自拟平喘方联合西医常规疗法治疗小儿支气管哮喘急性发作临床研究  

Clinical observasion of Pingchuan Decoction combined with routine western medicine therapy for the children with acute attack of bronchial asthma

作　　者：梅玉霞 沈毅韵[1] 刘小敏[1] 虞坚尔[2] 庄承[1] Mei Yuxia;Shen Yiyun;Liu Xiaomin;Yu Jianer;Zhuang Cheng(Department of Pediatrics,the Seventh People’s Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200137,China;Institute of Pediatrics,Shanghai University of Traditional Chinese Medicine,Shanghai 200071,China)

机构地区：[1]上海中医药大学附属第七人民医院儿科,200137 [2]上海中医药大学儿科研究所,200071

出　　处：《国际中医中药杂志》2021年第5期452-456,共5页International Journal of Traditional Chinese Medicine

基　　金：上海市浦东新区卫生和计划生育委员会临床中医特色学科建设项目(PDZY-2018-0609)。

摘　　要：目的评价自拟平喘方联合西医常规疗法治疗小儿支气管哮喘急性发作的疗效。方法选择2017年1月-2019年6月上海中医药大学附属第七人民医院支气管哮喘急性发作患儿118例,采用随机数字表法分为2组,每组59例。对照组采用西医常规疗法治疗,观察组在对照组基础上口服自拟平喘方,2组均连续治疗14 d。分别于治疗前后进行主要症状评分。采用肺功能测量仪检测用力肺活量占预计值百分比(FVC%预计值)、第1秒用力呼气容积占预计值百分比(FEV1%预计值),采用流式细胞仪检测外周血CD3^(+)、CD4^(+)水平及CD4^(+)/CD8^(+)比值;记录治疗期间的不良反应,评价临床疗效。结果观察组总有效率为93.2%(55/59)、对照组为71.2%(42/59),2组比较差异有统计学意义(χ^(2)=9.790,P=0.002)。观察组治疗后咳嗽、喘息、哮鸣音评分均低于对照组(t值分别为27.695、17.573、32.827,P值均<0.001)。治疗后,观察组FVC%预计值[(80.21±4.06)%比(71.71±3.95)%,t=11.526]、FEV1%预计值[(78.84±3.92)%比(72.26±3.59)%,t=9.508]均高于对照组(P<0.01);CD3^(+)[(74.05±5.13)%比(67.44±4.98)%,t=7.101]、CD4^(+)[(48.43±4.31)%比(42.20±4.06)%,t=8.082]水平及CD4^(+)/CD8^(+)[(1.67±0.29)比(1.34±0.25),t=6.620]比值均高于对照组(P<0.01)。治疗期间,观察组不良反应发生率为10.2%(6/59)、对照组为6.8%(4/59),2组比较差异无统计学意义(χ^(2)=0.437,P=0.509)。结论自拟平喘方联合西医常规疗法可有效减轻支气管哮喘急性发作患儿的临床症状,改善肺功能,提高机体免疫力,且安全性较好。Objective To explore the clinical effect of Pingchuan Decoction combined with routine western medicine therapy in the treatment of acute attack of bronchial asthma in children.Methods From January 2017 to June 2019,118 children with acute attack of bronchial asthma were selected from the Seventh People’s Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,and they were randomly divided into control group(59 cases)and observation group(59 cases)according to the random number table.The control group was treated with routine western medicine therapy,and the observation group was treated with Pingchuan Decoction on the base of control group,and both groups were treated for 14 days.The main symptom scores before and after treatment were evaluated.The percentage of forced vital capacity expressed as percent predicted(FVC%pred)and the forced expiratory volume in 1 second expressed as percent predicted(FEV1%pred)were measured by pulmonary function meter.The levels of CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)in peripheral blood were detected by flow cytometry.The adverse reactions during the treatment were recorded and the clinical efficacy was evaluated.Results The total clinical effective rate was 93.2%(55/59)in the observation group and 71.2%(42/59)in the control group,where the difference between the two groups was statistically significant(χ^(2)=9.790,P=0.002).After treatment,the scores of cough,wheezing and wheezing rale in the observation group were significantly lower than those in the control group(t=27.695,17.573,32.827,P<0.001).After treatment,FVC%pred[(80.21±4.06)%vs.(71.71±3.95)%,t=11.526],FEV1%pred[(78.84±3.92)%vs.(72.26±3.59)%,t=9.508]in the observation group were significantly higher than those in the control group(P<0.01).The levels of CD3^(+)[(74.05±5.13)%vs.(67.44±4.98)%,t=7.101],CD4^(+)[(48.43±4.31)%vs.(42.20±4.06)%,t=8.082]and the ratio of CD4^(+)/CD8^(+)(1.67±0.29 vs.1.34±0.25,t=6.620)in the observation group were significantly higher than those in the control group(P<0.0

关 键 词：哮喘 支气管 急性发作 儿童 平喘方 中西医结合疗法 

分 类 号：R725.6[医药卫生—儿科]