【摘要】：研究背景 小兒咳嗽變異性哮喘是一種特殊類型哮喘,以慢性咳嗽為主要或唯一的臨床表現(xiàn)。臨床表現(xiàn)為慢性咳嗽1個(gè)月以上,干咳、嗆咳、少痰或無痰、咽癢,甚或出現(xiàn)胸悶、氣喘等。且具有慢性遷延、頑固難治及反復(fù)發(fā)作的特點(diǎn),常在夜間及(或)清晨發(fā)作,常因油煙、運(yùn)動(dòng)、冷空氣、過敏原或上呼吸道病毒感染等誘發(fā)。小兒咳嗽變異性哮喘在臨床上往往無感染征象,或者經(jīng)較長時(shí)間抗生素治療無效。患兒多見有過敏史或伴有家族過敏史,好發(fā)季節(jié)為春秋季。在西醫(yī)治療方面,主要以吸入糖皮質(zhì)激素及支氣管擴(kuò)張劑為主 在傳統(tǒng)中醫(yī)著述中,尚未發(fā)現(xiàn)與之完全相對(duì)應(yīng)的病名,眾醫(yī)家從該病的病因病機(jī)及其發(fā)生、發(fā)展過程中所表現(xiàn)出的臨床證候特點(diǎn),將其分屬于“干咳”、“咳嗽”、“久咳”、“肺痙”、“風(fēng)咳”、“心咳”、“頑咳”等不同疾病范疇。治療方面,運(yùn)用辨證論治理論,整體施治,具有臨床療效好、不良反應(yīng)及副作用小的優(yōu)勢(shì),能明顯改善CVA患兒的臨床癥狀。 本課題分別通過理論、臨床研究二個(gè)部分探討了現(xiàn)代醫(yī)學(xué)及中醫(yī)對(duì)小兒咳嗽變異性哮喘的認(rèn)識(shí)和機(jī)制。 綜述部分 綜述部分從三方面論述：第一方面闡述了近代中醫(yī)對(duì)小兒咳嗽變異性哮喘的認(rèn)識(shí)；第二方面主要為西醫(yī)對(duì)小兒咳嗽變異性哮喘的認(rèn)識(shí)；第三方面主要對(duì)近代中西醫(yī)結(jié)合研究及治療小兒咳嗽變異性哮喘做出簡(jiǎn)單總結(jié)。 臨床研究 目的：觀察及評(píng)價(jià)祛風(fēng)活血法治療小兒咳嗽變異性哮喘肺風(fēng)咳嗽證的臨床療效。 方法：以北京中醫(yī)藥大學(xué)東直門醫(yī)院兒科門診的40例咳嗽變異性哮喘的患兒臨床資料為依據(jù),療程28天,記錄祛風(fēng)活血法治療小兒咳嗽變異性哮喘前后癥狀及中醫(yī)癥候的改變,觀察祛風(fēng)活血法對(duì)小兒咳嗽變異性哮喘的臨床療效。 結(jié)果：祛風(fēng)活血法可以明顯改善小兒CVA咳嗽程度及頻率、咯痰、咽癢、咽紅等,總有效率為97.5%,評(píng)分較治療前均有統(tǒng)計(jì)學(xué)意義。 結(jié)論：祛風(fēng)活血法是治療小兒咳嗽變異性哮喘肺風(fēng)咳嗽證的有效方法,可改善患者的癥狀、體征,防止進(jìn)一步發(fā)展成典型哮喘。
[Abstract]:Background cough variant asthma in children is a special type of asthma with chronic cough as the main or only clinical manifestation. The clinical manifestations include chronic cough for more than one month, dry cough, choking cough, little or no phlegm, itchy pharynx, chest tightness, asthma and so on. It has the characteristics of chronic prolongation, stubborn refractory and recurrent attacks, often occurring at night and / or early in the morning, often induced by oil fumes, exercise, cold air, allergen or upper respiratory tract virus infection. Cough variant asthma in children often has no clinical signs of infection, or after a long period of antibiotic treatment is ineffective. Children often have allergic history or family allergic history, the predilection season is spring and autumn. In western medicine treatment, inhaled glucocorticoid and bronchiectasis are the main factors in traditional Chinese medicine works. The characteristics of clinical syndromes in the course of development are classified as "dry cough", "long cough", "lung spasm", "wind cough", "heart cough", "stubborn cough" and so on. In the aspect of treatment, using the theory of syndrome differentiation and treatment as a whole has the advantages of good clinical effect, less adverse reactions and side effects, and can obviously improve the clinical symptoms of children with CVA. In this paper, the understanding and mechanism of cough variant asthma in children in modern medicine and traditional Chinese medicine were discussed in two parts: theory and clinical research. The summary part includes three parts: the first part expounds the cognition of modern Chinese medicine to cough variant asthma in children, the second part mainly discusses the knowledge of children cough variant asthma in western medicine. The third aspect mainly summarizes the research and treatment of cough variant asthma in modern Chinese and western medicine. Objective: to observe and evaluate the clinical effect of expelling wind and activating blood circulation in treating children cough variant asthma with pulmonary wind cough. Methods: according to the clinical data of 40 children with cough variant asthma in pediatric outpatient department of Dongzhimen Hospital of Beijing University of traditional Chinese Medicine, for 28 days, the changes of symptoms and symptoms of traditional Chinese medicine before and after treatment of children with cough variant asthma by expelling wind and activating blood circulation were recorded. To observe the clinical effect of dispelling wind and activating blood circulation on cough variant asthma in children. Results: the method of expelling wind and activating blood circulation could obviously improve the cough degree and frequency, sputum, pharynx itch, pharynx red and so on in children with CVA. The total effective rate was 97.5.The score was significantly higher than that before treatment. Conclusion: the method of expelling wind and activating blood circulation is an effective method for treating children cough variant asthma with pulmonary wind cough, which can improve the symptoms and signs of the patients and prevent the further development into typical asthma.
【學(xué)位授予單位】：北京中醫(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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