本文選題：穴位敷貼 + 支氣管哮喘　； 參考：《廣州中醫(yī)藥大學(xué)》2012年碩士論文

【摘要】：支氣管哮喘是一種慢性氣道炎癥性疾病,呈反復(fù)發(fā)作,近年來哮喘患病率有所上升,影響患兒缺課率升高、活動(dòng)受到限制、影響社交能力等,對(duì)兒童的發(fā)育和成長十分不利。臨床上穴位敷貼在防治支氣管哮喘方面歷史悠久,用于哮喘慢性持續(xù)期、臨床緩解期,預(yù)防哮喘的復(fù)發(fā)有明確的療效。研究目的： 本研究旨在應(yīng)用許華教授臨床經(jīng)驗(yàn)方(穴位敷貼I方)配合西醫(yī)治療方案,治療支氣管哮喘慢性持續(xù)期分屬不同中醫(yī)證型(冷哮、熱哮)的患兒,觀察治療前后的臨床癥狀與體征,以評(píng)估臨床療效,探討穴位敷貼治療支氣管哮喘的不同證型的針對(duì)性,為支氣管哮喘慢性持續(xù)期進(jìn)行穴位敷貼的選藥、選穴的進(jìn)一步研究提供客觀依據(jù)。 方法： 將冷哮30例患兒按1：1隨機(jī)分為治療組和對(duì)照組。冷哮治療組、冷哮對(duì)照組各15例；熱哮30例患兒按以上方法,分為熱哮治療組、熱哮對(duì)照組各15例。治療組給予穴位敷貼隔天一次,每次2-4小時(shí),并每天給予西醫(yī)治療；對(duì)照組每天給予西醫(yī)治療。療程3周。比較各組治療前后哮喘主要癥狀和體征積分,并進(jìn)行組間比較；評(píng)估治療第3周哮喘控制水平；記錄敷貼后皮膚不良反應(yīng)。所有的研究數(shù)據(jù)輸入計(jì)算機(jī),運(yùn)用SPSS19.0統(tǒng)計(jì)軟件統(tǒng)計(jì)分析結(jié)果。 結(jié)果： 1、自身前后對(duì)比,四組癥狀、體征積分治療第3周較治療前明顯下降,差異均有統(tǒng)計(jì)學(xué)意義(P0.05)。說明各組治療均可減輕哮喘慢性持續(xù)期癥狀及特征。 2、組間對(duì)比,治療第1周,冷哮治療組癥狀、體征積分較冷哮對(duì)照組明顯下降,差異有統(tǒng)計(jì)學(xué)意義(P0.05)；熱哮治療組積分較熱哮對(duì)照組明顯下降,差異有統(tǒng)計(jì)學(xué)意義(P0.05)；冷哮治療組積分與熱哮治療組差異無統(tǒng)計(jì)學(xué)意義。治療第2周及第3周,各組癥狀、體征積分無顯著性差異(P0.05)。說明穴位敷貼輔助治療緩解癥狀時(shí)間更迅速；而長期效果趨于相近,該穴位敷貼對(duì)冷哮、熱哮均有效。 3、治療第3周各組有效率比較,差異無統(tǒng)計(jì)學(xué)意義(P0.05)。 4、治療第3周比較各組的哮喘控制水平,冷哮治療組、熱哮治療組分別與對(duì)照組比較,控制的例數(shù)明顯多,但各組差異無統(tǒng)計(jì)學(xué)意義(P0.05)。 5、60例患兒使用穴位敷貼,未發(fā)現(xiàn)所貼皮膚處疼痛、水泡及皮膚過敏等嚴(yán)重不良反應(yīng)。 結(jié)論： 在哮喘長期治療方案基礎(chǔ)上,穴位敷貼配合相應(yīng)穴位,能有效、迅速的減輕慢性持續(xù)期哮喘患兒的主要臨床癥狀,幫助哮喘慢性持續(xù)期患兒更快達(dá)到控制水平,且對(duì)冷哮、熱哮患兒有相近療效。穴位敷貼有效、安全、方便、依從性好,值得在臨床推廣應(yīng)用。
[Abstract]:Bronchial asthma is a kind of chronic airway inflammatory disease. In recent years, the prevalence rate of asthma has increased, which affects children's absenteeism rate, limited activities, social ability and so on, which is very unfavorable to the development and growth of children. Acupoint application has a long history in the prevention and treatment of bronchial asthma. It is used in the chronic duration, clinical remission and prevention of asthma recurrence. Objectives of the study: The purpose of this study was to apply Professor Xu Hua's clinical experience prescription (acupoint application of I prescription) in combination with western medicine to treat children with bronchial asthma of chronic duration belonging to different TCM syndromes (cold asthma, heat asthma). The clinical symptoms and signs before and after treatment were observed in order to evaluate the clinical efficacy, to explore the pertinence of different syndrome types of bronchial asthma treated by acupoint application, and to select the drugs for the chronic duration of bronchial asthma. The further study on the selection of acupoints provides an objective basis. Methods: Thirty children with cold asthma were randomly divided into treatment group and control group according to 1:1. There were 15 cases in the cold asthma group and 15 cases in the cold asthma control group, and the 30 cases in the heat asthma group were divided into the heat asthma treatment group and the heat asthma control group according to the above methods. The treatment group was given acupoint application every other day for 2-4 hours, and the control group was treated with western medicine every day. The course of treatment was 3 weeks. The main symptoms and signs of asthma before and after treatment were compared and compared between groups; the control level of asthma was evaluated at the 3rd week of treatment; adverse skin reactions were recorded after application. All the research data were input into the computer and the statistical results were analyzed by SPSS19.0 statistical software. Results: 1. Compared with before and after treatment, the scores of symptoms and signs in the four groups decreased significantly in the third week compared with those before treatment, and the differences were statistically significant (P 0.05). The results showed that the symptoms and characteristics of chronic duration of asthma could be alleviated by the treatment of each group. 2, comparison between groups, in the first week of treatment, the scores of symptoms and signs in the cold asthma treatment group were significantly lower than those in the cold asthma control group, the difference was statistically significant (P 0.05), and the score in the heat asthma treatment group was significantly lower than that in the heat asthma control group. The difference was statistically significant (P 0.05), but there was no significant difference between the cold asthma treatment group and the heat asthma treatment group. At week 2 and week 3, there was no significant difference in the scores of symptoms and signs in each group (P 0.05). The results showed that the treatment of acupoint application was more rapid in relieving symptoms, but the long-term effect tended to be similar. The acupoint application was effective for cold wheezing and heat wheezing. 3. There was no significant difference in the effective rate of each group at the third week of treatment (P 0.05). 4. At the 3rd week of treatment, the control level of asthma in each group was compared. Compared with the control group, the cases of cold asthma treatment group and heat asthma treatment group were significantly higher than that of control group, but there was no significant difference in each group (P 0.05). There were no severe adverse reactions such as skin pain, blisters and skin allergies. Conclusion: On the basis of long-term treatment of asthma, acupoint application combined with corresponding acupoints can effectively and rapidly alleviate the main clinical symptoms of children with chronic persistent asthma, and help children with chronic asthma to reach the level of control faster, and to cold asthma. Children with heat wheezing have similar curative effect. Acupoint application is effective, safe, convenient and good compliance. It is worth popularizing in clinic.
【學(xué)位授予單位】：廣州中醫(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)】：R272

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