唐氏固表方治疗肺脾气虚证儿童反复呼吸道感染的临床研究  

Clinical Study of Tang’s Gubiao Recipe for the Treatment of Recurrent Respiratory Tract Infection in Children with Lung-qi and Spleen-qi Deficiency Syndrome

作　　者：芦小叶 赵鋆[1] 金莺[2] 刘怡菁 杨楚文 马春艳[1] LU Xiao-Ye;ZHAO Yun;JIN Ying;LIU Yi-Jing;YANG Chu-Wen;MA Chun-Yan(Dept.of Pediatrics,Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China;The First Affiliated Hospital of Zhejiang Chinese Medical University(Zhejiang Provincial Hospital of Traditional Chinese Medicine),Zhejiang 310006,China;Shanghai Fangta Traditional Chinese Medicine Hospital,Shanghai 201699,China)

机构地区：[1]上海中医药大学附属曙光医院儿科,上海201203 [2]浙江中医药大学附属第一医院(浙江省中医院),浙江杭州310006 [3]上海市松江区方塔中医医院,上海201699

出　　处：《广州中医药大学学报》2023年第9期2237-2243,共7页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：上海市科学技术委员会科技计划项目(编号:18401904700,17401970900);上海市中医药传承创新发展三年行动计划(2021-2023)资助项目[编号:ZY(2021-2023)-0206-02];上海市卫生健康委临床科研专项(编号:20204Y0192)。

摘　　要：【目的】观察唐氏固表方对儿童反复呼吸道感染(RRTI)肺脾气虚证的临床疗效及免疫指标的影响。【方法】将300例肺脾气虚证RRTI患儿随机分为对照组和治疗组,每组各150例。治疗组给予唐氏固表方治疗,对照组给予玉屏风颗粒治疗,疗程为2个月并随访12个月。观察2组患儿治疗前后中医证候积分、血清免疫球蛋白IgG、IgA、IgM、IgE及T细胞亚群CD3^(+)、CD4^(+)、CD8^(+)水平的变化情况,并评价2组患儿的临床疗效。【结果】(1)完成治疗和随访情况:治疗过程中,治疗组脱落8例,对照组脱落7例,总脱落率为5%,完成治疗285例,其中,治疗组142例,对照组143例;完成第一次随访269例,完成第二次随访261例,完成第三次随访257例(包括治疗组127例和对照组130例)。(2)疗效情况:经随访12个月,治疗组的总有效率为99.21%(126/127),对照组为87.69%(114/130),组间比较,治疗组的总有效率(χ^(2)检验)和总体疗效(秩和检验)均明显优于对照组(P<0.01)。(3)中医证候积分情况:治疗后及治疗后3个月、6个月和12个月随访时,2组患儿的中医证候积分均较治疗前明显降低(P<0.05),且随着时间延长均呈逐渐递减的趋势;组间比较,治疗组在治疗后3个月、6个月和12个月随访时的降低幅度均明显优于对照组(P<0.01)。(4)免疫球蛋白情况:治疗后,2组患儿血清IgA水平均较治疗前明显升高(P<0.05),血清IgE水平均较治疗前明显降低(P<0.05),且治疗组血清IgA水平的升高幅度及血清IgE水平的降低幅度均明显优于对照组(P<0.01);而2组患儿血清IgG、IgM水平治疗前后及组间比较,差异均无统计学意义(P>0.05)。(5)T细胞亚群情况:治疗后,2组患儿的T细胞亚群CD3^(+)、CD8^(+)水平均较治疗前明显升高(P<0.05),且治疗组的升高幅度均明显优于对照组,差异均有统计学意义(P<0.01);而2组患儿的CD4^(+)水平治疗前后及组间比较差异均无统计学意义(P>0.05)。【结论】唐氏�Objective To observe the clinical efficacy of Tang’s Gubiao Recipe in treating children with recurrent respiratory tract infection(RRTI)with lung-qi and spleen-qi deficiency syndrome and to investigate its effect on the immune indexes.Methods The 300 children with RRTI of lung-qi and spleen-qi deficiency type were randomly divided into a control group and a treatment group,with 150 cases in each group.The treatment group was treated with Tang’s Gubiao Recipe and the control group was treated with Yupingfeng Granules.Both groups were treated for a period of 2 months and were followed up for 12 months.The changes in the traditional Chinese medicine(TCM)syndrome scores and the serum levels of immunoglobulin IgG,IgA,IgM,IgE and T cell subsets CD3^(+),CD4^(+)and CD8^(+)were observed before and after treatment.After treatment,the clinical efficacy of the two groups was evaluated.Results(1)During the treatment,there were 8 cases falling off from the treatment group and 7 cases falling off from the control group,with an overall falling-off rate of 5%.A total of 285 cases completed the treatment,including 142 cases in the treatment group and 143 cases in the control group.A total of 269 cases completed the first follow-up,261 cases completed the second follow-up,and 257 cases(127 cases from the treatment group and 130 cases from the control group)completed the third follow-up.(2)After 12 months of follow-up,the overall effective rate of the treatment group was 99.21%(126/127)and that of the control group was 87.69%(114/130).The intergroup comparison showed that the overall effective rate(tested by Chi-square test)and overall efficacy(tested by rank sum test)of the treatment group were significantly superior to those of the control group(P<0.01).(3)After treatment and at the 3-month,6-month and 12-month follow-ups after treatment,the TCM syndrome scores in both groups were significantly decreased compared with those before treatment(P<0.05),and the scores showed a decreasing trend with the prolongation of the follow-up

关 键 词：唐氏固表方 反复呼吸道感染 肺脾气虚证 玉屏风颗粒 免疫功能 临床疗效 

分 类 号：R259.622[医药卫生—中西医结合]