激素依赖型哮喘撤减激素过程中的证候学：变化及三步序贯法临床疗效观察  

Changes of Syndrome in the Patients with Steroid-Dependent Asthma during Steroid Withdrawal and the Therapeutic Effect of Three-Stage Sequential Treatment

作　　者：崔红生[1] 徐光勋[2] 任传云[1] 冯淬灵[1] 武维屏[1] 

机构地区：[1]北京中医药大学东直门医院呼吸科,北京市100700 [2]首都医科大学附属北京中医医院

出　　处：《中医杂志》2008年第10期886-889,共4页Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金资助项目(30371714)

摘　　要：目的观察激素依赖型哮喘(SDA)患者撤减激素过程中的证候学变化及三步序贯法临床疗效。方法将入选病例按随机数字表分为治疗组和对照组各40例,对照组予普米克都保,每次400μg,每日两次吸入;治疗组按证型不同分别给予相应方剂口服,每次100ml,每日两次,同时给予普米克都保200μg,每日两次吸入。两组疗程均12周。观察SDA患者撤减激素过程中的证候学变化和两组阴虚火旺证患者治疗前后激素撤减情况、万托林使用频率、肺功能的改变以及哮喘生活质量各方面积分的变化。结果在撤减激素过程中,两组患者均存在着由阴虚火旺(撤前)→阴阳两虚(撤中)→肾阳亏虚(撤后)的证候学演变规律。治疗组在万托林使用频率、哮喘患者生活质量等方面明显优于对照组(P<0.05)。结论SDA患者在撤减激素过程中存在着由阴虚火旺(撤前)→阴阳两虚(撤中)→肾阳亏虚(撤后)的证候学演变规律,三步序贯法能够有效撤减SDA患者口服激素用量,减少支气管舒张剂使用频率,改善肺通气功能,提高哮喘患者生活质量。Objective To observe changes of syndrome in the patients with steroid-dependent asthma （SDA） during steroid with- drawal and the therapeutic effect of three-stage sequential therapy on SDA. Methods The 80 patients with SDA were divided ran domly into two groups, 40 patients were treated with Chinese medicines depending on different syndromes plus Pulmicort Turbuhaler （400μg/day） in the treatment group, while 40 patients with Pulmicort Turbuhaler （800μg/day） in the control group. The therapeutic course was both 12 weeks. Changes of syndrome in the patients with SDA during steroid withdrawal as well as the oral steroid dose, the inhaling frequency of Vantolin, the lung function and the scores of the functional areas of asthma quality of life questionnaire （AQLQ） before and after treatment in the two groups of deficiency of yin and hyperactivity of evil fire were observed. Results In the process of steroid withdrawal, the patients presented such a pathologic change regularity as from deficiency of yin and hyperactivity Of evil fire （before withdrawal） to deficiency of yin and yang （during withdrawal） to deficiency of kidney-yang （after withdrawal）. The effect of treatment group was superior to that of control group in terms of the inhaling frequency of Vantolin and the quality of life （P〈0.05）. Conclusion In the patients with SDA during steroid withdrawal, there exists such a pathologic change regularity as from deficiency of yin and hyperactivity of evil fire （before withdrawal） to deficiency of yin and yang （during withdrawal） to deficiency of kidney-yang （after withdrawal）. The three-stage sequential therapy could reduce the oral steroid dose, decrease the inhaling frequency of Vantolin, promote the recovery of lung function and improve the quality of life of the SDA patients.

关 键 词：激素依赖型哮喘 证候学 三步序贯法 肺功能 哮喘生活质量问卷调查(AQLQ) 

分 类 号：R259[医药卫生—中西医结合]