本文關(guān)鍵詞：寧哮暢中顆粒劑配合穴位貼敷治療兒童哮喘遷延期的療效觀察　出處：《河北醫(yī)科大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

  更多相關(guān)文章： 兒童哮喘 遷延期 寧哮暢中 穴位貼敷 療效觀察

【摘要】：目的:支氣管哮喘(bronchial asthma)簡稱哮喘,是兒童時(shí)期最常見的一種慢性呼吸道疾病。其發(fā)病原因是痰伏于肺,并在肺、脾、腎相對(duì)不足的基礎(chǔ)上,外邪侵襲、飲食失節(jié)、情志失調(diào)、接觸異味異物等因素共同作用的結(jié)果,具有反復(fù)發(fā)作的特點(diǎn),在嚴(yán)重使患兒的身心健康受到影響的同時(shí),也對(duì)其家庭產(chǎn)生了巨大壓力。若兒童哮喘控制不良,則發(fā)展為成人哮喘的可能性就會(huì)很大,而成為終身疾患。所以是目前小兒慢性疾病中,需要積極防治的重點(diǎn)疾病。本文旨在從中醫(yī)理論及臨床療效方面對(duì)兒童哮喘遷延期的病因病機(jī)和方藥進(jìn)行觀察與探討,尋求兒童哮喘遷延期的有效防治藥物,探討防哮藥物的療效機(jī)理。以“肺與中焦脾胃相關(guān)性”理論為切入點(diǎn),并結(jié)合兒童哮喘的發(fā)病特點(diǎn),采用中藥結(jié)合穴位貼敷的方法進(jìn)行臨床研究,為臨床治療兒童哮喘尋求一條既安全又有效的治療方法。方法:選擇河北省中醫(yī)院兒科門診符合統(tǒng)一的診斷標(biāo)準(zhǔn)、納入標(biāo)準(zhǔn)和排除標(biāo)準(zhǔn)的支氣管哮喘遷延期的患兒60例,通過查隨機(jī)數(shù)字表,隨機(jī)的分為兩組。其中治療組30例,對(duì)照組30例。對(duì)照組在常規(guī)小劑量糖皮質(zhì)激素吸入的基礎(chǔ)上給予口服清咳平喘顆粒。治療組在常規(guī)小劑量糖皮質(zhì)激素吸入的基礎(chǔ)上,給予口服寧哮暢中顆粒劑及穴位貼敷聯(lián)合治療。寧哮暢中顆粒劑的藥物組成:葶藶子8-12g、桑白皮8-12g、浙貝母8-10g、炒苦杏仁8-10g、炒僵蠶6-8g、清半夏6-8g、陳皮6-8g、炒萊菔子8-10g、炒枳殼6-8g、炒白術(shù)10-12g、郁金8-10g、砂仁6-8g、炒谷芽8-10g等(每盒7劑,日一劑,分兩次沖服)。穴位貼敷療法,是將吳茱萸,蘇子,桔梗等藥物,按適當(dāng)比例研磨成細(xì)粉末,用醋調(diào)制成糊狀,制成圓餅狀,分別貼在患兒肺俞穴(雙側(cè))、定喘穴(雙側(cè))、膻中穴。第1周貼敷每天1次,第2周至第4周為隔日1次,每次貼4-6h,并且根據(jù)患兒耐受情況調(diào)整貼敷時(shí)間。1個(gè)月為一療程,共計(jì)治療3個(gè)療程。兩組患兒在治療期間均囑其清淡飲食和避免風(fēng)寒及過敏原。通過觀察兩組總有效率、中醫(yī)證候療效、主要癥狀及體征變化、外周血嗜酸性粒細(xì)胞計(jì)數(shù)及血清Ig E來評(píng)價(jià)臨床綜合療效。通過SPSS17.0統(tǒng)計(jì)軟件對(duì)收集的資料進(jìn)行數(shù)據(jù)分析,計(jì)量資料用均數(shù)±標(biāo)準(zhǔn)差,組間及組內(nèi)治療前后比較懫用t檢驗(yàn),計(jì)數(shù)資料采用χ2檢驗(yàn),等級(jí)資料采用非參數(shù)檢驗(yàn)中的Wilcoxon秩和檢驗(yàn)作為統(tǒng)計(jì)分析方法。P0.05,認(rèn)為具有差異性,來評(píng)價(jià)治療組與對(duì)照組的治療效果。結(jié)果:1兩組在總有效率方面比較:治療組顯效病例18例,有效病例11例,無效病例1例,總有效率96.67%;對(duì)照組顯效病例10例,有效病18例,無效病例2例,總有效率93.33%。結(jié)果示治療組的總有效率高于對(duì)照組。2兩組在中醫(yī)證候療效方面的比較:運(yùn)用Wilcoxon秩和檢驗(yàn)對(duì)兩組進(jìn)行統(tǒng)計(jì)分析,結(jié)果說明兩組的治療效果存在差異,有統(tǒng)計(jì)學(xué)意義(P0.05)。并且治療組的平均秩次高于對(duì)照組,更說明治療組在中醫(yī)證候療效方面要優(yōu)于對(duì)照組。3兩組在中醫(yī)主要癥狀、體征方面的比較:結(jié)果示治療組與對(duì)照組均能減輕臨床癥狀及體征,且治療組優(yōu)于對(duì)照組,有統(tǒng)計(jì)學(xué)意義(P0.05)。4兩組在外周血嗜酸性粒細(xì)胞計(jì)數(shù)(Eos)方面的比較:治療前,兩組數(shù)據(jù)無差異,具有可比性(P0.05)。經(jīng)治療,結(jié)果示治療后兩組Eos均有所下降,且治療組要優(yōu)于對(duì)照組,有統(tǒng)計(jì)學(xué)意義(P0.05)。5兩組在血清IgE水平的比較:治療前,經(jīng)數(shù)據(jù)分析,兩組數(shù)據(jù)無差異,具有可比性(P0.05)。經(jīng)治療,結(jié)果示治療后兩組IgE水平均有所下降,并且治療組的療效要優(yōu)于對(duì)照組,有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:寧哮暢中顆粒劑配合穴位貼敷治療兒童哮喘遷延期型在總有效率、中醫(yī)證候療效、中醫(yī)主要癥狀及體征、外周血嗜酸性粒細(xì)胞計(jì)數(shù)和血清IgE方面優(yōu)于對(duì)照組的治療。寧哮暢中顆粒劑是以中醫(yī)藥基礎(chǔ)理論為指導(dǎo),具有清肺化痰、祛風(fēng)平喘、理氣暢中、健脾和胃的功效,并且證明了中醫(yī)藥在哮喘的治療中起到了良好的治療作用。
