發(fā)布時間：2018-01-04 20:06

  本文關(guān)鍵詞：固本平哮湯治療支氣管哮喘非急性發(fā)作期肺腎兩虛型臨床療效觀察　出處：《湖北中醫(yī)藥大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

  更多相關(guān)文章： 哮喘 非急性發(fā)作期 中醫(yī)治療 固本平哮湯

【摘要】：導(dǎo)師根據(jù)文獻(xiàn)研究及豐富的臨床經(jīng)驗(yàn)將哮喘非急性發(fā)作期病機(jī)關(guān)鍵總結(jié)為“肺腎兩虛,痰邪伏肺”,并確立“補(bǔ)肺益腎,化痰平喘”的治療法則,以固本平哮湯為基礎(chǔ)方辨證加減后運(yùn)用于臨床哮喘非急性發(fā)作期的治療。為了對固本平哮湯療效做進(jìn)一步客觀評價(jià),本研究采用隨機(jī)對照法,探討固本平哮湯對支氣管哮喘非急性發(fā)作期肺腎兩虛型患者的癥狀、肺功能、哮喘控制情況的影響。目的:觀察固本平哮湯治療支氣管哮喘非急性發(fā)作期肺腎兩虛型的臨床療效。方法:根據(jù)中醫(yī)辨證要點(diǎn),選取支氣管哮喘非急性發(fā)作期辨證屬肺腎兩虛型患者共68例,隨機(jī)分為治療組和對照組,每組各34例患者。兩組患者治療前對性別、年齡、病程長短、病情輕重程度方面進(jìn)行比較,經(jīng)統(tǒng)計(jì)學(xué)處理無顯著差異性(P0.05),可以進(jìn)行比較。治療組患者給于固本平哮湯(黃芪20g,黨參15g,靈芝10g,補(bǔ)骨脂15g,肉蓯蓉10g,五味子6g,磁石18g,蘇子15g,蜜紫菀12g,款冬花12g,法半夏12g,橘紅6g)聯(lián)合沙美特羅氟替卡松(舒利迭葛蘭素史克50ug/250ug,每次1吸,每天2次)治療,對照組僅給于沙美特羅氟替卡松(舒利迭葛蘭素史克50ug/250ug,每次1吸,每天2次)常規(guī)治療。治療30天后停中藥固本平哮湯,兩組患者繼續(xù)予以沙美特羅氟替卡松常規(guī)吸入。觀察并記錄治療前后兩組患者中醫(yī)癥候總積分、各單項(xiàng)癥狀積分、肺功能、哮喘控制測試(ACT)評分的變化情況。對記錄的數(shù)據(jù)使用SPSS19.0軟件進(jìn)行統(tǒng)計(jì)分析。結(jié)果:(1)總有效率比較:治療30天后治療組總有效率為91.17%,對照組為85.29%,經(jīng)統(tǒng)計(jì)學(xué)處理,有顯著性差異(P0.05),治療組療效明顯優(yōu)于對照組。(2)總體癥候積分及單項(xiàng)癥狀積分比較:兩組治療后組內(nèi)及組間總體癥候積分改善上,經(jīng)統(tǒng)計(jì)學(xué)處理P0.05,具有顯著性差異,兩組均可以改善總體癥候積分,治療組明顯優(yōu)于對照組。兩組在喘息、咳嗽、咳痰、乏力、畏寒肢冷等主要、次要單項(xiàng)癥狀改善上,經(jīng)統(tǒng)計(jì)學(xué)處理,具有顯著性差異P0.05,治療組療效明顯優(yōu)于對照組。兩組均可改善胸膈滿悶癥狀,但無顯著差異,P0.05。治療組可有效改善自汗、腰膝酸軟的癥狀,對照組對自汗、腰膝酸軟則無明顯改善。(3)肺功能比較:兩組治療后肺功能FEV1%,PEF均有顯著提高,經(jīng)統(tǒng)計(jì)學(xué)處理P0.05,治療組改善程度優(yōu)于對照組。(4)哮喘控制水平方面:兩組均可提高哮喘控制ACT評分,經(jīng)統(tǒng)計(jì)學(xué)處理P0.05,具有顯著差異性。治療組優(yōu)于對照組。結(jié)論:固本平哮湯與沙美特羅氟替卡松有很好的協(xié)同作用,比單純使用沙美特羅氟替卡松更能有效控制哮喘,改善癥狀、提高肺功能。因此固本平哮湯聯(lián)合沙美特羅氟替卡松在哮喘非急性發(fā)作期的治療上比單純運(yùn)用沙美特羅氟替卡松具有一定的優(yōu)勢。
[Abstract]:According to the literature research and abundant clinical experience, the tutor summarized the key of pathogenesis of asthma in non-acute attack period as "deficiency of lung and kidney, accumulation of phlegm and evil", and established the treatment principle of "tonifying the lung and tonifying the kidney, resolving phlegm and relieving asthma". Guben Pingxiao decoction is used in the treatment of clinical asthma during non-acute attack after differentiation of symptoms and signs. In order to make further objective evaluation of the curative effect of Guben Pingxiao decoction, this study adopts a randomized controlled method. To explore the symptoms and pulmonary function of Gubenping decoction in patients with deficiency of both kidney and lung in non-acute stage of bronchial asthma. Objective: to observe the clinical effect of Gubenping Xiao decoction in treating asthmatic patients with deficiency of lung and kidney in non-acute attack period. Methods: according to the main points of TCM syndrome differentiation. A total of 68 patients with lung and kidney deficiency syndrome were randomly divided into treatment group and control group with 34 patients in each group. The two groups had sex, age and course of disease before treatment. Compared with the severity of the disease, there is no significant difference between