本文選題：毛細(xì)支氣管炎 + 風(fēng)寒閉肺型��； 參考：《湖北中醫(yī)藥大學(xué)》2012年碩士論文

【摘要】：毛細(xì)支氣管炎,是一種2歲以下嬰幼兒時(shí)期常見(jiàn)的下呼吸道感染疾病,尤其以2-6個(gè)月最為多見(jiàn),主要為病毒感染引起,80%左右系病毒感染,58%為呼吸道合胞病毒(RSV)感染。臨床以喘憋、氣促和呼吸困難為主要特征。其癥狀如肺炎,且喘憋更著,病變常累及肺泡與肺泡間壁,故國(guó)內(nèi)認(rèn)為是毛細(xì)支氣管炎一種特殊的肺炎,有人又稱(chēng)之為喘憋性肺炎。祖國(guó)醫(yī)學(xué)多將其納入“肺炎喘嗽”或“哮病”的范疇。毛細(xì)支氣管炎多為病毒感染,中藥治療具有優(yōu)勢(shì),成為中醫(yī)兒科研究方向之一。有研究證實(shí),使用中藥聯(lián)合西藥治療方案治療小兒毛細(xì)支氣管炎,在癥狀緩解、治療時(shí)間及病后恢復(fù)等方面,效果均優(yōu)于單純西醫(yī)治療,臨床療效滿(mǎn)意。 目的： 采用中藥聯(lián)合西藥常規(guī)治療的方案,觀察中藥聯(lián)合西藥常規(guī)治療(治療組)與西藥常規(guī)治療(對(duì)照組),治療毛細(xì)支氣管炎(風(fēng)寒閉肺型)的臨床療效、緩解臨床癥狀體征、血清RSV抗體陽(yáng)性轉(zhuǎn)陰情況、T細(xì)胞亞群(CD4%、CD8%、CD41/CD8)、免疫球蛋白E(IgE)、嗜酸性粒細(xì)胞(EOS)計(jì)數(shù)水平變化,并探討其可能的作用機(jī)制。 方法： 本研究60例患兒均為武漢市兒童醫(yī)院呼吸科、中醫(yī)科住院患兒,均符合毛細(xì)支氣管炎的西醫(yī)診斷標(biāo)準(zhǔn)和中醫(yī)風(fēng)寒閉肺證候診斷標(biāo)準(zhǔn),采用隨機(jī)、對(duì)照方法,將其分為治療組和對(duì)照組,治療組30例,對(duì)照組30例,兩組均均給予痰熱清(0.5ml/Kg.1次/d)靜點(diǎn)抗病毒、普米克(布地奈德)霧化吸入止咳平喘、常規(guī)叩背吸痰、退熱等對(duì)癥處理,入院后根據(jù)痰細(xì)菌培養(yǎng)結(jié)果以及藥敏結(jié)果,合理選用抗生素,根據(jù)患兒缺氧情況,必要時(shí)予吸氧治療。治療組在上述治療的基礎(chǔ)上,口服溫肺化痰合劑,七天為一療程,觀察1個(gè)療程,進(jìn)行療效評(píng)定,并于停藥后士5天后隨訪。 結(jié)果： (1)兩組治療前后在癥狀、體征消失時(shí)間上治療組明顯優(yōu)于對(duì)照組(P0.01)； (2)兩組治療前血清RSV抗體陽(yáng)性情況無(wú)顯著差異性(P0.05),具有可比性,治療后兩組RSV抗體轉(zhuǎn)陰情況比較,有顯著性差異,治療組效果優(yōu)于對(duì)照組(P0.05)； (3)兩組療前CD4%、CD8%、CD4/CD8無(wú)顯著性差異(P0.05),經(jīng)過(guò)治療后,兩組患兒CD4%及CD4/CD8均有不同程度的升高,CD8%均有不同程度的降低,治療組與對(duì)照組比較有非常顯著性差異,治療組效果明顯優(yōu)于對(duì)照組(P0.01)； (4)兩組治療前實(shí)驗(yàn)室指標(biāo)IgE、EOS計(jì)數(shù)無(wú)顯著差異性(P0.05),具有可比性,治療后實(shí)驗(yàn)室指標(biāo)IgE、EOS計(jì)數(shù)變化有顯著性差異,治療組效果優(yōu)于對(duì)照組(P0.05)； (5)兩組治療前后中醫(yī)癥候療效對(duì)比,總有效率治療組90%,對(duì)照組66.67%,治療組優(yōu)于對(duì)照組(P0.05)； (6)治療1周后,兩組疾病療效對(duì)比,總有效率治療組93.33%,對(duì)照組73.33%,治療組優(yōu)于對(duì)照組(P0.05)。 結(jié)論： 此次臨床觀察說(shuō)明根據(jù)中醫(yī)辨證論治的原則,對(duì)風(fēng)寒閉肺型毛細(xì)支氣管炎采用中藥聯(lián)合西藥常規(guī)治療的方法治療,結(jié)果說(shuō)明中藥治療組在臨床療效、緩解臨床癥狀體征、促進(jìn)血清RSV抗體陽(yáng)性轉(zhuǎn)陰、改善T細(xì)胞亞群(CD4%、CD8%、CD41/CD8)、IgE、EOS計(jì)數(shù)指標(biāo)方面明顯優(yōu)于單純西藥療法的對(duì)照組。
[Abstract]:Bronchiolitis is a common lower respiratory tract infection of children under 2 years of age, especially for 2-6 months, mainly caused by virus infection, about 80% of the virus infection, and 58% of the respiratory syncytial virus (RSV) infection. The disease often involves the alveoli and the alveolar wall, so it is considered as a special pneumonia of bronchiolitis in China, and some people call it asthma suffocating pneumonia. The Chinese medicine is mostly included in the category of "pneumonia asthma" or "asthma". The bronchiolitis is mostly infected by virus, and the treatment of Chinese medicine has advantages, and it has become one of the research directions of traditional Chinese medicine. It has been proved that the effect of traditional Chinese medicine combined with western medicine in the treatment of bronchiolitis of children's bronchiolitis is better than that of simple western medicine in the treatment of symptoms, treatment time and recovery after the disease.
Objective:
The traditional Chinese medicine combined with western medicine routine treatment was used to observe the clinical efficacy of traditional Chinese medicine combined with western medicine routine treatment (treatment group) and Western medicine routine treatment (control group) to treat bronchiolitis (wind cold closed lung type), relieve clinical symptoms and signs, serum RSV antibody positive conversion, T cell subgroup (CD4%, CD8%, CD41/CD8), and immunoglobulin E (IgE), Eosinophil (EOS) counts were measured and the possible mechanisms of action were discussed.
Method錛，

本文編號(hào)：1990156