發(fā)布時(shí)間：2018-12-18 03:28

【摘要】：目的:本課題以小青龍湯聯(lián)合寒哮貼貼穴治療符合寒性哮喘的患兒,以觀察小青龍湯聯(lián)合寒哮貼貼穴治療急性發(fā)作期小兒寒性哮喘的臨床療效和安全性,豐富小兒寒性哮喘的中醫(yī)治法,為小青龍湯聯(lián)合寒哮貼貼穴治療小兒寒性哮喘提供臨床依據(jù)。方法:本研究收集符合納入標(biāo)準(zhǔn)的小兒寒性哮喘患兒120例,按照簡(jiǎn)單隨機(jī)化原則,將120例將患兒按照就診順序進(jìn)行編號(hào),應(yīng)用SPSS Transform程序?qū)幪?hào)進(jìn)行分組,分為小青龍湯組和小青龍湯聯(lián)合寒哮貼貼穴組(聯(lián)合組),其中,小青龍湯組60例患者,聯(lián)合組60例患者。小青龍湯組單獨(dú)使用小青龍湯口服治療,聯(lián)合組在小青龍湯組的基礎(chǔ)上加用寒哮貼貼穴(生麻黃、丁香、細(xì)辛、白芥子、甘遂,按照1:1:1:2:1的比例研末,姜汁調(diào)勻,制蠶豆大小藥餅貼肺腧穴、定喘穴、大椎穴、膏肓穴、膻中穴、脾腧穴、腎腧穴)治療。觀察治療1周后患兒臨床癥狀、體征、肺功能的改變,且持續(xù)觀察對(duì)比兩組治療療程,并觀察血常規(guī)、肝腎功能等安全性指標(biāo)。數(shù)據(jù)皆采用SPSS19.0統(tǒng)計(jì)方法進(jìn)行統(tǒng)計(jì)分析。結(jié)果:1.小青龍湯組:臨床控制6例、顯效23例、有效19例、無效9例,總有效率達(dá)85.00%;聯(lián)合組:臨床控制10例、顯效31例、有效13例、無效4例,總有效率達(dá)93.33%,差異具備統(tǒng)計(jì)學(xué)意義(P0.05);與小青龍湯組比較,聯(lián)合組總有效率提升,差異具備統(tǒng)計(jì)學(xué)意義(P0.05)。2.中醫(yī)癥候療效:小青龍湯組中臨床治愈4例、顯效36例、有效12例、無效5例,總有效率達(dá)91.22%;聯(lián)合組中臨床治愈9例、顯效42例、有效6例、無效1例,總有效率達(dá)98.27%,差異有統(tǒng)計(jì)學(xué)意義(P0.05);與小青龍湯組比較,聯(lián)合組總有效率升高,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。3.治療后,其患者肺功能PEF值改善情況明顯優(yōu)于治療前,其中小青龍湯療程大于聯(lián)合組,其差異有統(tǒng)計(jì)學(xué)意義(P0.01)。與小青龍湯組比較,聯(lián)合組總有效率提高,療程縮短,差異有統(tǒng)計(jì)學(xué)意義(P0.05,P0.01)。4.治療前后,兩組患兒的血常規(guī)、肝腎功能檢查無明顯變化。治療過程中無不良反應(yīng)出現(xiàn)。結(jié)論:小青龍湯聯(lián)合寒哮貼貼穴治療小兒寒性哮喘較單獨(dú)使用小青龍湯口服,療效明顯提高,且具有良好的安全性。通過以上臨床研究佐證了內(nèi)外結(jié)合治療小兒寒性哮喘的科學(xué)價(jià)值,驗(yàn)證了小青龍湯聯(lián)合寒哮貼貼穴在改善小兒寒性哮喘方面的確切作用,為臨床醫(yī)治小兒寒性哮喘提供了頗為有效的治療思路。
[Abstract]:Objective: to observe the clinical efficacy and safety of Xiao Azure Dragon decoction combined with Cold Asthma paste in the treatment of children with cold asthma. It can provide clinical basis for treating children cold asthma with Xiao Azure Dragon decoction combined with cold plaster. Methods: in this study, 120 children with cold asthma were collected. According to the principle of simple randomization, 120 children with cold asthma were numbered according to the order of seeing a doctor, and the numbers were divided into groups by SPSS Transform program. It was divided into two groups: Xiao Azure Dragon decoction group and Xiao Azure Dragon decoction combined with Han Xiao tie point group (combined group). Among them, there were 60 patients in the small Azure Dragon decoction group and 60 patients in the combined group. The Xiao Azure Dragon decoction group was treated by oral administration of Xiaolai_person1# decoction alone, while the combined group was treated with Han Xiao tie points (raw ephedra, clove, Asarum, mustard, kansui) on the basis of the small Azure Dragon decoction group. At the rate of 1: 1: 1: 1: 2: 1, at the end of the study, Ginger juice blending, make broad bean size medicine cake paste lung acupoint, Dingchuan point, Dazhui point, Yan Zhong point, spleen acupoint, kidney acupoint) treatment. The changes of clinical symptoms, signs and lung function were observed after 1 week of treatment, and the safety indexes such as blood routine, liver and kidney function were observed and compared continuously. The data were analyzed by SPSS19.0 statistical method. Results: 1. In the group of Xiao Azure Dragon decoction, there were 6 cases of clinical control, 23 cases of remarkable effect, 19 cases of effective and 9 cases of ineffective. The total effective rate was 85.00%. In the combined group, 10 cases were clinically controlled, 31 cases were effective, 13 cases were effective, 4 cases were ineffective, the total effective rate was 93.33 and the difference was statistically significant (P0.05). Compared with Xiao Azure Dragon decoction group, the total effective rate of the combined group was improved, the difference was statistically significant (P0.05). In the group of Xiao Azure Dragon decoction, 4 cases were clinically cured, 36 cases were markedly effective, 12 cases were effective, 5 cases were ineffective, and the total effective rate was 91.22 cases. In the combined group, 9 cases were clinically cured, 42 cases were obviously effective, 6 cases were effective, and 1 case was ineffective. The total effective rate was 98.277.The difference was statistically significant (P0.05). Compared with Xiao Azure Dragon decoction group, the total effective rate of combined group increased, the difference was statistically significant (P0.05). After treatment, the improvement of PEF value of pulmonary function was better than that before treatment, and the course of treatment of Xiao Azure Dragon decoction was greater than that of combined group, and the difference was statistically significant (P0.01). Compared with Xiao Azure Dragon decoction group, the total effective rate of combined group was increased, the course of treatment was shortened, the difference was statistically significant (P0.05, P0.01). Before and after treatment, the blood routine, liver and kidney function of the two groups did not change significantly. No adverse reactions occurred during the treatment. Conclusion: the therapeutic effect of Xiao Azure Dragon decoction combined with cold plaster on children with cold asthma is better than that of Xiao Azure Dragon decoction alone, and it has good safety. The above clinical studies have proved the scientific value of the combination of internal and external treatment of cold asthma in children, and verified the exact role of Xiao Azure Dragon decoction combined with cold asthma paste in improving children's cold asthma. For the clinical treatment of cold asthma in children to provide a rather effective way of treatment.
【學(xué)位授予單位】：山東中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R272

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