【摘要】：研究背景:支氣管哮喘[1]是由多種細(xì)胞包括氣道的炎性細(xì)胞(如肥大細(xì)胞、嗜酸性粒細(xì)胞、T淋巴細(xì)胞、中性粒細(xì)胞)和結(jié)構(gòu)細(xì)胞(如氣道上皮細(xì)胞、平滑肌細(xì)胞等)以及細(xì)胞組分參與的氣道慢性炎癥性疾病。慢性炎癥導(dǎo)致氣道高反應(yīng)性,通常表現(xiàn)為可逆性的氣流受限,并引起反復(fù)發(fā)作性的喘息、氣急、胸悶或咳嗽等癥狀,常在夜間和清晨發(fā)作、加劇,多數(shù)患者可自行緩解或經(jīng)治療緩解[2]。患者哮喘急性發(fā)作時其工作、學(xué)習(xí)和生活會受到嚴(yán)重困擾,病情重的患者需要住院治療,因而給社會和家庭帶來一定的經(jīng)濟(jì)和生活負(fù)擔(dān),目前己成為一個不可忽視的公共衛(wèi)生問題[3]。中醫(yī)藥在治療哮喘方面療效確鑿,不但可緩解哮喘急性發(fā)作時的癥狀,而且可通過補(bǔ)虛扶正達(dá)到控制復(fù)發(fā)的效果。因而對于哮喘急性發(fā)作住院的患者,配合中醫(yī)治療療效確鑿,但該法是否能夠縮短患者住院時間,加快撤減激素、減少激素的用量等缺乏系統(tǒng)評價。因此,對住院哮喘患者運用中醫(yī)辨證論治療法的應(yīng)用價值進(jìn)行研究具有重要的現(xiàn)實意義。研究目的:通過觀察分析哮喘患者住院期間支氣管哮喘相關(guān)中西醫(yī)治療方案、住院時間、癥狀改善情況、撤減激素等,探討中醫(yī)辨證論治療法的優(yōu)勢和價值,為建立一個規(guī)范、有效的中醫(yī)辨證論治療法+西醫(yī)基礎(chǔ)治療的中西醫(yī)結(jié)合治療方案提供實踐依據(jù)。研究方法:選取支氣管哮喘急性發(fā)作期的患者60例,分為兩組,分別采用西醫(yī)、中西醫(yī)結(jié)合方法治療。主要通過觀察以下項目評價各組療效:哮喘癥狀控制時間,住院時間;入院前、出院后4周哮喘控制測試評分(ACT評分);入院時、入院第7天(或出院時)、出院時臨床癥狀體征積分;糖皮質(zhì)激素使用量、撤減時間及總的使用時間等。通過統(tǒng)計學(xué)方法,比較西醫(yī)治療與中醫(yī)辨證論治療法+西醫(yī)基礎(chǔ)治療兩組患者治療的情況。研究結(jié)果:兩組患者在性別、年齡及病程上無明顯差異。兩組患者在哮喘癥狀控制時間、住院時間比較差異有統(tǒng)計學(xué)意義。兩組患者在入院時癥狀體征積分及入院時ACT評分無明顯差異。兩組患者在入院第7天(或出院時)、出院時癥狀體征積分、出院后4周ACT評分比較差異有統(tǒng)計學(xué)意義。兩組患者在糖皮質(zhì)激素使用量、激素撤減時間比較差異有統(tǒng)計學(xué)意義。研究結(jié)論:中醫(yī)辨證論治療法結(jié)合西醫(yī)治療哮喘急性發(fā)作住院患者,相較單純西醫(yī)治療,在改善患者癥狀,縮短住院時間,加快激素撤減、減少激素副作用等方面存在優(yōu)勢,中醫(yī)辨證論治療法在哮喘急性發(fā)作住院患者中的應(yīng)用具有重要價值。
[Abstract]:Background: bronchial Asthma [1] is composed of a variety of cells including inflammatory cells (such as mast cells, eosinophils, T lymphocytes, neutrophils) and structural cells (such as airway epithelial cells). Smooth muscle cells, etc.) and cellular components are involved in chronic inflammatory diseases of the airway. Chronic inflammation leads to airway hyperresponsiveness, usually characterized by reversible airflow limitation and recurrent wheezing, shortness of breath, chest tightness or cough, often occurring at night and early in the morning. Most of the patients were able to relieve by themselves or after treatment [2]. During the acute attack of asthma, the work, study and life of the patients will be seriously disturbed. The seriously ill patients need to be hospitalized, thus bringing a certain amount of economic and living burden to the society and families. At present, it has become a public health problem which can not be ignored. Chinese medicine has definite curative effect in treating asthma. It can not only relieve the symptoms of acute attack of asthma, but also control the recurrence by reinforcing deficiency and strengthening the center. Therefore, for the inpatients with acute asthma attack, the curative effect of TCM treatment is definite, but whether this method can shorten the hospitalization time, speed up the withdrawal of hormone, reduce the amount of hormone and so on is lack of systematic evaluation. Therefore, it is of great practical significance to study the application value of TCM dialectical therapy in asthmatic patients. Objective: to explore the advantages and value of TCM syndrome differentiation therapy through observing and analyzing the treatment plan, duration of stay, symptom improvement, withdrawal of hormone and so on, in order to establish a standard for the treatment of bronchial asthma during hospitalization. Effective TCM syndrome differentiation therapy and western medicine basic treatment of integrated traditional Chinese and western medicine treatment program to provide practical basis. Methods: 60 patients with acute attack of bronchial asthma were divided into two groups. The efficacy of each group was evaluated by observing the following items: asthma symptom control time, hospitalization time, asthma control test score (ACT score) before admission and 4 weeks after discharge. On admission, on the 7th day of admission (or at discharge), the clinical symptoms and signs scores, glucocorticoid usage, withdrawal time and total use time were obtained. By means of statistics, the treatment of western medicine and traditional Chinese medicine syndrome differentiation therapy were compared between the two groups. Results: there was no significant difference in sex, age and course of disease between the two groups. There was a significant difference in symptom control time and hospitalization time between the two groups. There was no significant difference in symptom score and ACT score between the two groups. There were significant differences between the two groups on the 7th day of admission (or at discharge), the scores of symptoms and signs at discharge, and the ACT score at 4 weeks after discharge. There were significant differences in glucocorticoid use and withdrawal time between the two groups. Conclusion: there are advantages in improving symptoms, shortening hospitalization time, quickening hormone withdrawal, reducing hormone side effects and so on, compared with western medicine alone in treating inpatients with acute asthma attack by TCM treatment based on syndrome differentiation and western medicine. The application of TCM treatment based on syndrome differentiation in patients with acute asthma attack is of great value.
【學(xué)位授予單位】：南京中醫(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

