麻杏石甘汤加味辅助治疗儿童咳嗽变异性哮喘痰热闭肺证41例临床观察  

Clinical observation on 41 cases of cough variant asthma in children with phlegm-heat obstructing lung syndrome adjuvantly treated by modified Maxing Shigan Tang(麻杏石甘汤)

作　　者：姚百会 冉志玲 王君霞 YAO Baihui;RAN Zhiling;WANG Junxia(College of Integrated Traditional Chinese and Western Medicine,Southwest Medical University,Luzhou,Sichuan,646000,China;Department of Pediatrics,Hospital of TCM Affiliated to Southwest Medical University,Luzhou,Sichuan,646000,China)

机构地区：[1]西南医科大学中西医结合学院,四川泸州646000 [2]西南医科大学附属中医医院儿科,四川泸州646000

出　　处：《中医儿科杂志》2022年第3期58-63,共6页Journal of Pediatrics of Traditional Chinese Medicine

摘　　要：目的观察麻杏石甘汤加味辅助治疗儿童咳嗽变异性哮喘(CVA)痰热闭肺证的临床疗效。方法选取2018年1月至2020年12月西南医科大学附属中医医院儿科门诊就诊的CVA痰热闭肺证患儿82例,采用随机数字表法分为对照组和治疗组,各41例。对照组予雾化吸入硫酸特布他林雾化液、布地奈德混悬液治疗,治疗组在对照组治疗方法的基础上予麻杏石甘汤加味治疗,2组均连续治疗14 d后,比较临床疗效、咳嗽转归和复发情况,治疗前后咳嗽症状积分、中医证候积分、肺功能[用力肺活量(FVC)、呼气峰流量率(PEFR)和第1秒用力呼气容积(FEV_(1))]指标情况、血清炎症因子[白介素-4(IL-4)、白介素-5(IL-5)、白介素-12(IL-12)、白介素-13(IL-13)及嗜酸性粒细胞(EOS)]水平。结果治疗组总有效率为97.5%(40/41),显著高于对照组的87.8%(36/41),2组比较,差异有统计学意义(P<0.05)。治疗前,2组日间、夜间咳嗽症状积分比较,差异无统计学意义(P>0.05),具有可比性;治疗后,2组上述咳嗽症状积分均较同组治疗前显著降低(P<0.05),且治疗组降低更显著,2组比较,差异有统计学意义(P<0.05)。治疗前,2组咳嗽、痰黄稠、尿赤便干、舌苔黄腻等中医证候积分比较,差异无统计学意义(P>0.05),具有可比性;治疗后,2组上述中医证候积分均较同组治疗前显著降低(P<0.05),且治疗组降低更显著(P<0.05)。治疗前,2组肺功能FVC、PEFR、FEV_(1)水平比较,差异无统计学意义(P>0.05),具有可比性;治疗后,2组上述肺功能指标水平均较同组治疗前显著上升(P<0.05),且治疗组上升更显著(P<0.05)。治疗前,2组血清IL-4、IL-5、IL-13和EOS水平比较,差异无统计学意义(P>0.05),具有可比性;治疗后,2组上述血清指标水平均较同组治疗前显著降低或升高(P<0.05),且治疗组降低或升高更显著(P<0.05)。治疗组咳嗽缓解、咳嗽消失时间明显短于对照组(P<0.05)。随访4周内,治疗组复发率�Objective To observe the clinical efficacy of modified Maxing Shigan Tang(麻杏石甘汤)in adjuvant treatment of cough variant asthma(CVA)in children with phlegm-heat obstructing lung syndrome.Methods From January 2018 to December 2020,82 cases of CVA in children with phlegm-heat obstructing lung syndrome consulted in outpatient service of pediatrics department in Hospital of TCM Affiliated to Southwest Medical University were divided into control group and treatment group according to random number table method,with 41 cases in each group.The control group was given nebulization inhalation of terbutaline sulphate solution for nebulization and budesonide suspension,on this basis,the treatment group was given modified Maxing Shigan Tang.After the 2 groups were continuously treated for 14 days,the clinical efficacy,recurrence and prognosis of cough,cough symptom score,TCM syndrome scores,pulmonary function indices[forced vital capacity(FVC),peak expiratory flow rate(PEFR)and forced expiratory volume in one second(FEV_(1))],serum inflammatory factors[interleukin-4(IL-4),interleukin-5(IL-5),interleukin-12(IL-12),interleukin-13(IL-13)and eosinophilic granulocyte(EOS)]levels before and after treatment were compared between the 2 groups.Results The total effective rate of the treatment group was 97.5%(40/41)in the treatment group,which was significantly higher than 87.8%(36/41)of the control group,and the difference was statistically significant between the 2 groups(P<0.05).Before treatment,the differences were not statistically significant in diurnal and nocturnal cough symptom scores between the 2 groups(P>0.05),indicating comparability.After treatment,the above-mentioned cough symptom scores in the 2 groups significantly decreased than those in the same group before treatment(P<0.05),moreover,the decrease was more significant in the treatment group,and the differences were statistically significant between the 2 groups(P<0.05).Before treatment,the differences were not statistically significant in TCM syndrome score

关 键 词：咳嗽变异性哮喘 小儿 痰热闭肺证 麻杏石甘汤 临床观察 

分 类 号：R256.12[医药卫生—中医内科学]