补肺健脾、化痰祛瘀法治疗轻中度小儿闭塞性细支气管炎临床观察  

Treatment of Mild and Moderate Children Bronchitis Obliterans by Supplementing Fei and Invigorating Pi,Resolving Phlegm and Removing Stasis

作　　者：张霞[1] 金在艳[1] 李国勤[1] 边永君[1] 唐菁菁[1] ZHANG Xia;JIN Zai-yan;LI Guo-qin;BIAN Yong-jun;TANG Jing-jing(Department of Respiratory,Guang'anmen Hospital,China Academy of Chinese Medical Sciences,Beiing,100053)

机构地区：[1]中国中医科学院广安门医院呼吸科,北京100053

出　　处：《中国中西医结合杂志》2021年第3期318-323,共6页Chinese Journal of Integrated Traditional and Western Medicine

摘　　要：目的观察补肺健脾、化痰祛瘀法治疗轻中度小儿闭塞性细支气管炎的临床疗效和安全性。方法将66例轻中度小儿闭塞性细支气管炎患儿按随机数字表法分为试验组和对照组,每组33例。试验组予补肺健脾、化痰祛瘀中药汤剂治疗,对照组予西药联合中成药治疗,疗程6个月。观察两组治疗前后临床观察表总评分(包括咳嗽、喘息、痰量、呼吸频率、肺部听诊、三凹征、血氧饱和度、单月感染次数、半年住院次数)、临床症状(咳嗽、喘息、痰量)及血氧饱和度评分、肺功能[第一秒钟呼气容积(FEV1)、第一秒钟呼气节容积占用力肺活量的百分比(FEV1/FVC)、最大呼气中段流量(MMEF)]、胸部高分辨CT(HRCT)评分。结果两组最终纳入合格病例共60例,试验组30例,对照组30例。试验组总有效率为86.67%(26/30),对照组为66.67%(20/30),试验组优于对照组(χ^(2)=4.056,P<0.05)。与治疗前比较,两组治疗后临床观察表总评分、临床症状(咳嗽、喘息、痰量)及血氧饱和度评分、肺功能指标、胸部HRCT评分均改善(P<0.05),且试验组优于对照组(P<0.05)。结论采用补肺健脾、化痰祛瘀法治疗轻中度小儿闭塞性细支气管炎,可改善患儿的症状、体征、肺功能及胸部HRCT。Objective To observe the clinical efficacy and safety of tonifying Fei and invigorating Pi(TFIP),eliminating phlegm and removing blood stasis(EPRBS)in treatment of mild and moderate bronchitis obliterans(BO).Methods Totally 66 children with mild and moderate BO were assigned to a trial group and a control group according to random digital table,33 cases in each group.Patients in the trial group took Chinese decoction for TFIP and EPRBS,while those in the control group took Western medicine and Chinese patent medicine.The treatment course for all was 6 months.The total score of clinical observation table(including cough,wheezing,sputum volume,respiratory frequency,lung auscultation,three concaves,blood oxygen saturation,monthly infection numbers,hospitalization numbers in half a year),clinical symptoms(cough,wheezing,sputum volume),and blood oxygen saturation score,pulmonary function[forced expiratory volume in one second(FEV1),forced expiratory volume in one second/forced vital capacity(FVC),maximal midexpiratory flow curve(MMEF)],chest HRCT score were observed in the two groups before and after treatment.Results Totally 60 qualified cases were finally recruited,30 in each group.The total effective rate was 86.67%(26/30)in the trial group,better than that of the control group[66.67%(20/30),χ^(2)=4.056,P<0.05].Compared with before treatment,the total score of clinical observation table,clinical symptoms(cough,wheezing,sputum volume),blood oxygen saturation score,lung function index,and chest HRCT score were improved in both groups after treatment(P<0.05),and they were better in the trial group than in the control group(P<0.05).Conclusion Applying TFIP and EPRBS for treating children with mild and moderate BO improved their symptoms,signs,lung function and chest CT.

关 键 词：小儿闭塞性细支气管炎 补肺健脾 化痰祛瘀 肺功能 胸部高分辨CT 

分 类 号：R272[医药卫生—中医儿科学]