1. 上海市儿童医院,上海交通大学附属儿童医院中医科,上海,200040
2. 上海中医药大学公共健康学院,上海,200040
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李颉, 戎芬, 李华, 等. 化痰祛风方治疗小儿呼吸道感染后慢性咳嗽(痰湿证)的临床研究[J]. 上海中医药杂志, 2020,54(10):62-67.
LI Jie, RONG Fen, LI Hua, et al. Clinical study on Huatan Qufeng Prescription in treating chronic cough (phlegm-dampness syndrome) after respiratory tract infection in children[J]. Shanghai Journal of Traditional Chinese Medicine, 2020,54(10):62-67.
李颉, 戎芬, 李华, 等. 化痰祛风方治疗小儿呼吸道感染后慢性咳嗽(痰湿证)的临床研究[J]. 上海中医药杂志, 2020,54(10):62-67. DOI: 10.16305/j.1007-1334.2020.2001071.
LI Jie, RONG Fen, LI Hua, et al. Clinical study on Huatan Qufeng Prescription in treating chronic cough (phlegm-dampness syndrome) after respiratory tract infection in children[J]. Shanghai Journal of Traditional Chinese Medicine, 2020,54(10):62-67. DOI: 10.16305/j.1007-1334.2020.2001071.
目的:研究化痰祛风方治疗小儿呼吸道感染后慢性咳嗽(痰湿证)的临床疗效。 方法:将92例呼吸道感染后慢性咳嗽(痰湿证)患儿随机分为对照组和治疗组,每组46例。对照组予孟鲁斯特钠咀嚼片,咳嗽严重者加服氨溴特罗口服溶液;治疗组给予化痰祛风方中药颗粒剂口服。两组疗程均为14 d,观察临床症状、体征、咳嗽视觉模拟评分(visual analogue scale,VAS)、血清学指标(白细胞、血红蛋白、嗜酸性粒细胞计数)变化情况,评价临床疗效及安全性。 结果:①治疗组组内两时间点之间进行两两比较(即D5与D0,D10与D5,D14与D10比较),VAS差异有统计学意义(P<0.05);对照组组内两时间点进行两两比较(即D5与D0,D10与D5,D14与D10比较),VAS差异有统计学意义(P<0.05);组间相同观察时点比较,D5、D10、D14时点VAS差异有统计学意义(P<0.05)。②治疗前后组内比较,两组主症总积分、次症总积分、体征量化积分差异均有统计学意义(P<0.05);组间治疗后比较,主症总积分、次症总积分、咳嗽体征量化积分均少于对照组(P<0.05)。③治疗组、对照组主症总有效率分别为87.0%、65.2%,组间主症疗效差异有统计学意义(P<0.05);治疗组、对照组次症总有效率分别为89.1%、60.9%,组间次症疗效差异有统计学意义(P<0.05);治疗组、对照组咳嗽体征量化评价总有效率分别为69.6%、39.1%,组间咳嗽体征量化评价疗效差异有统计学意义(P<0.05)。④治疗后,两组白细胞、血红蛋白指标比较,差异无统计学意义(P>0.05),治疗组嗜酸性粒细胞绝对计数低于对照组(P<0.05)。⑤研究期间,治疗组发生2例不良反应,对照组发生3例不良反应;两组间不良反应比较,差异无统计学意(P>0.05)。 结论:化痰祛风方能有效减少小儿呼吸道感染后慢性咳嗽(痰湿证)咳嗽次数,减轻咳嗽咳痰程度,同时改善精神状态、饮食情况、排便情况等相关症状群,疗效显著且使用安全,值得临床推广及进一步规范研究。
Objective:To study the clinical effect of Huatan Qufeng (resolving phlegm and dispelling wind) Prescription on chronic cough (phlegm-dampness syndrome) in children after respiratory tract infection. MethodsA total of 92 children with chronic cough (phlegm-dampness syndrome) after respiratory tract infection were randomly divided into control group and treatment group, 46 cases in each group. The control group was given montelukast sodium chewable tablets, and ambroxol oral solution was added to patients with severe cough. The treatment group was given Huatan Qufeng Prescription in granule form for oral intake. The course of treatment was 14 days in both groups. The clinical symptoms, signs, cough visual analogue scale (VAS) and serological indexes (leukocyte, hemoglobin, eosinophil count) were observed to evaluate the clinical efficacy and safety. Results:①There were significant differences in VAS between two time points (D5 and D0, D10 and D5, D14 and D10) in the treatment group (P<0.05); In the control group, there were significant differences in VAS between two time points (D5 and D0, D10 and D5, D14 and D10) (P<0.05); Compared between the two groups at the same observation time points, differences in VAS at D5, D10 and D14 were statistically significant (P<0.05). ②There were significant differences in the total score of main symptoms, the total score of secondary symptoms and the quantitative score of physical signs before and after treatment in both groups (P<0.05); After treatment, the total score of main symptoms, the total score of secondary symptoms and the quantitative score of cough physical signs of the treatment group were less than those of the control group (P<0.05). ③The total effective rates of the main symptoms in the treatment group and the control group were 87.0% and 65.2% respectively, and the difference between the two groups was statistically significant (P<0.05); The total effective rates of secondary symptoms in the treatment group and the control group were 89.1% and 60.9% respectively, and the difference between the two groups was statistically significant (P<0.05); The total effective rates of quantitative evaluation of cough signs in the treatment group and the control group were 69.6% and 39.1% respectively, and the difference between the two groups was statistically significant (P<0.05). ④After treatment, there was no significant difference in leukocyte and hemoglobin indexes between the two groups (P>0.05). The absolute eosinophil count in the treatment group was lower than that in the control group (P<0.05). ⑤In the course of study, 2 cases of adverse reactions occurred in the treatment group and 3 cases in the control group. There was no significant difference in adverse reactions between the two groups (P>0.05). Conclusion:Huatan Qufeng Prescription can effectively reduce the frequency and degree of cough and expectoration in children with chronic cough (phlegm-dampness syndrome) after respiratory tract infection, and improve their mental state, diet, defecation and other related symptom groups. The curative effect is remarkable, safe and effective, and is worthy of clinical application and further standardized research.
呼吸道感染后咳嗽慢性咳嗽儿科痰湿证中医药疗法化痰祛风方
cough after respiratory tract infectionchronic coughpediatricsphlegm-dampness syndromeTCM therapyHuatan Qufeng Prescription
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