【摘要】：目的：觀察自擬中藥湯劑桑貝保金湯加減治療小兒咳嗽變異性哮喘的臨床療效及對肺功能、血清總IgE的影響。 方法：本研究依據(jù)納入標(biāo)準(zhǔn)篩選符合咳嗽變異性哮喘診斷的3-14歲患兒，共80例，隨機(jī)分成試驗(yàn)組40例和對照組40例。試驗(yàn)組服用桑貝保金湯，，并隨證加減，對照組口服酮替芬和氨茶堿片，療程均為28天。觀察兩組治療前后患兒的臨床綜合改善率、中醫(yī)單項(xiàng)癥狀變化情況以及肺功能和血清總IgE水平的改變，以評價(jià)藥物的有效性。試驗(yàn)前后化驗(yàn)血、尿、便常規(guī)、肝、腎功能，并觀察試驗(yàn)期間有無不良反應(yīng)發(fā)生，以評價(jià)藥物的安全性。 結(jié)果： 1．試驗(yàn)組桑貝保金湯對咳嗽變異性哮喘的顯效率為76.9%,對照組顯效率為45.0%，兩組比較有統(tǒng)計(jì)學(xué)差異(P＜0.05)。在兩組患兒單項(xiàng)癥狀情況變化的比較方面，試驗(yàn)組咳嗽、咽癢癥狀的顯效率分別為84.6%、71.9%，對照組分別為60.0%、55.0%，試驗(yàn)組優(yōu)于對照組(P＜0.05)，而咯痰、氣促癥狀的顯效率兩組相比，無顯著性差異（P＞0.05）。在改善肺功能方面，經(jīng)治療后兩組患兒肺功能指標(biāo)有最大通氣量(MVV)、第1秒用力呼氣量(FEV1)、50％用力肺活量時(shí)流速(Vmax50)、最大呼氣流速(PEF)絕對值都得以顯著改善，但試驗(yàn)組優(yōu)于對照組(P＜0.05)。在對血清總IgE水平的影響方面，兩組治療后血清總IgE水平與同組治療前比較，P＜0.05；試驗(yàn)組治療后與對照組治療后相比，P＜0.05，存在統(tǒng)計(jì)學(xué)差異。 2．本臨床研究過程中所有患兒未發(fā)生明顯不良反應(yīng)，按照安全性評價(jià)標(biāo)準(zhǔn)認(rèn)為桑貝保金湯具有良好的安全性。 結(jié)論： 桑貝保金湯對小兒咳嗽變異性哮喘有顯著的臨床療效，可明顯提高咳嗽變異性哮喘患兒的肺功能，降低咳嗽變異性哮喘患兒血清總IgE水平，同時(shí)具有良好安全性。
[Abstract]:Objective: to observe the clinical effect of Sangbei Baojin decoction on cough variant asthma in children and its effect on lung function and serum total IgE. Methods: according to the inclusive criteria, 80 children aged 3 to 14 years with cough variant asthma were randomly divided into two groups: the experimental group (n = 40) and the control group (n = 40). The experimental group was treated with Sanbiebaojin decoction, and the control group was treated with ketotifen and aminophylline tablets for 28 days. In order to evaluate the effectiveness of drugs, the clinical comprehensive improvement rate, the changes of individual symptoms of TCM and the changes of pulmonary function and serum total IgE levels were observed before and after treatment in the two groups. Before and after the test, blood, urine, stool routine, liver, renal function, and observed the adverse reactions during the trial to evaluate the safety of drugs. Results: 1. The effective rate of Sangbei Baojin decoction on cough variant asthma was 76.9 in the trial group and 45.0 in the control group. There was significant difference between the two groups (P < 0.05). In the comparison of the changes of individual symptoms between the two groups, the marked effective rates of cough and pharyngotic symptoms in the trial group were 84.61.90 and 60.055.0, respectively. The experimental group was superior to the control group (P < 0.05), but the effective rate of expectoration and shortness of breath was higher than that of the control group, and the effective rate of the symptoms of sputum and shortness of breath was higher in the experimental group than that in the control group (P < 0.05). There was no significant difference (P > 0.05). In terms of improving pulmonary function, after treatment, the pulmonary function indexes of the two groups were maximal ventilation volume (MVV), forced expiratory volume (FEV1) of 50% forced vital capacity (Vmax50), and the absolute value of (PEF) of maximal expiratory flow (PEF) were significantly improved. But the experimental group was superior to the control group (P < 0.05). In terms of the effect on serum total IgE level, the serum total IgE level after treatment in the two groups was significantly lower than that in the same group before treatment (P < 0.05). Compared with the control group, there was a statistical difference between the experimental group and the control group (P < 0.05). 2. In this clinical study, no significant adverse reactions occurred in all the children. According to the safety evaluation standard, it is considered that Sambai Baojin decoction has good safety. Conclusion: Sangbei Baojin decoction has a significant clinical effect on children with cough variant asthma, it can obviously improve the lung function of children with cough variant asthma, and reduce the total serum IgE level of children with cough variant asthma. At the same time, it has good safety.
【學(xué)位授予單位】：遼寧中醫(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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