射干麻黄汤加减治疗痰湿蕴肺型儿童急性支气管炎临床研究  

Clinical Study on Modified Belamcanda and Ephedra Decoction in the Treatment of Children with Acute Bronchitis of Phlegm-Dampness Accumulation in the Lung Type

作　　者：罗申 LUO Shen(Gushi County Maternal and Child Health Hospital,Gushi,Henan,China,465200)

机构地区：[1]固始县妇幼保健院,河南固始465200

出　　处：《河南中医》2025年第2期183-188,共6页Henan Traditional Chinese Medicine

基　　金：河南省科技攻关计划项目(1021002310077)。

摘　　要：目的:观察射干麻黄汤加减治疗痰湿蕴肺型儿童急性支气管炎的临床疗效。方法:选取2023年2月至2024年7月固始县妇幼保健院收治的166例痰湿蕴肺型急性支气管炎患儿,按照随机数字表法分为研究组和对照组,每组各83例。对照组给予常规西药治疗,研究组在对照组治疗的基础上给予射干麻黄汤加减治疗,比较两组患儿的临床疗效、临床症状消失时间及治疗前后中医证候评分、炎性因子[白细胞介素(interleukin, IL)-6、IL-17、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)和干扰素-γ(interferon-γ,IFN-γ)]和肺功能指标[用力肺活量(forced vital capacity, FVC)、第1秒用力呼气容积(forced expiratory volume in one second, FEV1)、呼气流量峰值(forced expiratory peak, PEF)]改善情况。结果:研究组有效率为96.39%,高于同期对照组的84.33%(P<0.05)。治疗后两组患儿临床症状积分高于本组治疗前(P<0.05),研究组患儿咳嗽、发热、咽痛、流涕、鼻塞症状积分分别为(0.89±0.23)分、(1.15±0.29)分、(1.05±0.23)分、(1.02±0.37)分、(0.97±0.29)分,高于同期对照组(P<0.05)。治疗后研究组IL-6、IL-17和TNF-α水平分别为(25.29±4.18)μg·L^(-1)、(16.59±4.06)μg·L^(-1)和(82.63±8.59) ng·L^(-1),低于同期对照组(P<0.05),且IFN-γ水平为(10.26±1.53) ng·L^(-1),高于同期对照组(P<0.05)。研究组患儿体温恢复时间、咳嗽和咳痰消失时间分别为(3.53±0.95) d、(4.39±0.98) d、(3.46±0.81) d,短于对照组(P<0.05)。治疗后研究组患儿FVC、PEF和FEV1水平分别为(3.86±0.42) L、(3.07±0.42) L·s^(-1)、(3.04±0.39) L,高于同期对照组(P<0.05)。结论:射干麻黄汤加减治疗痰湿蕴肺型急性支气管炎疗效确切,能够缩短患儿症状恢复时间,还可改善中医证候、炎性因子水平和肺功能指标。Objective:To observe the clinical efficacy of Modified Belamcanda and Ephedra Decoction on children with acute bronchitis of phlegm-dampness accumulation in the lung type.Methods:A total of 166 children with acute bronchitis of phlegm-dampness accumulation the lung type admitted to Gushi County Maternal and Child Health Hospital from February 2023 to July 2024 were selected and randomly divided into the study group and the control group according to the random number table method,with 83 cases in each group.The control group was treated with conventional Western medicine,while the study group was treated with Modified Belamcandae and Ephedra Decoction on the basis of the control group′s treatment.The clinical efficacy,disappearance time of clinical symptoms,and improvement of TCM syndrome scores,inflammatory factors and lung function indicators before and after treatment were compared between the two groups.Results:The effective rate of the study group was 96.39%,which was higher than that of the control group(84.33%)during the same period(P<0.05).After treatment,the clinical symptom scores of both groups were higher than those before treatment(P<0.05);the scores of cough,fever,sore throat,runny nose and nasal congestion in the study group were(0.89±0.23)points,(1.15±0.29)points,(1.05±0.23)points,(1.02±0.37)points and(0.97±0.29)points respectively,which were higher than those of the control group during the same period(P<0.05);the levels of IL-6,IL-17 and TNF-αin the study group were(25.29±4.18)μg·L^(-1),(16.59±4.06)μg·L^(-1) and(82.63±8.59)ng·L^(-1) respectively,which were lower than those of the control group during the same period(P<0.05),and the level of IFN-γwas(10.26±1.53)ng·L^(-1),which was higher than that of the control group during the same period(P<0.05);the recovery time of body temperature,disappearance time of cough and expectoration in the study group were(3.53±0.95)days,(4.39±0.98)days and(3.46±0.81)days respectively,which were shorter than those of the control group(P<0.05);

关 键 词：儿童急性支气管炎 痰湿蕴肺证 射干麻黄汤 《金匮要略》 张仲景 

分 类 号：R272.256[医药卫生—中医儿科学]