【摘要】：目的:本研究旨在觀察咳喘平顆粒治療風(fēng)寒閉肺型毛細(xì)支氣管炎患兒的臨床療效及安全性,主要對中醫(yī)證候積分和綜合療效進(jìn)行評估,同時(shí)對患兒外周血血清I L-4、I L-1 7水平進(jìn)行檢測,初步探討咳喘平顆粒治療小兒毛細(xì)支氣管炎的作用機(jī)制,為毛細(xì)支氣管炎的臨床治療提供理論依據(jù)。方法:選取符合本研究標(biāo)準(zhǔn)的毛細(xì)支氣管炎患兒6 0例,運(yùn)用隨機(jī)數(shù)字法分為觀察組和對照組,每組各3 0例,兩組均予以西醫(yī)常規(guī)治療,其中觀察組在西醫(yī)常規(guī)治療的基礎(chǔ)上加予咳喘平顆�？诜�。兩組均以7天為1個(gè)療程,1個(gè)療程結(jié)束后,觀察兩組患兒中醫(yī)證候積分、綜合療效及藥物不良反應(yīng);同時(shí)兩組在治療前1天和治療最后1天分別檢測患兒外周血血清I L-4水平、I L-1 7水平、血常規(guī)、肝功能、腎功能、尿常規(guī)及大便常規(guī),旨在觀察咳喘平顆粒治療風(fēng)寒閉肺型毛細(xì)支氣管炎患兒的臨床療效、安全性及初步探討其作用機(jī)制。結(jié)果:1.總療效比較:觀察組的總有效率為9 6.6 7%,對照組的總有效率為8 0.0 0%,兩組的總有效率相比較,差異有統(tǒng)計(jì)學(xué)意義(p0.0 5),提示兩組治療后均能顯著提高風(fēng)寒閉肺型毛細(xì)支氣管炎患兒的臨床療效,且觀察組優(yōu)于對照組。2.中醫(yī)證候總積分比較:兩組患兒中醫(yī)證候總積分治療后均較治療前低,差異均有統(tǒng)計(jì)學(xué)意義(p0.0 5)。治療后兩組組間中醫(yī)證候總積分相比較,差異有統(tǒng)計(jì)學(xué)意義(p0.0 5)。提示兩組治療后均可顯著改善風(fēng)寒閉肺型毛細(xì)支氣管炎患兒的臨床癥狀和體征,且觀察組優(yōu)于對照組。3.中醫(yī)各主要證候積分比較:兩組患兒中醫(yī)各主要證候積分治療后均較治療前低,差異均有統(tǒng)計(jì)學(xué)意義(p0.0 1或p0.0 5);且兩組組間氣喘、咳嗽、痰鳴三個(gè)主要證候積分相比較,觀察組優(yōu)于對照組(p0.0 5)。4.中醫(yī)各次要證候積分比較:兩組患兒中醫(yī)各次要證候積分治療后均較治療前低,差異均有統(tǒng)計(jì)學(xué)意義(p0.0 1或p0.0 5);且兩組組間鼻翼煽動、口唇青紫兩個(gè)次要證候積分相比較,觀察組優(yōu)于對照組(p0.0 5)。5.外周血血清I L-4和I L-1 7比較:治療前后兩組組內(nèi)患兒血清I L-4、I L-1 7水平相比較,差異均有統(tǒng)計(jì)學(xué)意義(p0.0 5),提示兩組均可降低患兒血清I L-4、I L-1 7水平;治療后兩組組間患兒血清I L-4、I L-1 7水平相比較,觀察組優(yōu)于對照組(p0.0 5)。6.安全性觀察:本研究過程中,6 0名患兒未出現(xiàn)嚴(yán)重的不良反應(yīng),僅對照組有2例患兒出現(xiàn)一過性腹瀉、嘔吐,未予處理后癥狀很快消失。同時(shí)兩組在治療前后對患兒進(jìn)行安全性指標(biāo)的檢測,結(jié)果提示血常規(guī)、肝功能、腎功能、尿常規(guī)及大便常規(guī)均未見異常。本研究表明咳喘平顆粒在治療風(fēng)寒閉肺型毛細(xì)支氣管炎患兒的過程中安全可靠。結(jié)論:1.咳喘平顆粒可明顯改善風(fēng)寒閉肺型毛細(xì)支氣管炎患兒中醫(yī)證候積分、增強(qiáng)患兒體質(zhì),提高臨床綜合療效。2.咳喘平顆粒能降低患兒外周血血清I L-4、I L-1 7水平,提示咳喘平顆粒治療風(fēng)寒閉肺型毛細(xì)支氣管炎患兒的機(jī)制可能是調(diào)節(jié)T h 1/T h 2平衡失調(diào)、減輕氣道炎癥。3.咳喘平顆粒安全性好,值得在臨床上推廣應(yīng)用。
[Abstract]:Objective: the purpose of this study was to observe the clinical efficacy and safety of Ke Chuan Ping granules in the treatment of children with wind cold and pulmonary bronchiolitis, mainly to evaluate the TCM syndrome integral and comprehensive effect, and to detect the level of I L-4 and I L-1 7 in the peripheral blood serum of the children, and discuss the effect of Ke Chuan Ping Granule on the treatment of bronchiolitis in children. The mechanism is to provide theoretical basis for the clinical treatment of bronchiolitis. Methods: 60 children with bronchiolitis were selected in accordance with the standard of this study, and were divided into the observation group and the control group by random number method, 30 cases in each group, and the two groups were treated with western medicine routine treatment. The observation group was added to the cough and asthma Granule on the basis of the routine treatment of Western medicine. The two groups were treated with 7 days as 1 courses. After the 1 course of treatment, the scores of TCM syndromes, comprehensive curative effect and drug adverse reaction were observed in the two groups. At the same time, the level of I L-4 in the peripheral blood serum, the level of I L-1 7, the blood routine, the liver function, the renal function, the routine urine and the routine stool routine were observed in the two groups in the 1 days before the treatment and the last 1 days of treatment. The clinical efficacy, safety and preliminary discussion of the effect mechanism of CHD Chan Ping granule in the treatment of children with bronchiolitis with wind cold and closed pulmonary bronchitis. Results: 1. total effective effect