定喘汤加味治疗支气管哮喘急性发作期热哮证的临床疗效观察

发布时间：2019-01-19 16:31

【摘要】：目的：观察定喘汤加味治疗支气管哮喘急性发作期热哮证的临床疗效,进一步验证中药复方治疗支气管哮喘的可行性及优势,同时探讨定喘汤加味减少气道炎症及降低气道阻塞,改善肺功能的作用机制。方法：本课题选取门诊60例热哮证支气管哮喘急性发作期热哮证患者,采用随机单盲法分为对照组(氨茶碱)和治疗组(氨茶碱+定喘汤加味)各30例,两组患者均以一周为1个疗程,1个疗程为限。通过观察中医证候临床疗效、中医证候总积分以及中医单个症状、体征积分,测定肺功能(FEV1%(第1秒用力呼气容积占预计值百分比)、FEV1/FVC%(第1秒用力呼气容积占用力肺活量百分比))和血清IgE水平和EOS计数,并进行治疗前后分析比较。结果：1.中医临床疗效：本课题观察结果显示,治疗组总有效率为96.67%,对照组总有效率为90%,差异具有统计学意义(P0.05),提示中药治疗方案总疗效较佳。2.中医证候总积分和单个症状、体征积分：两组证候总积分及单个症状、体征积分比较经统计学分析后P0.05,具有统计学差异,治疗组疗效优于对照组,提示定喘汤加味能有效改善症状、体征,且提示治疗组在治疗咳嗽咳痰方面效果更好。3.FEV1%、PEV1/FVC%:两组肺功能FEV1%、FEV1/FVC%组内、组间及治疗前后差值比较,均有统计学差异(P0.05),且治疗组肺功能改善优于对照组。4.免疫指标血清IgE水平及EOS计数：两组患者组内、组间及之后差值比较,经统计学分析后P0.05,均有统计学差异,较治疗前均有所下降,且治疗组疗效优于对照组。结论：定喘汤加味具有较好的临床疗效,能明显改善患者临床症状、体征,特别是对咳嗽、咳痰的改善,能有效提高肺功能指标,改善气道阻塞,减少免疫IgE水平及EOS计数,减轻免疫炎症反应。
[Abstract]:Objective: to observe the clinical effect of Dingchuan decoction on heat asthma in acute attack of bronchial asthma, and to verify the feasibility and superiority of traditional Chinese medicine compound in treating bronchial asthma. At the same time, the mechanism of Dingchuan decoction to reduce airway inflammation and airway obstruction and improve lung function was discussed. Methods: in this study, 60 outpatients with heat asthma were randomly divided into control group (aminophylline) and treatment group (aminophylline Dingchuan decoction), which were divided into two groups: control group (30 cases) and treatment group (30 cases of aminophylline Dingchuan decoction). Two groups of patients were one week as a course of treatment, one course of treatment was limited. Pulmonary function (FEV1%) was measured by observing the clinical efficacy of TCM syndromes, the total score of TCM syndromes and the scores of individual symptoms and signs of TCM. FEV1/FVC% (percentage of forced expiratory volume occupying capacity) and serum IgE and EOS count were compared before and after treatment. Results: 1. Clinical efficacy of TCM: the results showed that the total effective rate of the treatment group was 96.677.The total effective rate of the control group was 90, the difference was statistically significant (P0.05). TCM syndromes total integral and single symptom and sign integral: two groups of syndrome total integral and single symptom, physical sign integral comparison after statistical analysis of P0.05, there is statistical difference, the treatment group is better than the control group, the treatment group is better than the control group, the treatment group is better than the control group, It suggested that Dingchuan decoction could effectively improve symptoms and signs, and that the treatment group was more effective in the treatment of cough and expectoration. 3. FEV1 and PEV1 / FVC5: the difference of pulmonary function between the two groups in FEV1%,FEV1/FVC% group, between groups and before and after treatment was compared. There was statistical difference (P0.05), and the improvement of pulmonary function in the treatment group was better than that in the control group. 4. 4. Serum IgE level and EOS count: the difference between the two groups was statistically significant (P 0.05), which was lower than that before treatment, and the curative effect of the treatment group was better than that of the control group. Conclusion: Dingchuan decoction has better clinical effect, can obviously improve the clinical symptoms and signs, especially the improvement of cough and expectoration, can effectively improve the pulmonary function index, improve airway obstruction, reduce the level of immune IgE and EOS count. Reduce the immune inflammation.
【学位授予单位】：福建中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R256.12

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