麻杏二陈汤加味联合火罐治疗儿童支气管哮喘慢性持续期肺脾两虚证临床研究  

Clinical Study on Modified Maxing Erchen Decoction Combined with Fire Cupping for Chronic Persistent Bronchial Asthma in Children with Deficiency of Both Lung and Spleen Syndrome

作　　者：陈萍萍 CHEN Pingping(Haining Hospital of Chinese Medicine,Haining Zhejiang 314400,China)

机构地区：[1]海宁市中医院,浙江海宁314400

出　　处：《新中医》2025年第8期93-98,共6页New Chinese Medicine

基　　金：海宁市科技计划项目(2021107)。

摘　　要：目的:观察在舒利迭基础上加用麻杏二陈汤加味联合火罐治疗儿童支气管哮喘慢性持续期肺脾两虚证的临床疗效。方法:选择2023年4月—2024年5月于海宁市中医院就诊的88例支气管哮喘慢性持续期肺脾两虚证患儿,随机分为对照组和观察组各44例。2组均予舒利迭治疗,观察组加用麻杏二陈汤加味联合火罐治疗,2组均治疗4周。治疗前后评定中医证候评分,检测肺功能指标[用力肺活量(FVC)、第1秒用力呼气容积(FEV_(1))、最大呼气流速(PEF)及FEV_(1)/FVC值]、炎症因子指标[嗜酸性粒细胞计数、淀粉样蛋白、C-反应蛋白]、气道重塑指标[血管内皮生长因子、转化生长因子β1、内皮素1],比较2组的咳痰消失时间、咳嗽消失时间、喘息消失时间、哮鸣音消失时间与临床疗效。结果:治疗后,观察组总有效率高于对照组(P<0.05)。观察组咳痰消失时间、咳嗽消失时间、喘息消失时间、哮鸣音消失时间均短于对照组(P<0.05)。2组咳嗽痰稀、神疲懒言、气短汗出、面白少华评分均较治疗前降低(P<0.05);观察组4项中医证候评分均低于对照组(P<0.05)。2组FVC、FEV_(1)、FEV_(1)/FVC、PEF值均较治疗前升高(P<0.05),观察组4项指标值均高于对照组(P<0.05)。2组血清嗜酸性粒细胞计数、淀粉样蛋白、C-反应蛋白、血管内皮生长因子、转化生长因子β1、内皮素1水平均较治疗前下降(P<0.05),观察组6项指标值均低于对照组(P<0.05)。结论:在舒利迭基础上加用麻杏二陈汤加味联合火罐治疗儿童支气管哮喘慢性持续期肺脾两虚证具有较好的临床效果,可加快症状的缓解、减轻炎症反应、改善肺功能,安全性较高。Objective:To observe the clinical effect of modified Maxing Erchen Decoction combined with fire cupping based on the Salmeterol and Fluficasone treatment on chronic persistent bronchial asthma in children with deficiency of both lung and spleen syndrome.Methods:A total of 88 children of chronic persistent bronchial asthma with deficiency of both lung and spleen syndrome who received treatment at Haining Hospital of Chinese Medicine from April 2023 to May 2024 were randomly divided into the control group and the observation group,with 44 cases in each group.Both groups were treated with Salmeterol and Fluficasone,while the observation group was treated with modified Maxing Erchen Decoction combined with fire cupping therapy.Both groups were treated for four weeks.Evaluated traditional Chinese medicine syndrome scores before and after treatment,measured lung function indicators such as forced vital capacity(FVC),forced expiratory volume in one second(FEV_(1)),maximum expiratory flow rate(PEF),and FEV_(1)/FVC values,inflammatory factor indicators such as eosinophil count,amyloid protein,C-reactive protein,and airway remodeling indicators such as vascular endothelial growth factor,transforming growth factor beta 1,and endothelin 1.Compared the disappearance time of sputum,cough,asthma,wheezing,and the clinical efficacy between the two groups.Results:After treatment,the total effective rate in the observation group was higher than that in the control group(P<0.05).The disappearance time of sputum,cough,asthma,and wheezing in the observation group was shorter than that in the control group(P<0.05).Both groups showed a decrease in scores of cough and thin phlegm,fatigue and no desire to speak,shortness of breath,sweating,and whitish complexion with lusterless complexion compared to those before treatment(P<0.05);the scores of the four traditional Chinese medicine syndromes in the observation group were lower than those in the control group(P<0.05).The FVC,FEV_(1),FEV_(1)/FVC,and PEF values in both groups were increased

关 键 词：支气管哮喘 慢性持续期 儿童 肺脾两虚证 麻杏二陈汤 火罐 肺功能 气道重塑 

分 类 号：R725.6[医药卫生—儿科]