疏风宣肺法治疗咳嗽变异性哮喘的临床疗效研究  

Clinical efficacy of method of dispelling wind and dispersing lung in treament of cough variant asthma

作　　者：罗社文[1] 李友林[2] 吴继全[2] 杨道文[2] 晁恩祥[2] 

机构地区：[1]武警总医院,北京100039 [2]中日友好医院,北京100029

出　　处：《中华中医药杂志》2007年第9期609-612,共4页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：国家中医药管理局科研基金项目(No.02-03LP01)

摘　　要：目的:对疏风宣肺法治疗咳嗽变异性哮喘(cough variant asthma,CVA)的临床疗效进行评价。方法:将260例咳嗽变异性哮喘患者,随机分为中药治疗组130例,对照组130例。治疗组服用风咳汤治疗;对照组用舒氟美加必可酮,疗程均为4周。主要观察证候积分、症状、气道反应性、外周血嗜酸性粒细胞(EOS)计数、IL-5、血清嗜酸性粒细胞阳离子蛋白(ECP)等的变化。结果:①治疗组总有效率为95.4%;对照组总有效率为84.7%,两组疗效经秩和检验有统计学意义(P<0.05)。②两组患者经治疗后,咳嗽、咽痒、咯痰均有明显好转,但治疗组优于对照组,且有统计学差异(P<0.05);气急、鼻塞方面两组间无统计学差异(P>0.05)。③两组治疗前后最低反应阈值(Dmin)均有明显升高,诱导控制值下降钭率(sGrs)均有明显下降,但治疗组与对照组比较,有显著性差异(P<0.05)。④两组治疗前后外周血EOS、ECP、IL-5均显著下降(P<0.01),但治疗组对ECP和IL-5的改善优于对照组(P<0.01)。⑤6个月后随访情况治疗组复发18例(14%),对照组34例(26%),两组之间具有显著统计学差异(P<0.05)。结论:疏风宣肺法治疗CVA具有良好的临床疗效,其疗效的作用机制可能是通过抗气道变应性炎症(AAI),降低气道高反应性(BHR)而实现的,且远期疗效明显优于单用西药组,能明显降低复发率。Objective： To evaluate the therapeutical effect of ShufengZhike decoction（SFZKD） for cough variant asthma（CVA）.Methods： The 260 cases of CVA were recruited, which were divided into two groups randomly： treatment group（130 cases） and control group（130 cases）.The treatment group was treated by SFZKD;The control group by slow-release theopylline and beclomethasone.Four weeks constituted the course of treatment.The scoring of symptoms,changes of airway responsiveness,the number of peripheric eosinophile（EOS）,IL-5 and serum eosinophil cationic protein（ECP） were observed.Results： ① The total effective rate was 95.4% in treatment group,while 84.7% in control group.There is obviously statistical difference between two groups（P〈0.05 Statistical analysis by rank sum test ）.② There was obvious improvement of cough,expectoration and throaty pruritus after therapy in both groups,but the treatment group was greater than the control group（P〈0.05）.There was no statistical difference on breath lessness and nasal obstruction between two groups（P〉0.05）.③ The Dmin was obviously increased and sGrs decreased in both groups,but the treatment group was greater than the control group（P〈0.05）.④ There were great decreased on EOS,IL-5 and ECP in both groups,but the ECP and IL-5 in treatment group was greater than control group（P〈0.01）.⑤ There occurred acute episode in 18 cases（14%）in treatment group,while 34 cases（26%）in control group,there is statistical difference between two groups.Conclusion： Method of dispersing wind and ventilating lung possesses a good clinical effect for CVA.The mechanism may be the anti-inflammatory in allergic airway and decreasing high airway responsiveness.Moreover,there was greater in long-term effect than control group,which decreased the rate of acute episode.

关 键 词：咳嗽变异性哮喘 疏风宣肺法 抗气道变应性炎症 气道高反应性 

分 类 号：R256.1[医药卫生—中医内科学]