沙参麦门冬汤合定喘汤加味治疗老年咳嗽变异性哮喘肺阴虚证  

Modified Shashen Maimendong Decoction and Dingchuan Decoction in the Treatment of Senile Cough Variant Asthma of Lung Yin Deficiency Syndrome

作　　者：吕建兴[1] 韩旭东[1] 殷红琴[1] 王克俭[1] 陆炜青[1] LYU Jianxing;HAN Xudong;YIN Hongqin;WANG Kejian;LU Weiqing(Changzhou Hospital of Chinese Medicine,Changzhou Jiangsu China 213000)

机构地区：[1]常州市中医医院,江苏常州213000

出　　处：《中医学报》2020年第3期657-661,共5页Acta Chinese Medicine

基　　金：江苏省中医药局科研项目(ZX2016C3)。

摘　　要：目的:观察沙参麦门冬汤合定喘汤加味治疗老年咳嗽变异性哮喘肺阴虚证患者的临床效果,并探讨其对患者气道炎症、肺功能、免疫状态的影响。方法:114例老年咳嗽变异性哮喘肺阴虚证患者随机分为对照组(n=57)和观察组(n=57)。对照组给予西药常规治疗;观察组在对照组治疗基础上给予沙参麦门冬汤合定喘汤加味口服。1个月为1个疗程,连续治疗3个疗程。评价主要症状的中医证候积分,测定肺通气功能指标、气道炎症指标、免疫状态指标变化,比较两组患者的临床效果。结果:对照组、观察组的有效率分别为77.19%(44/57)、92.98%(53/57),两组有效率比较,差异有统计学意义(P<0.05)。与治疗前比较,两组患者治疗后中医证候积分均降低,肺功能均有所改善,气道炎症有所减轻,免疫功能有所改善,差异均有统计学意义(P<0.05)。与对照组治疗后比较,观察组患者咳嗽、手足心热、口干咽燥等肺阴虚证候积分均显著低于对照组(P<0.05),肺功能改善更显著(P<0.05),血清中炎症指标及外周血嗜酸性粒细胞计数显著低于对照组(P<0.05),血清中T淋巴细胞亚群(CD4^+、CD4^+/CD8^+)水平显著高于对照组,CD8^+水平明显低于对照组(P<0.05)。结论:沙参麦门冬汤合定喘汤加味可显著改善老年咳嗽变异性哮喘肺阴虚证患者的临床症状,提高肺通气功能,其起效可能是通过降低气道炎症反应、提高免疫功能实现的。Objective:To observe the clinical efficacy of modified Shashen Maimendong Decoction and Dingchuan Decoction in the treatment of senile cough variant asthma of lung yin deficiency syndrome,and to explore its effect on airway inflammation,lung function and immune status.Methods:114 elderly patients with cough variant asthma of lung yin deficiency syndrome were randomly divided into control group(n=57)and observation group(n=57).The control group was given conventional western medicine treatment;the observation group was given Modified Shashen Maimendong Decoction and Dingchuan Decoction orally on the basis of the treatment in the control group.One month is a course of treatment,with three courses of treatment.TCM syndrome scores of main symptoms were evaluated,changes in pulmonary ventilation function indexes,airway inflammation indexes,and immune state indexes were measured,and the clinical effects of the two groups of patients were compared.Results:The effective rates of the control group and the observation group were 77.19%(44/57)and 92.98%(53/57)respectively.The comparison of the effective rates between the two groups was statistically significant(P<0.05).Compared with before treatment,the TCM syndrome scores of both groups were reduced,lung function was improved,airway inflammation was reduced,and immune function was improved.The differences were statistically significant(P<0.05).Compared with the control group after treatment,the scores of lung yin deficiency syndromes such as cough,heart and foot heat,dry mouth,and throat dryness in the observation group were significantly lower than those in the control group(P<0.05),and the lung function was significantly improved(P<0.05).Inflammation indicators in serum and eosinophil count in peripheral blood were significantly lower than those in the control group(P<0.05).T lymphocyte subsets(CD4^+,CD4^+/CD8^+)in serum were significantly higher than those in the control group,and CD8^+levels were significantly lower than those in the control group(P<0.05).Conclusion:Mo

关 键 词：沙参麦门冬汤 定喘汤 老年咳嗽变异性哮喘 肺阴虚证 孟鲁司特钠 气道炎症 肺功能 免疫功能 中西医结合 

分 类 号：R256.12[医药卫生—中医内科学]