微创埋线联合孟鲁司特钠治疗小儿咳嗽变异性哮喘:随机对照研究  

Micro-invasive embedding combined with montelukast sodium for children cough variant asthma:a randomized controlled trial

作　　者：王晓燕 刘宝琴 鲁斌 张艳梅 王利然 李海金 韩雪[2] 丁丹[3] 

机构地区：[1]郑州市中医院儿科,河南郑州450007 [2]郑州市儿童医院 [3]河南中医药大学第三附属医院儿科

出　　处：《中国针灸》2017年第3期259-264,共6页Chinese Acupuncture & Moxibustion

基　　金：河南省科技厅2013年科技攻关计划项目:132102310384;郑州市科技局2013年科技领军人才项目:131PLJRC672

摘　　要：目的:比较微创埋线联合孟鲁司特钠与单纯孟鲁司特纳治疗小儿咳嗽变异性哮喘(CVA)的临床疗效差异。方法:将240例患儿随机分为观察组和对照组,每组120例。排除脱落病例后观察组101例、对照组105例纳入统计。对照组口服孟鲁司特钠咀嚼片,每次5mg,每日1次,睡前服用,治疗3个月;观察组在对照组治疗基础上采用微创埋线,穴取肺俞、膻中、定喘、足三里,第1个月埋线2次,以后每月埋线1次,共治疗3个月。两组均于治疗后9个月随访。观察两组患儿治疗前后咳嗽症状积分、血清免疫球蛋白(IgE、IgG、IgA)、血小板活化因子(PAF)水平,治疗前、治疗后、随访时肺大气道功能指标[最大呼气流速峰值(PEF)、第1s最大呼气量(FEV1)]、小气道功能指标[剩余25%肺活量时的用力呼气流速(MEF25%)、剩余50%肺活量时的用力呼气流速(MEF50%)、剩余75%肺活量时的用力呼气流速(MEF75%)、中段呼气流速(MEF25%~75%)]的变化情况,并评定两组总体疗效。结果:观察组总有效率为93.1%(94/101),优于对照组的87.6%(92/105,P<0.05);观察组痊愈患儿咳嗽停止时间为(10.38±2.64)d,早于对照组的(10.72±2.60)d(P<0.05);治疗后两组患儿咳嗽症状积分均较治疗前明显下降(均P<0.05),且观察组优于对照组(P<0.05);随访时观察组复发次数为(1.43±1.20)次,少于对照组的(1.91±1.71)次(P<0.05)。2治疗后两组IgA、IgG较治疗前提高,IgE、PAF较治疗前降低,除对照组IgG外,其余各项指标治疗前后差异均有统计学意义(均P<0.05),且观察组改善更显著(均P<0.05)。3治疗后、随访时两组肺大气道功能指标均较治疗前明显升高(均P<0.05);治疗后、随访时组间比较差异无统计学意义(均P>0.05);4治疗后两组肺小气道功能各项指标与治疗前比较差异无统计学意义(均P>0.05),随访时均较治疗前提高(均P<0.05),且观察组优于对照组(均P<0.05)。结论:微创埋线联合孟鲁司特钠治疗小儿CVObjective To observe the effects of micro-invasive embedding combined with montelukast sodium and simple montelukast sodium for children cough variant asthma（CVA）.Methods A total of 240 patients were randomly assigned into an observation group and a control group,120 cases in each one.Considering of cases dropping,101 patients in the observation group and 105 cases in the control group were included.Montelukast sodium chewable tablets were applied before sleep for 3months in the control group,5mg a time,once a day.Based on the treatment as the control group,micro-invasive embedding was used for 3 months in the observation group,twice in the first month and once in the other two months.The acupoints were Feishu（BL 13）,Danzhong（CV 17）,Dingchuan（EX-B 1）,and Zusanli（ST 36）.Follow-up was conducted 9months after treatment in thetwo groups.The cough score,serum immunoglobulin（IgE,IgG,IgA）,platelet activating factor（PAF）were observed before and after treatment.The indices were compared before and after treatment and at follow-up,including pulmonary function indices [peak expiratory flow rate（PEF）,forced expiratory volume at the 1st second（FEV1）],and small airway function indices [forced expiratory flow rate with remaining 25% vital capacity（MEF25%）,forced expiratory flow rate with remaining 50% vital capacity（MEF50%）,forced expiratory flow rate with remaining 75% vital capacity（MEF75%）and mid expiratory flow rate（MEF25%-75%）].Also,the total effects were evaluated.Results（1）The total effective rate in the observation group was 93.1%（94/101）,which was better than 87.6%（92/105）in the control group（P〈0.05）.The cough disappearance time of the cured children in the observation group was（10.38±2.64）d,and it was shorter than（10.72 ±2.60）d of those in the control group（P〈0.05）.After treatment,the cough score apparently decreased compared with those before treatment in the two groups（both P〈0.05）,with better result in the observation group�

关 键 词：小儿咳嗽变异性哮喘 微创埋线 孟鲁司特钠 随机对照试验 

分 类 号：R246.4[医药卫生—针灸推拿学]