【摘要】：目的:探討咳嗽變異性哮喘(CVA)的發(fā)病機(jī)理,及“解痙、化痰、扶正”序貫治療對(duì)慢性氣道炎癥和氣道重塑的影響及機(jī)制。方法:本次研究采用隨機(jī)對(duì)照研究方法,收集廈門市中醫(yī)院兒科門診符合“風(fēng)痰化熱”型小兒咳嗽變異性哮喘患兒60例,年齡在2歲-14歲范圍內(nèi),分為實(shí)驗(yàn)組和對(duì)照組,每組各30例。實(shí)驗(yàn)組予中藥解痙方2周、消痰方2周、固本湯4周序貫治療;對(duì)照組予布地奈德氣霧劑外用,前期咳嗽明顯時(shí)配合丙卡特羅口服治療,總療程8周。觀察兩組患兒治療情況,記錄并進(jìn)行統(tǒng)計(jì)學(xué)處理。另兩組患兒分別于治療前后采靜脈血2mL,肝素抗凝,-20℃冰箱保存,待樣本試劑收集完全后寄往上海酶聯(lián)生物科技有限公司進(jìn)行試劑檢測(cè),均采用ELISA法。前期數(shù)據(jù)全權(quán)委托上海酶聯(lián)生物科技有限公司處理,后期由本人進(jìn)行數(shù)據(jù)整理及統(tǒng)計(jì)學(xué)處理,得出結(jié)論,撰寫論文。結(jié)果:(1)兩組治療方法均能降低咳嗽癥狀積分及中醫(yī)證候積分,但實(shí)驗(yàn)組咳嗽癥狀積分有效率為86.7%、中醫(yī)證候積分有效率為83.3%;對(duì)照組咳嗽癥狀積分有效率為60%、中醫(yī)證候積分有效率為56.7%。兩組咳嗽證候積分比較P = 0.0250.05,說明兩組療效在統(tǒng)計(jì)學(xué)上有差別,可認(rèn)為實(shí)驗(yàn)組的療效高于對(duì)照組。兩組中醫(yī)證候積分比較P=0.0300.05,說明兩組療效在統(tǒng)計(jì)學(xué)上有差別,可認(rèn)為實(shí)驗(yàn)組的療效高于對(duì)照組。(2)兩種治療方法均對(duì)血清中IL-12、IL-4、TGF-β、TLR4含量有影響,實(shí)驗(yàn)組治療后血清中TLR4、TGF-β含量均較治療前明顯降低,且實(shí)驗(yàn)組血清中TLR4、TGF-β含量治療后均顯著低于對(duì)照組;實(shí)驗(yàn)組治療后血清中IL-12含量顯著高于對(duì)照組、血清中IL-4含量在治療后顯著低于對(duì)照組,IL-12與IL-4出現(xiàn)負(fù)相關(guān)性。數(shù)據(jù)經(jīng)統(tǒng)計(jì)學(xué)處理得知,實(shí)驗(yàn)組與對(duì)照組對(duì)血清中IL-12、IL-4、TGF-β、TLR4含量的影響,在統(tǒng)計(jì)學(xué)上均有差異。結(jié)論:兩組治療“風(fēng)痰化熱”型小兒咳嗽變異性哮喘均有確切療效,實(shí)驗(yàn)組即解痙、化痰、扶正序貫治療咳嗽變異性哮喘與對(duì)照組即布地奈德氣霧劑聯(lián)合丙卡特羅治療咳嗽變異性哮喘比較具有統(tǒng)計(jì)學(xué)差異,因此中藥序貫治療“風(fēng)痰化熱”型小兒咳嗽變異性哮喘優(yōu)于布地奈德氣霧劑聯(lián)合丙卡特羅治療小兒咳嗽變異性哮喘,具有有效性、安全性及臨床價(jià)值。
[Abstract]:Objective: to investigate the pathogenesis of cough variant asthma (CVA) and the effect and mechanism of sequential treatment of "spasmolysis, phlegm and tonifying" on chronic airway inflammation and airway remodeling. Methods: a randomized controlled study was used to collect 60 children with cough variant asthma, aged from 2 to 14 years old, in the pediatrics clinic of Xiamen traditional Chinese Medicine Hospital, who were divided into experimental group and control group, and 60 children with cough variant asthma of "wind-phlegm and heat" type were divided into experimental group and control group. There were 30 cases in each group. The experimental group was treated with traditional Chinese medicine for 2 weeks, Xiaotan decoction for 2 weeks, and Guben decoction for 4 weeks, while the control group was given budesonide aerosol for external use and oral treatment with Procaterol for 8 weeks when cough was obvious. Observation of the treatment of the two groups, records and statistical analysis. The other two groups were collected venous blood 2mL before and after treatment, heparin anticoagulant, -20 鈩，

本文編號(hào)：2303096