温阳补肾填精膏方对低剂量吸入性糖皮质激素维持治疗的哮喘患者激素撤停的影响
Effects of "Yang-warming and kidney essence-replenishing" herbal paste on withdrawal of inhaled corticosteroids in asthma patients using low-dose inhaled corticosteroids as maintenance treatment
- 上海中医药杂志 2021年55卷第12期 页码：74-77
- 作者机构：
1.上海市嘉定区中医医院药剂科（上海 201800）
2.上海中医药大学附属市中医医院肺病科（上海 200071）
3.上海中医药大学附属龙华医院内科（上海 200032）
4.上海中医药大学附属龙华医院中医预防保健科（上海 200032）
5.上海市长宁区天山中医医院内科（上海 200051）
- 作者简介：
卫海颖，女，主管中药师，主要从事中药临床药理研究工作
唐斌擎，副主任医师；E-mail：tangbinqing1979@aliyun.com
- 基金信息：上海市中医药管理局上海市中药专家传承工作室建设项目(2020ZYGZS-13)
DOI：10.16305/j.1007-1334.2021.2101123
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卫海颖, 石克华, 吴银根, 等. 温阳补肾填精膏方对低剂量吸入性糖皮质激素维持治疗的哮喘患者激素撤停的影响[J]. 上海中医药杂志, 2021,55(12):74-77.
Haiying WEI, Kehua SHI, Yingen WU, et al. Effects of "Yang-warming and kidney essence-replenishing" herbal paste on withdrawal of inhaled corticosteroids in asthma patients using low-dose inhaled corticosteroids as maintenance treatment[J]. Shanghai Journal of Traditional Chinese Medicine, 2021,55(12):74-77.
卫海颖, 石克华, 吴银根, 等. 温阳补肾填精膏方对低剂量吸入性糖皮质激素维持治疗的哮喘患者激素撤停的影响[J]. 上海中医药杂志, 2021,55(12):74-77. DOI： 10.16305/j.1007-1334.2021.2101123.
Haiying WEI, Kehua SHI, Yingen WU, et al. Effects of "Yang-warming and kidney essence-replenishing" herbal paste on withdrawal of inhaled corticosteroids in asthma patients using low-dose inhaled corticosteroids as maintenance treatment[J]. Shanghai Journal of Traditional Chinese Medicine, 2021,55(12):74-77. DOI： 10.16305/j.1007-1334.2021.2101123.
摘要
目的,2,观察温阳补肾填精膏方对低剂量吸入性糖皮质激素维持治疗的哮喘患者激素撤停的影响。,方法,2,将140例低剂量吸入性糖皮质激素维持治疗的哮喘患者随机分为治疗组（71例）、对照组（69例）。对照组入组后即停用激素，治疗组停用激素的同时加用有温阳补肾填精功效的膏方，膏方服用时间为8周；从病例纳入当天开始计算，共计随访16周。观察比较治疗失败率，以及哮喘症状发生次数、缓解药物用量、哮喘控制测试评分表（ACT）评分、呼气峰流速（PEF）、第一秒用力呼吸量（FEV,1,）、FEV,1,实测值占预计值百分比（FEV,1,%）的变化情况。,结果,2,①治疗组、对照组治疗失败率分别为8.45%、24.64%，治疗组治疗失败率低于对照组（,P,<,0.01）。②与激素撤停前比较，治疗组患者激素撤停后每周日间症状发生次数、每周缓解药物用量增多（,P,<,0.05），对照组患者激素撤停后每周日间症状发生次数、每周夜间症状发生次数、每周活动受限次数、每周缓解药物用量增多（,P,<,0.05）；激素撤停后组间比较，治疗组患者每周日间症状发生次数、每周夜间症状发生次数、每周活动受限次数及每周缓解药物用量少于对照组（,P,<,0.01）。③与激素撤停前比较，治疗组患者激素撤停后ACT评分降低（,P,<,0.01）；对照组患者激素撤停后ACT评分及PEF、FEV,1,、FEV,1,%值降低（,P,<,0.01）；激素撤停后组间比较，治疗组ACT评分及PEF、FEV,1,、FEV,1,%值高于对照组（,P,<,0.01）。,结论,2,温阳补肾填精膏方有助于低剂量吸入性糖皮质激素维持治疗的哮喘患者撤停激素。
Abstract
Objective,2,To investigate the effects of "Yang-warming and kidney essence-replenishing" herbal paste on withdrawal of inhaled corticosteroids (ICS) in asthmatic patients controlled by low-dose ICS therapy., Methods,2,One hundred and forty patients with asthma treated with low-dose ICS as maintenance treatment were randomly divided into a treatment group (,n,=71) and a control group (,n,=69). ICS was withdrawn upon the case enrollment in both groups, and in the treatment group, "Yang-warming and kidney essence-replenishing" herbal paste was applied on withdrawal of ICS therapy. The herbal paste was used for 8 weeks. The total follow-up period lasted 16 weeks from the day of case inclusion. We observed and compared the rate of treatment failure, as well as the changes in the frequency of asthma symptoms, the dosage of relieving drugs, the Asthma Control Test Scale (ACT) score, peak expiratory flow rate (PEF), forced expiratory volume in the first second (FEV,1,), and FEV,1, percentage (FEV,1,%).,Results,2,①Treatment failure occurred in 8.45 % of patients in the treatment group, which was lower compared with 24.64% in the control group (,P,<,0.01). ②After ICS withdrawal, frequency of weekly daytime symptoms, weekly dosage of relieving drugs increased for patients of the treatment group (,P,<,0.05), frequency of weekly daytime symptoms, frequency of weekly night symptoms, frequency of weekly activity restriction, weekly dosage of relieving drugs increased for patients of the control group (,P,<,0.05). After ICS withdrawal, the frequency of weekly daytime symptoms, the frequency of weekly night symptoms, the frequency of weekly activity restriction and the weekly dosage of relieving drugs in the treatment group were less than those in the control group (,P,<,0.01). ③After ICS withdrawal, ACT score in the treatment group decreased (,P,<,0.01); while in the control group ACT score, PEF, FEV,1, and FEV,1,% values decreased (,P,<,0.01). After ICS withdrawal, ACT score, PEF, FEV,1, and FEV,1,% values in the treatment group were higher than those in the control group (,P,<,0.01).,Conclusion,2,By applying "Yang-warming and kidney essence-replenishing" herbal paste, patients with asthma controlled by low-dose ICS can maintain sound condition control during the withdrawal of ICS.