[Abstract]:Objective: bronchial asthma (bronchial asthma) asthma is a chronic respiratory disease, the most common childhood. Its pathogenesis is phlegm in the lung, spleen, lung and kidney in, based on the relative shortage, evil, improper diet, emotional disorders, interaction of contact with foreign body odor and other factors result that has a recurring feature, so that children's physical and mental health in severely affected at the same time, also had a huge pressure on the family. If children with poor asthma control, is likely to develop asthma in adults, and become a lifelong disease. So it is the children with chronic diseases, the need to focus on prevention of the disease. The purpose of this paper is the observation and Discussion on children asthma delayed pathogenesis and prescription in TCM theory and clinical efficacy, to seek effective drugs for prevention and treatment of childhood asthma delayed, to investigate the anti asthma drugs The effect mechanism of "relevance". In the lung and spleen and stomach theory as the breakthrough point, combined with the characteristics of the incidence of asthma in children, the method combined with acupoint sticking therapy using traditional Chinese medicine for clinical research, to seek a safe and effective method for the clinical treatment of children with asthma. Methods: select Hebei Province Hospital of traditional Chinese medicine outpatient department of Pediatrics conforms to the diagnosis standard unified, included 60 cases of bronchial asthma and exclusion criteria were delayed, by random number table, randomly divided into two groups. The treatment group of 30 cases, 30 cases in the control group. The control group in the conventional low-dose glucocorticoid inhalation on the basis of oral administration of Pingchuan Granule. Qing cough the treatment group in the conventional low-dose inhaled corticosteroids, oral therapy and acupoint dressing combined with Xiao Chang Ning Granule paste. Chang Ning granules composed of asthma drugs: Tinglizi 8-12g, 8-12g Sangbaipi, Zhejiang Fritillaria 8 -10g,鐐掕嫤鏉忎粊8-10g,鐐掑兊铓，

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