1. 上海市东方医院,同济大学附属东方医院)儿科,上海,200123
2. 上海中医药大学附属市中医医院儿科,上海,200071
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刘芳, 虞坚尔, 张新光, 等. 中西医结合分期控制儿童支气管哮喘的临床疗效评价[J]. 上海中医药杂志, 2018,52(12):39-43.
LIU Fang, YU Jianer, ZHANG Xinguang, et al. Clinical efficacy evaluation on therapy of integrated traditional Chinese and western medicine by stages in controlling bronchial asthma in children[J]. Shanghai Journal of Traditional Chinese Medicine, 2018,52(12):39-43.
刘芳, 虞坚尔, 张新光, 等. 中西医结合分期控制儿童支气管哮喘的临床疗效评价[J]. 上海中医药杂志, 2018,52(12):39-43. DOI: 10.16305/j.1007-1334.2018.12.012.
LIU Fang, YU Jianer, ZHANG Xinguang, et al. Clinical efficacy evaluation on therapy of integrated traditional Chinese and western medicine by stages in controlling bronchial asthma in children[J]. Shanghai Journal of Traditional Chinese Medicine, 2018,52(12):39-43. DOI: 10.16305/j.1007-1334.2018.12.012.
目的:观察中西医结合分期疗法治疗儿童支气管哮喘的临床疗效。 方法:将80例支气管哮喘患儿随机分为治疗组与对照组,每组40例。对照组全程予西药GINA方案,治疗组予中西医结合方案分期治疗。两组疗程均约为4个半月、随访1年,观察临床疗效,比较主要症状体征积分及肺功能指标的变化情况,并采用儿童哮喘控制测试问卷 (C-ACT) 评分评估与比较哮喘的长期控制水平。 结果:①治疗组、对照组总有效率分别为92.5%、87.5%;组间临床疗效比较,治疗组存在优于对照组的趋势,但差异尚无统计学意义(P>0.05)。②治疗前与治疗1个半月、疗程结束时组内比较,两组主要症状体征积分差异均有统计学意义,均明显降低(P,<,0.05);治疗1个半月时,治疗组主要症状体征积分已明显低于对照组(P,<,0.05);疗程结束时,治疗组主要症状体征积分明显低于对照组(P,<,0.05)。③疗程结束时、随访6个月、随访1年与治疗前组内比较,两组C-ACT评分均明显升高(P,<,0.05)。随访1年与疗程结束时组内比较,对照组C-ACT评分明显降低(P,<,0.05),而治疗组C-ACT评分差异无统计学意义(P>0.05)。组间随访1年比较,治疗组C-ACT评分均明显高于对照组(P,<,0.05)。④治疗前与疗程结束时组内比较,两组FEV,1,%、PEF%水平差异均有统计学意义,均明显升高(P,<,0.05)。组间疗程结束时比较,FEV,1,%、PEF%水平差异无统计学意义(P>0.05)。 结论:在儿童支气管哮喘的全阶段,中西医结合分期疗法与全程西药疗法的临床疗效相当,但中西医结合分期疗法在慢性持续期、临床缓解期改善患儿症状与体征,随访期哮喘控制的远期疗效方面存在优势。
Objective:To observe the clinical efficacy of therapy of integrated traditional Chinese and western medicine by stages in treating bronchial asthma in children. Methods80 children with bronchial asthma were randomly divided into the treatment group and control group, 40 cases in each group. The control group was treated with western medicine according to GINA guidelines. The treatment group was treated with integrated traditional Chinese and western medicine by stages, with a treatment course of four and a half months and follow-up for one year. The clinical efficacy was observed, and the changes of main symptoms and signs scores and lung function indexes were compared, and the children asthma control test (C-ACT) questionnaire score was used to assess and compare the long-term control level of asthma. Results:①The total effective rates were 92.5% in the treatment group and 87.5% in the control group. The clinical efficacy of the treatment group was better than that of the control group, but with no statistically significant difference (P,>,0.05). ②Compared with treatment before, the main symptoms and signs scores were obviously decreased in both groups after treatment for one and a half months and at the end of treatment, with statistically significant differences (P,<,0.05). After treatment for one and a half months, the main symptoms and signs scores in the treatment group were significantly lower than those in the control group (P,<,0.05). At the end of the treatment, the main symptoms and signs scores in the treatment group were significantly lower than those in the control group (P,<,0.05). ③Compared with treatment before, the C-ACT score was significantly increased in both groups at the end of the treatment, after follow-up for 6 months and 1 year, respectively (P,<,0.05). Compared between the end of the treatment and follow-up for 1 year, the C-ACT score in the control group was significantly decreased (P,<,0.05), while no statistically significant difference on C-ACT score was observed in the treatment group (P,>,0.05). The C-ACT score in the treatment group was obviously higher than that in the control group after follow-up for 1 year (P,<,0.05). ④Compared with treatment before, the levels of FEV,1,% and PEF% were significantly increased in both groups at the end of the treatment, with statistically significant differences (P,<,0.05). At the end of the treatment, there were no statistically significant differences on the levels of FEV,1,% and PEF% between the two groups (P,>,0.05). Conclusion:At the whole stage of bronchial asthma in children, the therapy of integrated traditional Chinese and western medicine by stages shows equivalent clinical efficacy with western medicine therapy, while the therapy of integrated traditional Chinese and western medicine by stages shows advantages in improving symptoms and signs in the chronic persistent phase and clinical remission stage and enhancing long-term efficacy of asthma controlling during follow-up.
儿童哮喘中西医结合分期治疗病情控制C-ACT评分远期疗效
childhood asthmaintegrated traditional Chinese and western medicinetreatment by stagesdisease controlC-ACT scorelong-term efficacy
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