本文選題：加味薯蕷丸　切入點(diǎn)：膏方　出處：《湖北中醫(yī)藥大學(xué)》2017年碩士論文

【摘要】：目的:本研究通過觀察加味薯蕷丸膏方治療中醫(yī)哮喘緩解期患兒中醫(yī)癥狀及體征、免疫功能、微量元素、外周血嗜酸性粒細(xì)胞的自身前后對(duì)比及安全性指標(biāo)等,旨在客觀評(píng)價(jià)加味薯蕷丸膏方治療小兒哮喘緩解期的臨床療效及安全性。方法:通過自身前后對(duì)照的臨床試驗(yàn)設(shè)計(jì),觀察37例符合本研究要求的病例,冬至開始服用加味薯蕷丸膏方,療程3個(gè)月,并進(jìn)行隨訪1年,觀察患兒治療前后的中醫(yī)癥狀及體征、哮喘發(fā)病次數(shù)及平均發(fā)作時(shí)間,呼吸道感染發(fā)病次數(shù)、病程和病種,外周血嗜酸性粒細(xì)胞、免疫球蛋白(Ig M、Ig G、Ig A)、微量元素(鈣、鋅、鐵、鉛、鎂)的變化情況,及血常規(guī)、尿常規(guī)、肝功能(AST、ALT、γ-GT、ALP、TBIL)、腎功能(BUN、SCR、e GFR)、心電圖等安全性指標(biāo)。結(jié)果:(1)37例患兒中臨床治愈4例(10.81%),顯效12例(32.43%),有效16例(43.24%),無效5例(13.51%),總有效率為86.49%。(2)治療后患兒主癥積分均較治療前下降,其中咳嗽、神疲乏力改善較明顯,其差異具有統(tǒng)計(jì)學(xué)意義,P0.05;(3)治療后患兒次癥積分均較治療前有所下降,其中反復(fù)感冒、形寒肢冷、潮熱盜汗、口干咽燥、便秘較治療前改善明顯,差異具有統(tǒng)計(jì)學(xué)意義,P0.05,自汗、食少納呆較治療前改善顯著,P0.01;其他癥狀與治療前比較,差異無統(tǒng)計(jì)學(xué)意義,P0.05;(4)治療后各中醫(yī)證型總積分均較前改善,差異具有統(tǒng)計(jì)學(xué)意義,P0.05;其中肺脾氣虛證總積分改善顯著,差異具有統(tǒng)計(jì)學(xué)意義,P0.01;(5)治療后哮喘每3個(gè)月發(fā)病次數(shù)及平均發(fā)作持續(xù)時(shí)間均較治療前改善,差異具有統(tǒng)計(jì)學(xué)意義,P0.05;(6)治療后患兒呼吸道感染發(fā)病次數(shù)等級(jí)、單次發(fā)病病程等級(jí)及單次發(fā)病病種等級(jí)均較治療前有所下降,差異有統(tǒng)計(jì)學(xué)意義,P0.05;(7)治療后患兒免疫球蛋白Ig A、Ig G較治療前升高,差異具有統(tǒng)計(jì)學(xué)意義,P0.05;其中Ig A升高較顯著,差異具有顯著性差異,P0.01;Ig M較治療前降低,差異具有統(tǒng)計(jì)學(xué)意義,P0.05;(8)治療前后患兒外周血嗜酸性粒細(xì)胞計(jì)數(shù)無明顯差異,P0.05。(9)治療后患兒外周血鈣含量較治療前升高,P0.05,差異不具有統(tǒng)計(jì)學(xué)意義;鐵、鋅、鉛、鎂均較治療前降低,P0.05,差異不具有統(tǒng)計(jì)學(xué)意義;(10)治療后患兒血常規(guī)、尿常規(guī)、肝功能(AST、ALT、γ-GT、ALP、TBIL)、腎功能(BUN、SCR、e GFR)、心電圖均未出現(xiàn)異常。結(jié)論:冬令服用加味薯蕷丸膏方治療小兒哮喘緩解期,能夠改善中醫(yī)證侯,減少呼吸道感染發(fā)病次數(shù),縮短呼吸道感染單次發(fā)病病程,降低呼吸道感染病種等級(jí)方面療效明顯,提高患兒免疫功能,減輕哮喘發(fā)作程度,減少哮喘發(fā)作次數(shù),縮短哮喘發(fā)作病程,且在治療過程中均未出現(xiàn)不良反應(yīng)。說明服用加味薯蕷丸膏方從補(bǔ)益肺脾腎、祛痰化瘀疏風(fēng)等方面能夠有效改善哮喘患兒臨床癥狀及體質(zhì),提高免疫功能,且具有良好的安全性。
[Abstract]:Objective: to observe the effect of modified Dioscorea Zingiberensis Pill on symptoms and signs of TCM, immune function, trace elements, eosinophil in peripheral blood and safety index in children with asthma.Objective to evaluate the clinical efficacy and safety of modified Dioscorea zingiberensis Pill recipe in the remission of childhood asthma.Methods: according to the clinical trial design, 37 cases were observed. The Winter Solstice began to take Dioscorea zingiberensis pill ointment for 3 months and followed up for 1 year.The symptoms and signs of traditional Chinese medicine (TCM) before and after treatment, the incidence times and average attack time of asthma, the incidence of respiratory tract infection, the course of disease, the eosinophil in peripheral blood, the immunoglobulin Ig MU Ig G G G An, trace elements (Ca, Zn, Fe), were observed before and after treatment.The changes of lead, magnesium, blood routine, urine routine, liver function, liver function, liver function, liver function, liver function, liver function, liver function, liver function, liver function, liver function, liver function, liver function, liver function, liver function, liver function, liver function, liver