1. 上海市浦东新区公利医院中医科,上海,200135
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叶璐, 唐苾芯, 郭艳芳, 等. 抗敏治咳方联合咳喘宁穴位敷贴治疗儿童风寒型咳嗽变异性哮喘疗效观察[J]. 上海中医药杂志, 2019,53(12):56-60.
YE Lu, TANG Bixin, GUO Yanfang, et al. Observation on the therapeutic effect of Kangmin Zhike decoction combined with Kechuanning acupoint application on children with cough variant asthma of wind cold type[J]. Shanghai Journal of Traditional Chinese Medicine, 2019,53(12):56-60.
叶璐, 唐苾芯, 郭艳芳, 等. 抗敏治咳方联合咳喘宁穴位敷贴治疗儿童风寒型咳嗽变异性哮喘疗效观察[J]. 上海中医药杂志, 2019,53(12):56-60. DOI: 10.16305/j.1007-1334.2019.12.016.
YE Lu, TANG Bixin, GUO Yanfang, et al. Observation on the therapeutic effect of Kangmin Zhike decoction combined with Kechuanning acupoint application on children with cough variant asthma of wind cold type[J]. Shanghai Journal of Traditional Chinese Medicine, 2019,53(12):56-60. DOI: 10.16305/j.1007-1334.2019.12.016.
目的:观察抗敏治咳方联合咳喘宁穴位敷贴治疗儿童风寒型咳嗽变异性哮喘的临床疗效。 方法:将90例风寒型咳嗽变异性哮喘患儿随机分为对照组、汤药组与联合组,每组30例。对照组予孟鲁司特钠咀嚼片,汤药组予抗敏治咳方口服,联合组予抗敏治咳方联合咳喘宁穴位敷贴。各组疗程均为8周,观察比较中医证候积分、第1秒用力呼气容积占预计值百分比(FEV1%)、最大呼气流量占预计值百分比(PEF%)、呼出气一氧化氮(FeNO)浓度的变化情况,疗程结束后2个月观察复发情况。 结果:①治疗前后组内比较,各组中医证候积分差异均有统计学意义(P<0.01);组间中医证候积分治疗前后差值比较,汤药组改善优于对照组(P<0.05),联合组改善优于对照组(P<0.01)和汤药组(P<0.05)。②治疗前后组内比较,各组FEV1%、PEF%水平均有升高(P<0.05),其中联合组升高幅度更加明显(P<0.01);组间治疗后FEV1%、PEF%比较,汤药组改善优于对照组(P<0.05),联合组改善优于对照组(P<0.01)和汤药组(P<0.05)。③治疗前后组内比较,各组FeNO水平均有下降(P<0.05),其中联合组降低幅度更加显著(P<0.01);组间治疗后比较,汤药组FeNO改善优于对照组(P<0.05),联合组改善优于对照组(P<0.01)和汤药组(P<0.05)。④对照组、汤药组与联合组复发率分别为32.00%、18.52%和7.14%,差异有统计学意义(P<0.01)。⑤试验期间,各组患者均未见严重不良反应,血常规、二便常规、肝肾功能均未检出异常。 结论:抗敏治咳方联合咳喘宁穴位敷贴治疗儿童风寒型咳嗽变异性哮喘,可明显改善患儿症状、肺功能和气道炎症,并降低复发率。
Objective:To observe the clinical effect of Kangmin Zhike (anti-allergy and cough-relieving) decoction combined with Kechuanning (cough-asthma-calming) acupoint application on children with cough variant asthma (CVA) due to wind-cold. MethodsRandomly divide 90 children with CVA into the control group, the decoction group and the combination group with 30 cases each. The control group was given montelukast sodium chewable tablets, the decoction group was given Kangmin Zhike (anti-allergy and cough-relieving) decoction orally, and the combination group was given Kangmin Zhike (anti-allergy and cough-relieving) decoction and Kechuanning (cough-asthma-calming) acupoint application. All the three groups were treated for 8 weeks. The scores of TCM patterns, the changes of percentage of forced expiratory volume in 1 second (FEV1%), percentage of predicted peak expiratory flow (PEF%) and fractional exhaled nitric oxide (FeNO) concentration were observed and compared, and the recurrence was also observed 2 months after the treatment. Results:①The differences of TCM pattern scores in each group before and after treatment were significant (P<0.01); according to the comparison of difference values calculated based on TCM pattern scores before and after treatment, the decoction group showed better improvement than the control group (P<0.05) and the improvement in the combination group was even more significant than that in the control group (P<0.01) and that in the control group (P<0.01) and that in the decoction group (P<0.05). ②The FEV1% and PEF% of the three groups all increased after treatment (P<0.05), and the increase of FEV1% and PEF% was especially significant in the combination group (P<0.01); Based on the comparison of FEV1% and PEF% among three groups after treatment, the improvement in the decoction group was better than that in the control group (P<0.05) and the improvement in the combination group was better than that in the control group (P<0.01) and that in the decoction group (P<0.05). ③The levels of FeNO of the three groups all decreased when compared before and after treatment (P<0.05), and the decrease of FeNO level was more significant in the combination group (P<0.01); According to the comparison of FeNO levels among groups after treatment, the decoction group had a lower FeNO level than the control group (P<0.05), and the combination group had an even lower FeNO level than the control group (P<0.01) and the decoction group (P<0.05). ④The recurrence rates of the control group, decoction group and combination group were 32.00%, 18.52% and 7.14% respectively, and the differences were statistically significant (P<0.01). ⑤During the trial, no serious adverse reactions were found in each group, and no abnormality was found in blood routine test, urination and stool routine test, and liver and kidney function test. Conclusion:The combination of Kangmin Zhike (anti-allergy and cough-relieving) decoction and Kechuanning (cough-asthma-calming) acupoint application can significantly improve the symptoms, pulmonary function and airway inflammation of children with wind-cold type CVA, and reduce the recurrence rate.
咳嗽变异性哮喘儿童中医药疗法抗敏治咳方咳喘宁穴位敷贴
cough variant asthma (CVA)childrenTCM therapyKangmin Zhike (anti-allergy and cough-relieving) decoctionKechuanning (cough-asthma-calming)acupoint application
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