关键词
哮喘激素温阳补肾填精膏方
Keywords
asthmacorticosteroidYang-warming and kidney essence-replenishingherbal paste
references
LEMANSKE R F J r, SORKNESS C A, MAUGER E A, et al. Inhaled corticosteroid reduction and elimination in patients with persistent asthma receiving salmeterol: a randomized controlled trial[J]. JAMA, 2001, 285(20): 2594-2603.
李炬明，冯京帅，辛大永，等. 补肾益气法治疗肾虚型支气管哮喘慢性持续期46例[J]. 环球中医药，2018, 11(3): 467-469.
GINA Executive Committee. Global strategy for asthma management and prevention[EB/OL]. [2021-01-01]. http://www.ginasthma.org/Guidelineitem.asp?l1=2&l2=1&intId=1388http://www.ginasthma.org/Guidelineitem.asp?l1=2&l2=1&intId=1388,2016-12-12.
NATHAN R A，SORKNESS C A，KOSINSKI M，et al. Development of the asthma control test: a survey for assessing asthma control[J]. J Allergy Clin Immunol, 2004, 113(1): 59-65.
BATEMAN E D, BOUSHEY H A, BOUSQUET J, et al. Can guideline-defined asthma control be achieved? The Gaining Optimal Asthma ControL study[J]. Am J Respir Crit Care Med, 2004, 170(8): 836-844.
HAWKINS G, MCMAHON A D, TWADDLE S, et al. Stepping down inhaled corticosteroids in asthma: randomized controlled trial[J]. BMJ, 2003, 326(7399): 1115-1120.
MASOLI M, WEATHERALL M, HOLT S, et al. Budesonide once versus twice-daily administration: meta-analysis[J]. Respirology, 2004, 9(4): 528-534.
GODARD P, GREILLIER P, PIGEARIAS B, et al. Maintaining asthma control in persisitent asthma: comparision of three straegies in a 6-month double-blind randomized study[J]. Respir Med, 2008, 102(8): 1124-1131.
O’BYRNE P M, FITZGERALD J M, BATEMAN E D, et al. Inhaled combined budesonide-formoterol as needed in mild asthma[J]. N Engl J Med, 2018, 378(20): 1865-1876.
BATEMAN E D, REDDEL H K, O’BYRNE P M, et al. As-needed budesonide-formeterol versus maintenance budesonide in mild asthma[J]. N Engl J Med, 2018, 378(20): 1877-1887.
张敏，温志红，杨彩琼. 达良好控制哮喘患儿停用低剂量吸入性糖皮质激素的临床随访研究[J]. 中国当代儿科杂志，2019, 21(5): 421-425.
吴银根，于素霞，张惠勇，等. 咳喘落治疗175例哮喘临床总结[J]. 上海中医药杂志，2000, 34(9): 19-21.
毛昌淳，许建华，管冬元. 不同补肾法对哮喘模型大鼠HPA轴的影响[J]. 上海中医药杂志，2003, 37(4): 3-6.
王宏长，吴红梅，倪伟，等. 中药止喘胶囊对哮喘大鼠糖皮质激素受体及皮质酮的影响[J]. 广东医学，2001, 22(21): 1108-1110.
石克华，吴银根，熊必丹，等. 补肾平喘膏方对支气管哮喘大鼠肺组织糖皮质激素受体的影响[J]. 中西医结合学报，2010, 8(8): 785-789.
董竞成，石志云，沈自尹，等. 大剂量皮质类固醇吸入加补肾中药治疗激素依赖型哮喘的临床研究[J]. 中国中西医结合杂志，1994, 14(8): 458-461.
唐斌擎，吴银根. 随访冬令温阳补肾膏方治疗支气管哮喘疗效观察[J]. 上海中医药大学学报，2007, 21(5): 41-43.
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