自拟二陈汤加味方对风痰袭肺型咳嗽变异性哮喘患者气道反应性的影响
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摘要
目的探讨自拟二陈汤加味方对风痰袭肺型咳嗽变异性哮喘患者气道反应性的影响。方法将我院于2015年8月—2016年7月期间收治的128例风痰袭肺型咳嗽变异性哮喘患者随机分为两组,即对照组和治疗组,均64例。对照组采用复方甲氧那明胶囊治疗,治疗组采用自拟二陈汤加味方治疗。比较治疗前后两组临床症状、肺功能指标[1 s用力呼气量与用力肺活量比值(forced expiratory volume in one second to forced vital capacity ratio,FEV1%)]、气道反应性指标[第一秒用力呼气容积降低20%所需的药物累积量(The cumulative amount of drug required to reduce the forced expiratory volume in the first second by 20%,PD20FEV1)]的变化情况及不良反应发生情况,并评价两组临床疗效。结果与治疗前比较,对照组和治疗组中医证候积分在治疗后均明显下降,而FEV1%、PD20FEV1明显上升,且治疗组上述观察指标均优于对照组,差异有统计学意义(P <0. 05);治疗组临床疗效总有效率为96. 88%(62/64),明显高于对照组79. 69%(51/64),差异有统计学意义(P <0. 05);治疗组不良反应发生率为1. 56%(1/64),明显低于对照组12. 50%(8/64),差异有统计学意义(P <0. 05)。结论采用自拟二陈汤加味方治疗风痰袭肺型咳嗽变异性哮喘,可显著提高临床疗效,缓解临床症状,降低气道反应性,改善肺功能,促进患者身体恢复,值得临床大力推广。
Objective To explore the implications of self-prepared modified erchen decoction on airway reactivity in the patients with cough variant asthma of wind-phlegm attacking lung type. Methods From August 2015 through July 2016,128 patients with cough variant asthma of wind-phlegm attacking lung type were randomized into two groups,a control group and a treatment group,64 cases in each one. In the control group,the compound methoxyphenamine capsules were used. In the treatment group,the self-prepared modified erchen decoction was used. Before and after treatment,the changes in clinical symptoms,lung function indicators( FEV1%),airway reactivity measure( PD20 FEV1) and adverse reactions were compared before and after treatment between the two groups and the clinical effects were evaluated in the two groups. Results Compared with before treatment,TCM symptom scores in the control group and the treatment group were all reduced obviously after treatment,the values of FEV1% and PD20 FEV1 were increased obviously. The above outcomes in the treatment groups were better than the control group,indicating the statistical significant differences( P < 0. 05). The total effective rate was 96. 88%( 62/64) in the treatment group,obviously higher than 79. 69%( 51/64) in the control group,indicating the significant difference( P < 0. 05). The incidence of adverse reaction was 1. 56%( 1/64) in the treatment group,lower obviously than 12. 50%( 8/64) in the control group,indicating the significant difference( P < 0. 05). Conclusion The self-prepared modified erchen decoction significantly improves clinical effects on cough variant asthma of wind-phlegm attacking lung type,relieves the symptoms,reduces airway reactivity,improves lung function and intensifies the body recovery in the patients. Hence,this therapy deserves to be greatly promoted in clinical practice.
Objective To explore the implications of self-prepared modified erchen decoction on airway reactivity in the patients with cough variant asthma of wind-phlegm attacking lung type. Methods From August 2015 through July 2016,128 patients with cough variant asthma of wind-phlegm attacking lung type were randomized into two groups,a control group and a treatment group,64 cases in each one. In the control group,the compound methoxyphenamine capsules were used. In the treatment group,the self-prepared modified erchen decoction was used. Before and after treatment,the changes in clinical symptoms,lung function indicators( FEV1%),airway reactivity measure( PD20 FEV1) and adverse reactions were compared before and after treatment between the two groups and the clinical effects were evaluated in the two groups. Results Compared with before treatment,TCM symptom scores in the control group and the treatment group were all reduced obviously after treatment,the values of FEV1% and PD20 FEV1 were increased obviously. The above outcomes in the treatment groups were better than the control group,indicating the statistical significant differences( P < 0. 05). The total effective rate was 96. 88%( 62/64) in the treatment group,obviously higher than 79. 69%( 51/64) in the control group,indicating the significant difference( P < 0. 05). The incidence of adverse reaction was 1. 56%( 1/64) in the treatment group,lower obviously than 12. 50%( 8/64) in the control group,indicating the significant difference( P < 0. 05). Conclusion The self-prepared modified erchen decoction significantly improves clinical effects on cough variant asthma of wind-phlegm attacking lung type,relieves the symptoms,reduces airway reactivity,improves lung function and intensifies the body recovery in the patients. Hence,this therapy deserves to be greatly promoted in clinical practice.
引文
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[2]陈建川,潘凤,余思捷,等.孟鲁司特钠联合丙酸氟替卡松治疗儿童咳嗽变异性哮喘的临床研究[J].中华全科医师杂志,2016,15(8):608-613.
[3]Usta Guc B,Asilsoy S,Durmaz C,et al. The assessment and management of chronic cough in children according to the British Thoracic Society guidelines:descriptive,prospective,clinical trial[J]. Clin Respir J,2014,8(3):330-337.
[4]胡伟林,赵珊珊,涂明利,等.疏风化痰方对咳嗽变异性哮喘临床疗效及气道炎性因子的影响[J].中医药信息,2016,33(5):81-84.
[5]中华医学会呼吸病学分会哮喘学组.咳嗽的诊断与治疗指南(2015)[J].中华结核和呼吸杂志,2016,39(5):323-354.
[6]周仲英.中医内科学[M].北京:中国中医药出版社,2003:4-82.
