【摘要】：目的：觀察定喘湯加味治療支氣管哮喘急性發(fā)作期熱哮證的臨床療效,進一步驗證中藥復方治療支氣管哮喘的可行性及優(yōu)勢,同時探討定喘湯加味減少氣道炎癥及降低氣道阻塞,改善肺功能的作用機制。方法：本課題選取門診60例熱哮證支氣管哮喘急性發(fā)作期熱哮證患者,采用隨機單盲法分為對照組(氨茶堿)和治療組(氨茶堿+定喘湯加味)各30例,兩組患者均以一周為1個療程,1個療程為限。通過觀察中醫(yī)證候臨床療效、中醫(yī)證候總積分以及中醫(yī)單個癥狀、體征積分,測定肺功能(FEV1%(第1秒用力呼氣容積占預計值百分比)、FEV1/FVC%(第1秒用力呼氣容積占用力肺活量百分比))和血清IgE水平和EOS計數(shù),并進行治療前后分析比較。結果：1.中醫(yī)臨床療效：本課題觀察結果顯示,治療組總有效率為96.67%,對照組總有效率為90%,差異具有統(tǒng)計學意義(P0.05),提示中藥治療方案總療效較佳。2.中醫(yī)證候總積分和單個癥狀、體征積分：兩組證候總積分及單個癥狀、體征積分比較經(jīng)統(tǒng)計學分析后P0.05,具有統(tǒng)計學差異,治療組療效優(yōu)于對照組,提示定喘湯加味能有效改善癥狀、體征,且提示治療組在治療咳嗽咳痰方面效果更好。3.FEV1%、PEV1/FVC%:兩組肺功能FEV1%、FEV1/FVC%組內(nèi)、組間及治療前后差值比較,均有統(tǒng)計學差異(P0.05),且治療組肺功能改善優(yōu)于對照組。4.免疫指標血清IgE水平及EOS計數(shù)：兩組患者組內(nèi)、組間及之后差值比較,經(jīng)統(tǒng)計學分析后P0.05,均有統(tǒng)計學差異,較治療前均有所下降,且治療組療效優(yōu)于對照組。結論：定喘湯加味具有較好的臨床療效,能明顯改善患者臨床癥狀、體征,特別是對咳嗽、咳痰的改善,能有效提高肺功能指標,改善氣道阻塞,減少免疫IgE水平及EOS計數(shù),減輕免疫炎癥反應。
[Abstract]:Objective: to observe the clinical effect of Dingchuan decoction on heat asthma in acute attack of bronchial asthma, and to verify the feasibility and superiority of traditional Chinese medicine compound in treating bronchial asthma. At the same time, the mechanism of Dingchuan decoction to reduce airway inflammation and airway obstruction and improve lung function was discussed. Methods: in this study, 60 outpatients with heat asthma were randomly divided into control group (aminophylline) and treatment group (aminophylline Dingchuan decoction), which were divided into two groups: control group (30 cases) and treatment group (30 cases of aminophylline Dingchuan decoction). Two groups of patients were one week as a course of treatment, one course of treatment was limited. Pulmonary function (FEV1%) was measured by observing the clinical efficacy of TCM syndromes, the total score of TCM syndromes and the scores of individual symptoms and signs of TCM. FEV1/FVC% (percentage of forced expiratory volume occupying capacity) and serum IgE and EOS count were compared before and after treatment. Results: 1. Clinical efficacy of TCM: the results showed that the total effective rate of the treatment group was 96.677.The total effective rate of the control group was 90, the difference was statistically significant (P0.05). TCM syndromes total integral and single symptom and sign integral: two groups of syndrome total integral and single symptom, physical sign integral comparison after statistical analysis of P0.05, there is statistical difference, the treatment group is better than the control group, the treatment group is better than the control group, the treatment group is better than the control group, It suggested that Dingchuan decoction could effectively improve symptoms and signs, and that the treatment group was more effective in the treatment of cough and expectoration. 3. FEV1 and PEV1 / FVC5: the difference of pulmonary function between the two groups in FEV1%,FEV1/FVC% group, between groups and before and after treatment was compared. There was statistical difference (P0.05), and the improvement of pulmonary function in the treatment group was better than that in the control group. 4. 4. Serum IgE level and EOS count: the difference between the two groups was statistically significant (P 0.05), which was lower than that before treatment, and the curative effect of the treatment group was better than that of the control group. Conclusion: Dingchuan decoction has better clinical effect, can obviously improve the clinical symptoms and signs, especially the improvement of cough and expectoration, can effectively improve the pulmonary function index, improve airway obstruction, reduce the level of immune IgE and EOS count. Reduce the immune inflammation.
【學位授予單位】：福建中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2016
【分類號】：R256.12

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