麻黄附子细辛汤联合沙美特罗替卡松粉吸入剂治疗老年慢性支气管哮喘临床研究  

Clinical Study on the Treatment of Chronic Bronchial Asthma in the Elderly with Ephedra and Aconite and Asarum Decoction and Salmeterol Fluticasone Powder Inhaler

作　　者：杨玲[1] YANG Ling(Third Affiliated Hospital of Henan University of Traditional Chinese Medicine,Zhengzhou,Henan,China,450008)

机构地区：[1]河南中医药大学第三附属医院,河南郑州450008

出　　处：《河南中医》2023年第2期184-188,共5页Henan Traditional Chinese Medicine

摘　　要：目的:观察麻黄附子细辛汤联合沙美特罗替卡松粉吸入剂治疗老年慢性支气管哮喘的临床疗效。方法:将98例老年慢性支气管哮喘患者按照随机数字表法分为对照组47例和治疗组51例。对照组给予沙美特罗替卡松粉吸入剂经口吸入,治疗组在对照组治疗的基础上联合麻黄附子细辛汤。比较两组患者的临床疗效、不良反应发生率及治疗前后中医证候积分、哮喘控制测试(asthma control test,ACT)评分、肺功能[用力呼气流量峰值(forced expiratory peak,PEF)、用力肺活量(forced vital capacity,FVC)、一秒用力呼气容积(forced expiratory volume in one second,FEV_(1))]、细胞因子水平[白细胞介素-4(interleukin-4,IL-4)、干扰素-γ(interferon-γ,IFN-γ)、转化生长因子-β1(transforming growth factor-β1,TGF-β1)]变化情况。结果:对照组有效率为87.23%,治疗组有效率为98.04%,两组患者有效率比较,差异具有统计学意义(P<0.05)。两组治疗后中医证候积分低于本组治疗前,ACT评分高于本组治疗前,且治疗后组间比较,差异具有统计学意义(P<0.05)。两组治疗后PEF、FVC及FEV_(1)高于本组治疗前,且治疗后治疗组高于对对照组,差异具有统计学意义(P<0.05)。两组患者治疗后IFN-γ高于本组治疗前,IL-4及TGF-β1低于本组治疗前,且治疗后组间比较,差异具有统计学意义(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:麻黄附子细辛汤联合沙美特罗替卡松粉吸入剂治疗老年慢性支气管哮喘,可明显改善患者的临床症状及肺功能,有效拮抗炎性细胞因子及转化生长因子表达,减轻呼吸道炎症反应,阻止气道重塑发生。Objective:To observe the clinical efficacy of Ephedra and Aconite and Asarum Decoction and salmeterol fluticasone powder inhaler on chronic bronchial asthma in the elderly.Methods:A total of 98 elderly patients with chronic bronchial asthma were randomly divided into the control group with 47 cases and the treatment group with51 cases.The control group was given salmeterol fluticasone powder inhaler orally,while the treatment group was additionally given Ephedra and Aconite and Asarum Decoction on the basis of the treatment of the control group.Then the clinical efficacy,the incidence of adverse reactions,the changes of the score of TCM syndrome,the score of asthma control test(ACT),lung function[including forced expiratory peak(PEF),forced vital capacity(FVC),forced expiratory volume in one second(FEV_(1))],cytokine levels[including interleukin-4(IL-4),interferon-γ(IFN-γ),transforming growth factor-β1(TGF-β1)]of the two groups before and after treatment were compared.Results:The effective rate was 87.23%in the control group and 98.04%in the treatment group.The difference between the two groups was statistically significant(P<0.05).After treatment,the TCM syndrome score of the two groups was lower than that of the same group before treatment,while the ACT score was higher than that of the same group before treatment,and all the differences between the two groups were statistically significant(P<0.05).The PEF,FVC and FEV_(1)of the two groups after treatment were higher than those of the same group before treatment,and the above indexes of the treatment group were higher than those of the control group,and all the differences were statistically significant(P<0.05).IFN-γof two groupswere higher than those of the same group before treatment,while IL-4 and TGF-β1 were lower than those of the same group before treatment,and all the differences were statistically significant(P<0.05).However,there was no significant difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusion:Eph

关 键 词：慢性支气管哮喘 老年 麻黄附子细辛汤 沙美特罗替卡松粉吸入剂 中西医结合疗法 《伤寒论》 张仲景 

分 类 号：R259.622.5[医药卫生—中西医结合]