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[8]Nakade Y,Fujimura M,Ohkura N,et al. Reversibility of the pulmonary function based on the partial flow-volume curve predicts the efficacy of bronchodilator therapy for treating chronic cough[J]. Intern Med,2013,52(18):2017-2023.
[9]官和立,刘晓俊,杨恂,等.支气管哮喘吸入治疗与气道反应性关系的研究[J].重庆医学,2013,42(24):2854-2856.
[10]Rava M,Le Moual N,Dumont X,et al. Serum club cell protein 16 is associated with asymptomatic airway responsiveness in adults:Findings from the French epidemiological study on the genetics and environment of asthma[J]. Respirology,2015,20(8):1198-1205.
[11]周丽芬,林启旺,廖莉,等.外源性H2S干预对O3致哮喘小鼠气道反应性和气道重塑的影响[J].中国病理生理杂志,2016,32(2):347-351.
[12]高定一,杨贤鸿,陈俊良,等.小青龙汤合香砂六君子汤对过敏性哮喘小鼠气道反应性与细胞因子的影响[J].成都中医药大学学报,2015,38(1):21-24.
[13]叶飒,严建平,王宏,等.咳嗽变异性哮喘患者诱导痰P物质与气道反应性的关系研究[J].实用医学杂志,2013,29(16):2605-2607.
[14]Bar Yoseph R,Livnat G,Schnapp Z,et al. The effect of vitamin D on airway reactivity and inflammation in asthmatic children:A doubleblind placebo-controlled trial[J]. Pediatr Pulmonol,2015,50(8):747-753.
[15]胡军旗,郎雅丽,张副兴,等.止嗽散治疗咳嗽变异性哮喘疗效评价[J].中医学报,2015,30(3):333-336.
[16]郑云霞,陈彤君,王兰玉.疏风宣肺止咳方治疗咳嗽变异性哮喘(风邪犯肺证)疗效观察[J].中国中医急症,2016,25(3):505-507.
[17]卢世秀,李步满,尹李虎,等.疏风止嗽方治疗咳嗽变异性哮喘临床研究[J].中国中医药信息杂志,2016,23(12):30-33.
[18]祁云霞,吴美萍,邓顺娟,等.二陈汤合三子养亲汤治疗慢阻肺急性加重期疗效观察[J].世界中医药,2016,11(11):2278-2280,2285.
[2]陈建川,潘凤,余思捷,等.孟鲁司特钠联合丙酸氟替卡松治疗儿童咳嗽变异性哮喘的临床研究[J].中华全科医师杂志,2016,15(8):608-613.
[3]Usta Guc B,Asilsoy S,Durmaz C,et al. The assessment and management of chronic cough in children according to the British Thoracic Society guidelines:descriptive,prospective,clinical trial[J]. Clin Respir J,2014,8(3):330-337.
[4]胡伟林,赵珊珊,涂明利,等.疏风化痰方对咳嗽变异性哮喘临床疗效及气道炎性因子的影响[J].中医药信息,2016,33(5):81-84.
[5]中华医学会呼吸病学分会哮喘学组.咳嗽的诊断与治疗指南(2015)[J].中华结核和呼吸杂志,2016,39(5):323-354.
[6]周仲英.中医内科学[M].北京:中国中医药出版社,2003:4-82.
[7]国家中医药管理局.中医病证诊断疗效标准[S].南京:南京大学出版社,1994:287.
[8]Nakade Y,Fujimura M,Ohkura N,et al. Reversibility of the pulmonary function based on the partial flow-volume curve predicts the efficacy of bronchodilator therapy for treating chronic cough[J]. Intern Med,2013,52(18):2017-2023.
[9]官和立,刘晓俊,杨恂,等.支气管哮喘吸入治疗与气道反应性关系的研究[J].重庆医学,2013,42(24):2854-2856.
[10]Rava M,Le Moual N,Dumont X,et al. Serum club cell protein 16 is associated with asymptomatic airway responsiveness in adults:Findings from the French epidemiological study on the genetics and environment of asthma[J]. Respirology,2015,20(8):1198-1205.
[11]周丽芬,林启旺,廖莉,等.外源性H2S干预对O3致哮喘小鼠气道反应性和气道重塑的影响[J].中国病理生理杂志,2016,32(2):347-351.
[12]高定一,杨贤鸿,陈俊良,等.小青龙汤合香砂六君子汤对过敏性哮喘小鼠气道反应性与细胞因子的影响[J].成都中医药大学学报,2015,38(1):21-24.
[13]叶飒,严建平,王宏,等.咳嗽变异性哮喘患者诱导痰P物质与气道反应性的关系研究[J].实用医学杂志,2013,29(16):2605-2607.
[14]Bar Yoseph R,Livnat G,Schnapp Z,et al. The effect of vitamin D on airway reactivity and inflammation in asthmatic children:A doubleblind placebo-controlled trial[J]. Pediatr Pulmonol,2015,50(8):747-753.
[15]胡军旗,郎雅丽,张副兴,等.止嗽散治疗咳嗽变异性哮喘疗效评价[J].中医学报,2015,30(3):333-336.
[16]郑云霞,陈彤君,王兰玉.疏风宣肺止咳方治疗咳嗽变异性哮喘(风邪犯肺证)疗效观察[J].中国中医急症,2016,25(3):505-507.
[17]卢世秀,李步满,尹李虎,等.疏风止嗽方治疗咳嗽变异性哮喘临床研究[J].中国中医药信息杂志,2016,23(12):30-33.
[18]祁云霞,吴美萍,邓顺娟,等.二陈汤合三子养亲汤治疗慢阻肺急性加重期疗效观察[J].世界中医药,2016,11(11):2278-2280,2285.