function, liver function, liver function, liver function, liver function, liver function, liver function, liver function, liver function, liver function.The difference was statistically significant (P 0.05) after treatment, the scores of secondary symptoms were all decreased, including repeated colds, cold limbs, hot flashes and night sweating, dry mouth and dry pharynx, and constipation. The difference was statistically significant (P 0.05), and the difference was significant (P 0.05).The difference was statistically significant (P 0.01) after treatment, the incidence times and the mean attack duration of asthma were improved every 3 months compared with those before treatment, and the difference was statistically significant (P 0.05) after treatment, the incidence of respiratory tract infection in children was higher than that before treatment.The grade of single disease course and the grade of disease type of single attack were lower than those before treatment, and the difference was statistically significant (P 0.05) the level of immunoglobulin IgA in children after treatment was higher than that before treatment, and the difference was statistically significant (P0.05. among them, the increase of IgA was significant.The difference was significant (P 0.01) Ig M was lower than that before treatment.There was no significant difference in eosinophil count in peripheral blood of children before and after treatment (P 0.05. 9). The calcium content in peripheral blood of children after treatment was higher than that before treatment (P 0.05), and the difference was not statistically significant, iron, zinc, lead, lead, iron, zinc, lead, iron, zinc, lead, iron, zinc, lead, iron, zinc, lead, iron, zinc, lead,After the treatment, the blood routine, urine routine, liver function and liver function of the children were all lower than those before treatment (P 0.05, P 0.05, P < 0.05). There was no abnormal electrocardiogram (ECG) in the patients with liver function, liver function, liver function, liver function, liver function, renal function and renal function.Conclusion: Dongling Dioscorea zingiberensis Pill can improve TCM syndrome, reduce the incidence of respiratory tract infection, shorten the course of single respiratory infection, and reduce the grade of respiratory tract infection.It can improve the immune function, reduce the degree of asthma attack, reduce the frequency of asthma attack, shorten the course of asthma attack, and no adverse reactions occurred in the course of treatment.It is concluded that taking Dioscorea zingiberensis Pill ointment can effectively improve the clinical symptoms and physique, improve the immune function and have good safety in the aspects of tonifying lung, spleen and kidney, expelling phlegm and removing blood stasis and thinning wind.
【學(xué)位授予單位】：湖北中醫(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)】：R272

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