the treatment group and the treatment group (Astragalus, 20g, Codonopsis 15g), the treatment group patients were given Guben Ping Xiao Tang (Astragalus 20g, Codonopsis 15g). Ganoderma lucidum 10g, psoralen 15g, Cistanche 10g, Schisandra Schisandra 6g, magnetite 18g, Perilla 15g, Aster honey 12g, Flos lucifera 12g, Pternata ternata 12g. Orange red 6g) combined with salmeterol fluticasone (Schuliday GlaxoSmithKline 50ugr / 250ugg, 1 inhalation at a time, twice a day). The control group was treated with routine therapy only with salmeterol fluticasone (Schuliday GlaxoSmithKline 50ugr / 250ugg, once a time, twice a day). After 30 days of treatment, Guben Pingxiao decoction was stopped. Two groups of patients continue to receive salmeterol fluticasone routine inhalation. Observe and record the two groups of patients before and after treatment of TCM symptoms total score, each single symptom score, pulmonary function. Changes in the ACT score of Asthma Control Test. Statistical analysis of recorded data using SPSS19.0 software. Results: 1). Comparison of the total effective rate: after 30 days of treatment, the total effective rate of the treatment group was 91.17%. The control group was 85.29 (P 0.05). The curative effect of the treatment group was significantly better than that of the control group. 2) overall symptom score and single symptom score were compared: after treatment, the overall symptom score of the two groups was improved, which was treated by statistics (P0.05). There was significant difference, both groups can improve the overall symptom score, the treatment group is significantly better than the control group. The two groups in asthma, cough, expectoration, fatigue, cold chills and other major, secondary single symptoms improved. After statistical treatment, there was significant difference (P0.05). The curative effect of the treatment group was significantly better than that of the control group. Both groups can improve the symptoms of chest and diaphragm fullness, but there is no significant difference (P0.05. the treatment group can effectively improve self-sweating. The comparison of lung function in the control group and in the control group showed that the pulmonary function of the two groups was significantly higher than that of the control group (P < 0.01). After statistical treatment P0.05, the treatment group improved better than the control group. 4) Asthma control level: both groups can improve asthma control ACT score, by statistical treatment P0.05. The treatment group is superior to the control group. Conclusion: Guben Ping Xiao Tang and salmeterol fluticasone have very good synergistic effect, which can effectively control asthma and improve symptoms than using salmeterol fluticasone alone. Therefore Guben Ping Xiao Tang combined with salmeterol fluticasone has some advantages over salmeterol fluticasone alone in the treatment of asthma in non-acute stage.
【學(xué)位授予單位】：湖北中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R256.12

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