解痉定喘方治疗咳嗽变异性哮喘的临床疗效研究  

Study on the Clinical Efficacy of Jiejing Dingchuan Decoction for the Treatment of Cough Variant Asthma

作　　者：张瑞 徐卫方[1] 许国博 张羽若 ZHANG Rui;XU Wei-Fang;XU Guo-Bo;ZHANG Yu-Ruo(Shenzhen Futian Hospital of Guangzhou University of Chinese Medicine,Shenzhen 518000 Guangdong,China;The Sixth Clinical Medical School of Guangzhou University of Chinese Medicine,Shenzhen 518000 Guangdong,China)

机构地区：[1]广州中医药大学深圳医院(福田),广东深圳518000 [2]广州中医药大学第六临床医学院,广东深圳518000

出　　处：《广州中医药大学学报》2023年第6期1362-1368,共7页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：广东省自然科学基金面上项目(编号:2020A1515010589)。

摘　　要：【目的】评价解痉定喘方(由定喘汤加减组方而成)治疗咳嗽变异性哮喘(CVA)的临床疗效和安全性。【方法】将104例CVA风邪犯肺兼痰热证患者随机分为中药组51例和对照组53例。中药组给予解痉定喘方口服治疗,对照组给予布地奈德福莫特罗粉吸入剂吸入治疗,疗程为8周。观察2组患者治疗前后中医证候积分、咳嗽症状积分、中文版莱切斯特咳嗽问卷(LCQ-MC)评分、肺功能指标第一秒用力呼气容积(FEV1)、气道炎症指标呼出气一氧化氮(FeNO)的变化情况,比较2组患者的咳嗽缓解时间,并评价2组患者的中医证候疗效及安全性。【结果】(1)中医证候疗效方面,治疗8周后,中药组的控显率和总有效率分别为76.47%(39/51)、92.16%(47/51),对照组分别为56.60%(30/53)、81.13%(43/53),组间比较,中药组的控显率、总有效率和总体疗效均优于对照组(P<0.05)。(2)疗效性指标方面,治疗后,2组患者的中医证候积分、咳嗽症状积分、LCQ-MC评分、肺功能指标FEV1值和气道炎症指标FeNO水平均较治疗前明显改善(P<0.05或P<0.01),且中药组对中医证候积分、咳嗽症状积分、LCQ-MC评分、气道炎症指标FeNO水平的改善作用均明显优于对照组(P<0.05或P<0.01),而2组治疗后肺功能指标FEV1值比较差异无统计学意义(P>0.05)。(3)咳嗽缓解时间方面,中药组的咳嗽缓解时间为(8.96±4.57)d,较对照组的(19.17±8.71)d明显缩短(P<0.01)。(4)治疗过程中,仅对照组2例患者出现声音嘶哑,1例患者出现心慌症状但休息后可自行缓解外,其余患者均无明显不良反应发生。【结论】解痉定喘方治疗CVA风邪犯肺兼痰热证患者疗效显著,能够有效降低患者气道反应,改善患者临床症状,提高临床控制水平,并对患者生活质量有积极作用。Objective To evaluate the clinical efficacy and safety of the Jiejing Dingchuan Decoction(composed of modification of Dingchuan Decoction)for the treatment of cough variant asthma(CVA).Methods A total of 104 patients with CVA of wind-pathogen attacking lung complicated with phlegm-heat syndrome were randomly divided into 51 cases in the Chinese medicine group and 53 cases in the control group.The Chinese medicine group was given oral administration of Jiejing Dingchuan Decoction,while the control group was given inhalation of Budesonide Formoterol powder.Both groups of patients were treated for a period of 8 weeks.The changes in the traditional Chinese medicine(TCM)syndrome scores,cough symptom scores,Mandarin Chinese version of Leicester cough questionnaire(LCQ-MC)life quality scores,lung function indicator of forced expiratory volume in one second(FEV1)and airway inflammation indicator of fractional exhaled nitric oxide(FeNO)in the two groups were observed before and after treatment.Moreover,the duration of cough remission was compared between the two groups,and the TCM syndrome efficacy and safety of the two groups were evaluated.Results(1)After 8 weeks of treatment,the clinically controlled and markedly effective rate and total effective rate of TCM syndrome efficacy in the Chinese medicine group were 76.47%(39/51)and 92.16%(47/51)respectively,while those in the control group were 56.60%(30/53)and 81.13%(43/53)respectively.The intergroup comparison showed that the clinically controlled and markedly effective rate,total effective rate and overall efficacy of the Chinese medicine group were superior to those of the control group(P<0.05).(2)In terms of the efficacy indexes,the TCM syndrome scores,cough symptom scores,LCQ-MC scores,FEV1 value and FeNO level in the two groups after treatment were significantly improved compared with those before treatment(P<0.05 or P<0.01),and the improvement of TCM syndrome scores,cough symptom scores,LCQ-MC scores and FeNO level in the Chinese medicine group was significantly su

关 键 词：咳嗽变异性哮喘 风邪犯肺兼痰热证 解痉定喘方 肺功能 气道炎症 气道反应 生活质量 

分 类 号：R256.12[医药卫生—中医内科学]