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 張建華;胡潤芳;;關(guān)注嬰幼兒期抗生素使用對兒童哮喘發(fā)病的影響[J];臨床兒科雜志;2015年02期

2 魯偉威;徐艷玲;;支氣管哮喘病機(jī)研究簡況[J];實用中醫(yī)內(nèi)科雜志;2015年01期

3 李麗萍;包燁華;楚佳梅;曾友華;宣麗華;;冬病夏治穴位貼敷防治支氣管哮喘130例療效觀察[J];中醫(yī)雜志;2012年04期

4 郝一鳴;王憶勤;洪毓鍵;閆秀麗;張曉丹;翁詩婷;于明杰;金美玲;顧洪亮;;中西醫(yī)結(jié)合治療100例哮喘患者的臨床療效與生活質(zhì)量評價[J];中華中醫(yī)藥雜志;2011年11期

5 孫洪全;;支氣管哮喘常規(guī)治療藥物[J];中國醫(yī)藥科學(xué);2011年10期

6 姚亮;楊佩蘭;宋文寶;;中醫(yī)藥在治療支氣管哮喘激素撤減過程中的作用進(jìn)展[J];河南中醫(yī);2010年07期

7 王培;許利平;金喜宏;楊婧;劉仁慧;王秀娟;;糖皮質(zhì)激素對哮喘模型大鼠腎陰陽虛證候演變的影響[J];中西醫(yī)結(jié)合學(xué)報;2010年01期

8 郭素芳;李利賓;;中西醫(yī)結(jié)合治療支氣管哮喘激素依賴型20例[J];浙江中醫(yī)雜志;2008年06期

9 陳欣;林江濤;;支氣管哮喘的藥物治療[J];臨床藥物治療雜志;2008年01期

10 陸立東;李小鋼;黃建萍;;吸入皮質(zhì)激素聯(lián)合中醫(yī)辨證論治治療兒童支氣管哮喘療效觀察[J];中國誤診學(xué)雜志;2007年03期

，

本文編號：2413106