,也对其家庭产生了巨大压力。若儿童哮喘控制不良,则发展为成人哮喘的可能性就会很大,而成为终身疾患。所以是目前小儿慢性疾病中,需要积极防治的重点疾病。本文旨在从中医理论及临床疗效方面对儿童哮喘迁延期的病因病机和方药进行观察与探讨,寻求儿童哮喘迁延期的有效防治药物,探讨防哮药物的疗效机理。以“肺与中焦脾胃相关性”理论为切入点,并结合儿童哮喘的发病特点,采用中药结合穴位贴敷的方法进行临床研究,为临床治疗儿童哮喘寻求一条既安全又有效的治疗方法。方法:选择河北省中医院儿科门诊符合统一的诊断标准、纳入标准和排除标准的支气管哮喘迁延期的患儿60例,通过查随机数字表,随机的分为两组。其中治疗组30例,对照组30例。对照组在常规小剂量糖皮质激素吸入的基础上给予口服清咳平喘颗粒。治疗组在常规小剂量糖皮质激素吸入的基础上,给予口服宁哮畅中颗粒剂及穴位贴敷联合治疗。宁哮畅中颗粒剂的药物组成:葶苈子8-12g、桑白皮8-12g、浙贝母8-10g、炒苦杏仁8-10g、炒僵蚕6-8g、清半夏6-8g、陈皮6-8g、炒莱菔子8-10g、炒枳壳6-8g、炒白术10-12g、郁金8-10g、砂仁6-8g、炒谷芽8-10g等(每盒7剂,日一剂,分两次冲服)。穴位贴敷疗法,是将吴茱萸,苏子,桔梗等药物,按适当比例研磨成细粉末,用醋调制成糊状,制成圆饼状,分别贴在患儿肺俞穴(双侧)、定喘穴(双侧)、膻中穴。第1周贴敷每天1次,第2周至第4周为隔日1次,每次贴4-6h,并且根据患儿耐受情况调整贴敷时间。1个月为一疗程,共计治疗3个疗程。两组患儿在治疗期间均嘱其清淡饮食和避免风寒及过敏原。通过观察两组总有效率、中医证候疗效、主要症状及体征变化、外周血嗜酸性粒细胞计数及血清Ig E来评价临床综合疗效。通过SPSS17.0统计软件对收集的资料进行数据分析,计量资料用均数±标准差,组间及组内治疗前后比较懫用t检验,计数资料采用χ2检验,等级资料采用非参数检验中的Wilcoxon秩和检验作为统计分析方法。P0.05,认为具有差异性,来评价治疗组与对照组的治疗效果。结果:1两组在总有效率方面比较:治疗组显效病例18例,有效病例11例,无效病例1例,总有效率96.67%;对照组显效病例10例,有效病18例,无效病例2例,总有效率93.33%。结果示治疗组的总有效率高于对照组。2两组在中医证候疗效方面的比较:运用Wilcoxon秩和检验对两组进行统计分析,结果说明两组的治疗效果存在差异,有统计学意义(P0.05)。并且治疗组的平均秩次高于对照组,更说明治疗组在中医证候疗效方面要优于对照组。3两组在中医主要症状、体征方面的比较:结果示治疗组与对照组均能减轻临床症状及体征,且治疗组优于对照组,有统计学意义(P0.05)。4两组在外周血嗜酸性粒细胞计数(Eos)方面的比较:治疗前,两组数据无差异,具有可比性(P0.05)。经治疗,结果示治疗后两组Eos均有所下降,且治疗组要优于对照组,有统计学意义(P0.05)。5两组在血清IgE水平的比较:治疗前,经数据分析,两组数据无差异,具有可比性(P0.05)。经治疗,结果示治疗后两组IgE水平均有所下降,并且治疗组的疗效要优于对照组,有统计学意义(P0.05)。结论:宁哮畅中颗粒剂配合穴位贴敷治疗儿童哮喘迁延期型在总有效率、中医证候疗效、中医主要症状及体征、外周血嗜酸性粒细胞计数和血清IgE方面优于对照组的治疗。宁哮畅中颗粒剂是以中医药基础理论为指导,具有清肺化痰、祛风平喘、理气畅中、健脾和胃的功效,并且证明了中医药在哮喘的治疗中起到了良好的治疗作用。
[Abstract]:Objective: bronchial asthma (bronchial asthma) asthma is a chronic respiratory disease, the most common childhood. Its pathogenesis is phlegm in the lung, spleen, lung and kidney in, based on the relative shortage, evil, improper diet, emotional disorders, interaction of contact with foreign body odor and other factors result that has a recurring feature, so that children's physical and mental health in severely affected at the same time, also had a huge pressure on the family. If children with poor asthma control, is likely to develop asthma in adults, and become a lifelong disease. So it is the children with chronic diseases, the need to focus on prevention of the disease. The purpose of this paper is the observation and Discussion on children asthma delayed pathogenesis and prescription in TCM theory and clinical efficacy, to seek effective drugs for prevention and treatment of childhood asthma delayed, to investigate the anti asthma drugs The effect mechanism of "relevance". In the lung and spleen and stomach theory as the breakthrough point, combined with the characteristics of the incidence of asthma in children, the method combined with acupoint sticking therapy using traditional Chinese medicine for clinical research, to seek a safe and effective method for the clinical treatment of children with asthma. Methods: select Hebei Province Hospital of traditional Chinese medicine outpatient department of Pediatrics conforms to the diagnosis standard unified, included 60 cases of bronchial asthma and exclusion criteria were delayed, by random number table, randomly divided into two groups. The treatment group of 30 cases, 30 cases in the control group. The control group in the conventional low-dose glucocorticoid inhalation on the basis of oral administration of Pingchuan Granule. Qing cough the treatment group in the conventional low-dose inhaled corticosteroids, oral therapy and acupoint dressing combined with Xiao Chang Ning Granule paste. Chang Ning granules composed of asthma drugs: Tinglizi 8-12g, 8-12g Sangbaipi, Zhejiang Fritillaria 8 -10g,鐐掕嫤鏉忎粊8-10g,鐐掑兊铓，

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