中西医结合治疗轻中度小儿闭塞性细支气管炎痰热闭肺证43例临床观察  

Clinical observation on 43 cases of mild to moderate pediatric bronchiolitis obliterans with phlegm and heat syndrome treated by combination of traditional Chinese medicine with Western medicine

作　　者：曹丽萍 陈金来 杨晓鸿[4] CAO Liping;CHEN Jinlai;YANG Xiaohong(Second Clinical College of Medicine,Zhejiang University of Chinese Medicine,Hangzhou,Zhejiang,310053,China;Department of Integrated Traditional Chinese and Western Medicine,Fuyang Fuguang Chinese Medicine Hospital,Hangzhou,Zhejiang,311404,China;Department of Traditional Chinese Medicine,Hangzhou Fuguang Chinese Medicine Hospital,Hangzhou,Zhejiang,311404;Pediatrics of Taizhou Hospital,Taizhou,Zhejiang,317099,China)

机构地区：[1]浙江中医药大学第二临床医学院,浙江杭州310053 [2]杭州富阳福光中草药专科医院中西医结合科,浙江杭州311404 [3]杭州富阳福光中草药专科医院中医科,浙江杭州311404 [4]浙江省台州医院儿科,浙江台州317099

出　　处：《中医儿科杂志》2022年第5期52-56,共5页Journal of Pediatrics of Traditional Chinese Medicine

摘　　要：目的观察中西医结合治疗轻中度小儿闭塞性细支气管炎痰热闭肺证的临床疗效。方法选取2019年1月至2021年1月杭州富阳福光中草药专科医院中西医结合科收治的闭塞性细支气管炎痰热闭肺证患儿85例,采用随机数字表法分为对照组42例和治疗组43例。对照组给予布地奈德混悬液雾化吸入、孟鲁司特钠片口服、乳糖酸阿奇霉素静脉滴注,治疗组在对照组治疗方法的基础上给予中药清肺化痰方治疗。2组均以7 d为1个疗程,治疗2个疗程后统计疗效。结果对照组总有效率为78.57%(33/42),治疗组为95.35%(41/43),2组比较,差异有统计学意义(P<0.01)。治疗组咳嗽、气促、喘憋和肺部啰音消失时间明显短于对照组,2组比较,差异有统计学意义(P<0.05)。治疗前2组肺活量(FVC)、第1秒用力呼气容积(FEV_(1))、FEV_(1)/FVC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FVC、FEV_(1)、FEV_(1)/FVC水平均明显升高,与同组治疗前比较,差异有统计学意义(P<0.05),且治疗组升高更显著(P<0.05)。治疗前2组CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)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CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平明显升高,CD8^(+)水平明显下降,与同组治疗前比较,差异均有统计学意义(P<0.05),且治疗组升高或下降更显著(P<0.05)。结论中西医结合治疗轻中度小儿闭塞性细支气管炎痰热闭肺证,能有效缓解临床症状、体征,改善肺功能,提高机体免疫力,疗效满意,值得临床推广应用。Objective To observe the clinical efficacy of traditional Chinese medicine combined with Western medicine on mild to moderate pediatric obliterating bronchiolitis with phlegm and heat syndrome.Methods 85 cases of patients with mild to moderate obliterating bronchiolitis,who were admitted to the Department of Integrated Traditional Chinese and Western Medicine in Fuyang Fuguang Chinese Medicine Hospital from January 2019 to January 2021,were divided into control group with 42 cases and treatment group with 43 cases by random number table method.The control group was given budesonide suspension,oral montelukast sodium tablets,and intravenous infusion of azithromycin lactate,and the treatment group was given traditional Chinese medicine on the basis of treatment method of the control group.One week constituted 1 course of treatment for both groups.After 2 courses of treatment,the clinical efficacy,lung function and immune function were compared.Results The total effective rate was 78.57%(33/42)in the control group and 95.35%(41/43)in the treatment group,and the difference was statistically significant(P<0.01);cough,shortness of breath,wheezing and asthma in the treatment group disappeared earlier than in the control group,and the difference was statistically significant(P<0.05).Before treatment,there was no significant difference in vital capacity(FVC),forced expiratory volume in 1 second(FEV_(1)),and FEV_(1)/FVC levels between the two groups(P>0.05),which were comparable;After treatment,the levels of FVC,FEV_(1),FEV_(1)/FVC in the two groups were significantly increased,and the difference was statistically significant compared with that in the same group before treatment(P<0.05),and the increase in the treatment group was more significant(P<0.05).There was no significant difference in the levels of CD3^(+),CD4^(+),CD8^(+),CD4^(+)/CD8^(+)between the two groups before treatment(P>0.05),which was comparable;After treatment,the levels of CD3^(+),CD4^(+),CD4^(+)/CD8^(+)in the two groups were significantly increased,and

关 键 词：小儿 闭塞性细支气管炎 痰热闭肺证 临床观察 

分 类 号：R725.6[医药卫生—儿科]