温阳平喘方治疗阳虚型小儿咳嗽变异性哮喘临床疗效观察  

Clinical Observation of Yangming Pingchuan Decoction(阳明平喘方)in the Treatment of Children with Cough-variant Asthma of Spleen Yang Deficiency

作　　者：褚美娜 张皓[2] 蒋梦慈 孙歆骏 冯意会 张新光[1] CHU Meina;ZHANG Hao;JIANG Mengci;SUN Xinjun;FENG Yihui;ZHANG Xinguang(Shanghai Municipal Hospital of Traditional Chinese Medicine,Shanghai University of Traditional Chinese Medicine,Shanghai 200071,China;Shanghai Children's Medical Center,School of Medicine,Shanghai Jiaotong University,Shanghai 200120,China)

机构地区：[1]上海中医药大学附属市中医医院,上海200071 [2]上海交通大学医学院附属上海儿童医学中心,上海200120

出　　处：《辽宁中医药大学学报》2021年第6期120-123,共4页Journal of Liaoning University of Traditional Chinese Medicine

基　　金：国家自然科学基金(81202723);上海市进一步加快中医药事业发展三年行动计划(ZY3-JSFC-2-2013)。

摘　　要：目的评价温阳平喘方治疗阳虚型小儿咳嗽变异性哮喘(cough variant asthma,CVA)的临床疗效。方法采用随机对照的前瞻性研究方法,选择符合纳入标准的咳嗽变异性哮喘患儿92例,分为中医组27例、西医组30例和中西医结合组35例。中医组采用温阳平喘方口服治疗,西医组采用辅舒酮吸入治疗,中西医结合组采用温阳平喘方口服加辅舒酮吸入治疗,疗程均为3个月。评价3组患儿的临床疗效、咳嗽症状积分、中医证候积分和肺功能改善情况,治疗期间,记录3组患儿的不良反应发生情况。结果 (1)临床疗效:3组患儿临床疗效差异比较,中西医结合组明显优于其他两组(P<0.05),中医组和西医组之间差别无统计学意义(P>0.05)。(2)咳嗽症状积分:3组患儿治疗后均有不同程度的改善(P<0.05),且中西医结合组明显优于其他两组,中医组和西医组之间无明显差别(P>0.05)。(3)中医证候积分:3组患儿治疗前后均有不同程度的改善(P<0.05),且中西医结合组明显优于其他两组(P<0.05),中医组在恶寒、乏力方面疗效优于西医组(P<0.05),咳痰、气急方面两组无明显差别(P>0.05)。(4)肺功能指标:3组患儿治疗前后均有不同程度的改善(P<0.05),且中西医结合组明显优于其他两组(P<0.05),中医组和西医组除第1秒用力呼气容积(forced expiratory volume in1 second,FEV1)占预计值百分比(FEV1%)、第1秒用力呼气容积占用力肺活量(forced vital capacity,FVC)的比值(FEV1/FVC)外,两组无明显差别(P>0.05)。(5)不良反应发生情况:3组不良反应发生情况比较,差别无统计学意义(P>0.05)。治疗期间,3组均未发生严重不良反应事件。结论温阳平喘方联合辅舒酮治疗阳虚型小儿咳嗽变异性哮喘疗效显著,优于其他治疗,可以有效缓解患儿咳嗽症状与中医证候,改善患儿的肺通气功能。Objective To evaluate the clinical efficacy of Yangming Pingchuan Decoction(阳明平喘方)in the treatment of cough variant asthma(CVA)in children with Yang deficiency. Methods A prospective randomized controlled study was used to select 92 children with cough variant asthma who met the inclusion criteria,and they were divided into the TCM group(n=27),the Western medicine group(n=30)and the integrated Chinese and Western medicine group(n=35). The Chinese medicine group was treated with Yangming Pingchuan Decoction orally,the Western medicine group was treated with Flixotide inhalation,and the integrated Chinese and Western medicine group was treated with Yangming Pingchuan Decoction orally plus Flixotide inhalation,with a course of 3 months. Clinical efficacy,cough symptom score,TCM syndrome score and pulmonary function improvement of the three groups were evaluated. During the treatment,the incidence of adverse reactions in the three groups were recorded. Results(1)Clinical efficacy:Comparison of the clinical efficacy of the three groups of children,the combination of traditional Chinese and Western medicine group was significantly better than the other two groups(P<0.05),there was no statistical significance between the traditional Chinese medicine group and Western medicine group(P>0.05).(2)Cough symptom score:The scores of cough symptoms in the three groups were all improved to varying degrees after treatment(P<0.05)and the combination of traditional Chinese and Western medicine group was significantly better than the other two groups(P<0.05),there was no significant difference between the traditional Chinese medicine group and the Western medicine group(P>0.05).(3)TCM syndrome scores:Three groups of children before and after treatment had different degrees of improvement(P<0.05),and the combination of traditional Chinese and Western medicine group was significantly better than the other two groups(P<0.05),the Chinese medicine group in cold,fatigue effect was better than Western medicine group(P<0.05),sputu

关 键 词：温阳平喘方 阳虚 咳嗽变异性哮喘 疗效 

分 类 号：R256.12[医药卫生—中医内科学]