本文選題：喘息性支氣管炎　切入點(diǎn)：熱哮證　出處：《南京中醫(yī)藥大學(xué)》2012年碩士論文

【摘要】：目的：1.通過對(duì)文獻(xiàn)的研究,了解兒童喘息性支氣管炎的傳統(tǒng)醫(yī)學(xué)以及現(xiàn)代醫(yī)學(xué)的研究概況。 2.通過對(duì)疾病療效評(píng)價(jià)和中醫(yī)癥候療效評(píng)價(jià),探討并臨床驗(yàn)證中醫(yī)外治法(刺四縫、拿肩井、拍背療法)對(duì)兒童喘息性支氣管炎的輔助治療意義,以期形成治療喘息性支氣管炎簡(jiǎn)便、有效、經(jīng)濟(jì)、安全并適于推廣的治療方案。 方法：1.文獻(xiàn)研究：通過查閱古代、現(xiàn)代以及國內(nèi)外有關(guān)喘息性支氣管炎的研究文獻(xiàn),對(duì)兒童喘息性支氣管炎的中西醫(yī)研究狀況進(jìn)行總結(jié)和學(xué)習(xí)。 2.臨床研究：本次采用隨機(jī)、平行對(duì)照的研究方法,于江蘇省中醫(yī)院門診及住院部隨機(jī)抽取臨床試驗(yàn)總病例48例,按1∶1隨機(jī)分為中醫(yī)治療組、西醫(yī)對(duì)照組兩組接受觀察,每組24例。西醫(yī)對(duì)照組采用西醫(yī)常規(guī)治療,中醫(yī)治療組除常規(guī)治療外加用中醫(yī)外治法(刺四縫、拿肩井、拍背療法)。觀察治療前后咳嗽、痰壅、氣喘(呼吸次數(shù))、肺部聽診、精神、食欲食量等情況的改變。將喘息性支氣管炎熱哮證的癥狀進(jìn)行量化積分,根據(jù)(治療前總積分-治療后總積分)/治療前總積分來計(jì)算療效指數(shù)作為臨床觀察的依據(jù),探討中醫(yī)外治法(刺四縫、拿肩井、拍背療法)對(duì)兒童喘息性支氣管炎的輔助治療意義。 結(jié)果：兩組患兒臨床療效經(jīng)統(tǒng)計(jì)學(xué)處理有統(tǒng)計(jì)學(xué)意義(P0.05),且治療組優(yōu)于對(duì)照組。治療前治療組與對(duì)照組各項(xiàng)基本條件、病情輕重、主次癥積分、總積分相比均無顯著差異。經(jīng)秩和統(tǒng)計(jì)學(xué)分析,治療組在改善患兒咳嗽、痰壅、哮鳴音等主要癥狀方面優(yōu)于對(duì)照組(P0.05),具有顯著性統(tǒng)計(jì)學(xué)差異,在改善患兒喘息、紫紺、心率方面,兩組在最終結(jié)果上無明顯差異(P0.05)。治療后治療組在改善患兒精神、食欲、二便、汗出、舌象等次要癥狀方面優(yōu)于對(duì)照組(P0.05),具有顯著性統(tǒng)計(jì)學(xué)差異,在改善患兒體溫、面色、口渴、惡心嘔吐方面兩組無明顯差異(P0.05)。但是治療組在緩解患兒咳嗽、喘息、痰壅、哮鳴音等主要癥狀方面所需時(shí)間明顯少于對(duì)照組(P0.01),具有顯著性統(tǒng)計(jì)學(xué)差異。 結(jié)論：中醫(yī)外治法輔助治療兒童喘息性支氣管炎是有效的方法。
[Abstract]:Objective to study the traditional medicine and modern medicine in children with asthmatic bronchitis. 2. By evaluating the curative effect of disease and syndrome of TCM, the significance of external treatment of TCM (pricking four seams, holding shoulder well, clapping back therapy) to children's wheezing bronchitis was discussed and verified. In order to form a simple, effective, economical, safe and suitable for the treatment of asthmatic bronchitis. Methods: literature study: by referring to ancient, modern and domestic literatures on asthmatic bronchitis, the research status of TCM and Western medicine in children with wheezing bronchitis was summarized and studied. 2. Clinical study: in this study, 48 cases of clinical trial were randomly selected from outpatient and inpatient department of Jiangsu Provincial traditional Chinese Medicine Hospital by a randomized, parallel control method. According to 1:1, 48 cases were randomly divided into traditional Chinese medicine treatment group and western medicine control group. There were 24 cases in each group. The western medicine control group was treated with routine western medicine, while the traditional Chinese medicine treatment group was treated with external Chinese medicine therapy in addition to routine treatment (pricking four seams, holding shoulder well, patting back therapy, etc.) before and after treatment, cough, phlegm obstruction, asthma (respiratory frequency, lung auscultation) were observed. The symptoms of asthmatic bronchitis heat wheezing syndrome were quantified and the curative effect index was calculated according to the total score before and after treatment / the total integral before and after treatment as the basis of clinical observation. Objective: to explore the significance of external therapy of traditional Chinese medicine (pricking four seams, holding shoulder well, clapping back therapy) in children with wheezing bronchitis. Results: the clinical efficacy of the two groups was statistically significant (P 0.05), and the treatment group was superior to the control group. By rank sum statistical analysis, the treatment group was superior to the control group in improving the main symptoms such as cough, phlegm, wheezing, etc. There was no significant difference in heart rate between the two groups in the final results. After treatment, the treatment group was superior to the control group in improving the mental state, appetite, stool, sweating, tongue appearance and other minor symptoms. There was significant statistical difference in the improvement of the temperature of the children. There was no significant difference in facial color, thirst, nausea and vomiting between the two groups. However, the time needed to relieve the main symptoms of cough, asthma, phlegm and wheezing in the treatment group was significantly less than that in the control group (P 0.01). Conclusion: external treatment of TCM is an effective method to treat asthmatic bronchitis in children.
【學(xué)位授予單位】：南京中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2012
【分類號(hào)】：R725.6

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