本文選題：加味麻杏石甘湯　切入點：小兒急性支氣管炎　出處：《北京中醫(yī)藥大學》2012年碩士論文

【摘要】：急性支氣管炎是小兒時期常見的一種呼吸道疾病,是病毒或細菌感染,物理化學刺激或過敏反應等對氣管-支氣管粘膜所造成的急性炎癥。臨床以咳嗽、咯痰為主要癥狀,雙肺可聞及干羅音或不固定的濕羅音。本病可發(fā)生于任何季節(jié),多見于寒冷季節(jié),冬春季發(fā)病率明顯增高。本病常繼發(fā)于上呼吸道感染,并為麻疹、百日咳及其他急性傳染病的一種臨床表現(xiàn)。以嬰幼兒時期發(fā)病較多、較重。根據(jù)本病臨床表現(xiàn),屬中醫(yī)“咳嗽”“喘證”等范疇,病因多為外感。 風熱犯肺多因小兒養(yǎng)護過溫,衣著太厚,熱傷于肺,兼感溫熱之邪,加之飲食調護不當,以致火熱熏灼肺金。王俊宏主任醫(yī)師從清熱宣肺,止咳化痰的治療原則入手,以加減麻杏石甘湯為基本方進行加減,用以治療風熱犯肺之肺熱重癥小兒急性支氣管炎臨床取得明顯療效。 小兒急性支氣管炎一般病程較短,但其嚴重影響患兒及其家長的日常生活,若治療、調護不當,易于導致病情遷延或反復發(fā)作,從而影響患兒生長發(fā)育。本次臨床研究主要為觀察王俊宏主任運用加味麻杏石甘湯治療風熱犯肺之肺熱重癥小兒急性支氣管炎的臨床療效。本論文包括文獻綜述和臨床研究兩部分內容。 1.文獻綜述 分兩部分：第一部分論述了祖國傳統(tǒng)醫(yī)學對小兒急性支氣管炎的認識及研究概況,其中從小兒生理病理特點與小兒急性支氣管炎的關系、古代中醫(yī)醫(yī)家對小兒急性支氣管炎的認識、現(xiàn)代中醫(yī)醫(yī)家對小兒急性支氣管炎的研究概況三部分進行闡述；第二部分論述了現(xiàn)代醫(yī)學對小兒急性支氣管炎的認識及研究概況。 2.臨床研究 目的：觀察王俊宏主任醫(yī)師運用加味麻杏石甘湯治療風熱犯肺型小兒急性支氣管炎的臨床療效。 方法：對符合納入標準的65例風熱犯肺型小兒急性支氣管炎的病例隨機分為治療組31例,對照組34例。治療組采用臨證加減中藥免煎顆粒劑治療,對照組采用麻杏止咳糖漿治療,觀察并對比兩組藥物在用藥后72小時、用藥后7天患兒的癥狀、體征及證候表現(xiàn)改善情況,采用SPSS13.0統(tǒng)計軟件進行統(tǒng)計學分析。 結果： (1)治療組在用藥72小時、7天對咳嗽、咯痰的療效均明顯優(yōu)于對照組(P0.05) (2)治療組在縮短咳嗽、咯痰癥狀的病程上明顯優(yōu)于對照組(P0.05)； (3)治療組在用藥72小時、7天主癥積分、次癥積分及總積分改善方面均優(yōu)于對照組(P0.05)： (4)治療組在用藥72小時、7天臨床總療效均明顯優(yōu)于對照組(P0.05)； (5)兩組用藥7天臨床總療效均優(yōu)于用藥72小時(P0.05)。 結論：采用加味麻杏石甘湯治療風熱犯肺型小兒急性支氣管炎在改善癥狀、縮短病程方面療效顯著,值得臨床推廣
[Abstract]:Acute bronchitis is a common respiratory disease in childhood. It is caused by viral or bacterial infection, physical and chemical stimulation or allergic reaction to the tracheobronchial mucosa. Both lungs can hear dry rales or wet rales. The disease can occur in any season and is more common in cold seasons. The incidence of this disease in winter and spring is significantly increased. The disease is usually secondary to upper respiratory tract infections and measles. A clinical manifestation of pertussis and other acute infectious diseases. The infantile period is more and more serious. According to the clinical manifestation of pertussis, it belongs to the category of TCM "cough" and "asthma syndrome", and the etiology is mostly exogenous. Most of the wind-heat offenses of the lungs are caused by the children's maintenance of excessive temperature, their clothing too thick, their injuries to the lungs, and the evil of feeling warm and hot, as well as the improper diet and nursing, which results in the burning heat and burning of the lungs. Chief physician Wang Junhong starts with the treatment principles of clearing away heat and dissipating the lungs, stopping coughing and resolving phlegm. To add and subtract maxingshigan decoction as the basic prescription for the treatment of severe acute bronchitis of children with lung fever caused by wind and heat, the clinical curative effect is obvious. The course of acute bronchitis in children is generally short, but it seriously affects the daily life of children and their parents. The main purpose of this clinical study was to observe the clinical effect of modified maxing Shigan decoction on acute bronchitis in children with severe pulmonary fever caused by wind and heat. This paper includes literature review. And clinical research. 1. Literature review. It is divided into two parts: the first part discusses the understanding and research of acute bronchitis in children in traditional Chinese medicine, including the relationship between the physiological and pathological characteristics of children and acute bronchitis in children. The understanding of acute bronchitis in children by ancient Chinese medicine doctors and the research survey of acute bronchitis in children by modern TCM doctors are described in three parts. The second part discusses the understanding and research situation of acute bronchitis in children in modern medicine. 2. Clinical studies. Objective: to observe the clinical effect of modified maxing Shigan decoction on acute bronchitis in children with wind and heat invasion. Methods: 65 children with acute bronchitis of wind-heat infantile pulmonary type were randomly divided into treatment group (n = 31) and control group (n = 34). The control group was treated with Maxingzhike syrup. The symptoms, signs and syndromes of the two groups were improved at 72 hours and 7 days after treatment. The statistical analysis was carried out by SPSS13.0 software. Results:. 1) the curative effect of cough and sputum in the treatment group was obviously better than that in the control group in 72 hours and 7 days. 2) the course of cough and sputum in the treatment group was significantly better than that in the control group (P 0.05); 3) the improvement of the main symptom score, the secondary symptom score and the total score in the treatment group were better than that in the control group in 72 hours and 7 days. 4) the total clinical efficacy of the treatment group was significantly better than that of the control group in 72 hours and 7 days. 5) the total curative effect of the two groups in 7 days was better than that in 72 hours (P 0.05). Conclusion: modified maxing Shigan decoction is effective in improving symptoms and shortening the course of disease in children with acute bronchitis of wind-heat infantile pulmonary type. It is worth popularizing in clinic.
【學位授予單位】：北京中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2012
【分類號】：R272

【引證文獻】

相關碩士學位論文 前1條

1 張望;銀萊湯對食積復合流感病毒感染小鼠免疫機制的研究[D];北京中醫(yī)藥大學;2013年

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本文編號：1682553