本文選題：過(guò)敏性鼻炎-哮喘綜合征　切入點(diǎn)：脫敏平喘顆粒　出處：《北京中醫(yī)藥大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:過(guò)敏性鼻炎-哮喘綜合征發(fā)病率逐年升高,已成為全球性健康問(wèn)題,目前現(xiàn)有中西醫(yī)治療方法仍存在諸多弊端,導(dǎo)致病情反復(fù)發(fā)作,遷延不愈。脫敏平喘顆粒是國(guó)醫(yī)大師王琦教授治療過(guò)敏性鼻炎-哮喘綜合征的經(jīng)驗(yàn)性用方,本研究旨在通過(guò)設(shè)立隨機(jī)對(duì)照試驗(yàn),研究脫敏平喘顆粒治療過(guò)敏性鼻炎-哮喘綜合征有效性及安全性,為進(jìn)一步臨床推廣提供確證性證據(jù)。方法:收集2016年5月至2017年2月就診于北京中醫(yī)藥大學(xué)第三附屬醫(yī)院呼吸科門診,西醫(yī)診斷符合過(guò)敏性鼻炎-哮喘綜合征,支氣管哮喘屬于急性發(fā)作期(輕、中度)或慢性持續(xù)期(輕、中度持續(xù)),過(guò)敏性鼻炎屬季節(jié)性或持續(xù)性(輕或中-重度),中醫(yī)辨證分型符合肺熱怫郁證患者60例。采用隨機(jī)、對(duì)照研究方法,按1:1比例分成治療組和對(duì)照組。對(duì)照組給予吸入布地奈德福莫特羅粉吸入劑和口服孟魯司特鈉片治療。治療組在此基礎(chǔ)上加服脫敏平喘配方顆粒。療程均為2周。分別于治療前、后采集兩組患者中醫(yī)證候評(píng)分、肺功能檢查以及各項(xiàng)安全性指標(biāo)。并于治療前及4周后采集兩組ACT評(píng)分。數(shù)據(jù)結(jié)果使用Microsoft Excel建立數(shù)據(jù)庫(kù),采用SPSS 21.0進(jìn)行統(tǒng)計(jì)分析。結(jié)果:中醫(yī)總體療效,治療組總有效率為92.86%,對(duì)照組總有效率為73.08%,兩組比較具有顯著性差異(P0.05)。中醫(yī)單項(xiàng)癥狀積分,治療組降低喘息、胸悶、鼻塞、鼻癢、噴嚏、咽癢、眼癢單項(xiàng)積分優(yōu)于對(duì)照組,差異具有統(tǒng)計(jì)學(xué)意義(P0.05);兩組在咳嗽、流涕、咳痰癥狀積分無(wú)明顯差異(P0.05)。鼻炎療效,治療組有效率為96.43%,對(duì)照組有效率為50%,治療組顯著高于對(duì)照組(P0.05)。ACT評(píng)分,治療組治療后完全控制病例2例,部分控制病例21例,未控制病例5例,對(duì)照組無(wú)完全控制病例,部分控制病例15例,未控制病例11例。治療后兩組數(shù)據(jù)進(jìn)行組間比較,差異具有統(tǒng)計(jì)學(xué)意義(P0.05)。肺功能結(jié)果,對(duì)照組 PEF(%)顯著增加(P0.05),FEV1(%)、FVC(%)、FEV1/FVC與治療前比較無(wú)顯著性差異(P0.05);治療組FEV1(%)、PEF(%)顯著增加(P0.05),FVC(%)、FEV1/FVC與治療前比較無(wú)明顯差異(P0.05)。治療后兩組間比較,治療組FEV1(%)優(yōu)于對(duì)照組(P0.05),FVC(%)、PEF(%)、FEV1/FVC與對(duì)照組無(wú)顯著性差異(P0.05)。結(jié)論:脫敏平喘顆粒顆可有效緩解過(guò)敏性鼻炎及哮喘癥狀,改善肺功能,提高ACT評(píng)分,改善患者生活質(zhì)量,提高綜合療效。同時(shí)治療前后血常規(guī)、尿常規(guī)、肝腎功能檢查未見(jiàn)明顯變化,治療過(guò)程中無(wú)不良反應(yīng)事件,可廣泛應(yīng)用于臨床。
[Abstract]:Objective: the incidence of allergic rhinitis and asthma syndrome has been increasing year by year and has become a global health problem. Desensitized Pingchuan granule is an empirical prescription for allergic rhinitis and asthma syndrome treated by Professor Wang Qi, a master of Chinese medicine. The purpose of this study was to establish a randomized controlled trial. To study the efficacy and safety of desensitized Pingchuan granule in the treatment of allergic rhinitis asthma syndrome. Methods: from May 2016 to February 2017, the clinic of respiratory department of the third affiliated Hospital of Beijing University of traditional Chinese Medicine was collected. The diagnosis of western medicine was consistent with allergic rhinitis and asthma syndrome. Bronchial asthma belongs to acute attack (mild, moderate) or chronic persistent (mild, moderate persistent), allergic rhinitis is seasonal or persistent (mild or moderate to severe). Comparative study methods, The control group was treated with inhaled budesonide formoterol powder inhalation and oral montelukast sodium tablets. The treatment group was treated with desensitized antiasthmatic granules on this basis. The course of treatment was 2 weeks. Before treatment, The scores of TCM syndromes, pulmonary function and various safety indexes were collected from two groups of patients. The scores of ACT were collected before and 4 weeks after treatment. The data were established by Microsoft Excel. Results: the total effective rate of the treatment group was 92.86, the total effective rate of the control group was 73.08, the difference between the two groups was significant (P 0.05). The single score of sneeze, pharyngoitch and eye itching was better than that of the control group, the difference was statistically significant (P 0.05), and there was no significant difference in the score of cough, runny and expectoration between the two groups (P 0.05). The effective rate of the treatment group was 96.43 and the effective rate of the control group was 50. The effective rate of the treatment group was significantly higher than that of the control group (P 0.05N. ACT score). After treatment, 2 cases were completely controlled in the treatment group, 21 cases were partially controlled cases, 5 cases were uncontrolled cases, and the control group had no complete control cases. There were 15 cases of partially controlled cases and 11 cases of uncontrolled cases. After treatment, the difference between the two groups was statistically significant (P 0.05). There was no significant difference in FEV1 / FVC between before and after treatment in the control group (P 0.05), but there was no significant difference in FEV1 / FVC between before and after treatment in the treatment group (P 0.05). There was no significant difference in FEV1 / FVC between the two groups after treatment. There was no significant difference between the treatment group and the control group in FEV1 / FVC. Conclusion: desensitized Pingchuan granule can effectively relieve allergic rhinitis and asthma symptoms, improve lung function, improve ACT score, and improve the quality of life of the patients. At the same time, blood routine, urine routine, liver and kidney function before and after treatment were not obviously changed, and there were no adverse events in the course of treatment, so they can be widely used in clinical practice.
【學(xué)位授予單位】：北京中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R276.1;R256.12

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