was compared: the total effective rate of the observation group was 96.67%, the total effective rate of the control group was 80%, the total effective rate of the two groups was compared, the difference was statistically significant (p0.0 5), suggesting the two groups of treatment. The latter can significantly improve the clinical efficacy of the children with bronchiolitis of wind cold and pulmonary bronchiolitis, and the observation group is better than the control group.2. TCM syndrome total score: the two groups of children's TCM syndromes after total integral treatment are lower than before the treatment, the difference is statistically significant (p0.0 5). After the treatment of the two groups of TCM syndromes, the difference is statistically significant. Study significance (p0.0 5). The clinical symptoms and signs of the children with wind cold and bronchiolitis were significantly improved after the treatment of two groups, and the observation group was better than the control group.3.. The scores of the main syndromes in the two groups were lower than those before the treatment, the difference was statistically significant (p0.0 1 or p0.0 5). And the two groups of asthma, cough, phlegm, three main syndrome scores compared, the observation group was better than the control group (p0.0 5).4. traditional Chinese medicine syndrome score comparison: the two groups of children's secondary syndrome scores after treatment were lower than before the treatment, the difference was statistically significant (p0.0 1 or p0.0 5); and two groups of nasal alar incitement, lip and purple two times. To compare the syndrome score, the observation group was better than the control group (p0.0 5).5. peripheral blood serum I L-4 and I L-1 7. The difference of serum I L-4 and I L-1 7 in the two groups of children before and after treatment was statistically significant (p0.0 5), suggesting that the two groups could reduce the serum I levels and 7 levels of the children. Compared with the 7 level, the observation group was better than the control group (p0.0 5).6. safety observation: in the course of this study, 60 children had no serious adverse reactions, only 2 cases in the control group had an excessive diarrhea, vomiting, and the symptoms disappeared quickly after the treatment. At the same time, the safety indexes were detected in the two groups before and after treatment, and the results were suggested. Blood routine, liver function, renal function, urine routine and stool routine are not abnormal. This study shows that the cough and asthma granule is safe and reliable in the treatment of children with wind cold and pulmonary bronchiolitis. Conclusion: 1. cough and Chuan Ping granules can obviously improve the TCM syndrome score of wind cold closed pulmonary bronchiolitis, enhance the physique of the children and improve the prognosis. The comprehensive therapeutic effect of.2. Ke Chuan Ping granule can reduce the serum serum I L-4 and I L-1 7 level in the peripheral blood of the children. It is suggested that the mechanism of the cough and Chuan Ping granule in treating the children with wind cold closed pulmonary bronchiolitis may be the regulation of T h 1/T H 2 balance imbalance, the safety of the airway inflammation.3. cough and asthma granule, and it is worthy of clinical application.
【學(xué)位授予單位】：安徽中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R272

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