摘要
【目的】观察朱良春"旋覆夏麻芍草汤"加减治疗小儿咳嗽变异性哮喘(CVA)的临床疗效。【方法】采用随机、阳性药平行对照的前瞻性研究方法,将符合纳入标准的60例CVA患儿随机分为治疗组与对照组,每组各30例。治疗组给予旋覆夏麻芍草汤加减治疗,对照组给予常规西药治疗(包括布地奈德粉吸入剂吸入和孟鲁司特钠咀嚼片口服治疗),2组疗程均为3个月。观察2组临床疗效、中医证候疗效及随访6个月的复发情况,检测2组治疗前后血清嗜酸性粒细胞阳离子蛋白(ECP)水平和尿白三烯E4(LTE4)水平。【结果】治疗3个月后,治疗组完成28例,对照组完成27例。临床疗效方面:经符合方案集(PP)分析,治疗组总有效率为89.3%,愈显率为64.3%,对照组总有效率为85.2%,愈显率为51.9%,差异无统计学意义(P>0.05)。中医证候疗效方面:治疗组总有效率为85.7%,控显率为57.1%,对照组总有效率为81.5%,控显率为40.8%,差异无统计学意义(P>0.05)。随访6个月后,治疗组复发率为8.0%,低于对照组的30.4%,但组间比较差异无统计学意义(P>0.05)。单项证候疗效方面:治疗组在改善咯痰、咳呕、多汗、舌象异常、下眼睑发青等方面疗效明显优于对照组(P<0.01)。治疗后,2组血ECP和尿LTE4含量均较治疗前明显下降(P<0.01),且治疗组在改善血ECP含量方面明显优于对照组(P<0.01)。对治疗前后组内尿LTE4含量和血ECP含量进行相关性检测,相关系数r均<0.2,统计学分析结果显示无相关性(P>0.05)。【结论】"旋覆夏麻芍草汤"加减是治疗小儿CVA的有效方剂,并且有一定的疗效持续性,对改善CVA患儿的咯痰、咳呕、多汗、舌苔花剥、下眼睑发青等效果明显,且无不良反应。其下调CVA患儿异常的LTE4和ECP水平可能是起效途径之一。
Objective To observe the therapeutic effects of modified Xuanfu Xia Ma Shao Cao Decoction prescribed by Zhu Liang-chun,one of traditional Chinese medical（TCM）ractitioner masters,for the treatment of children with cough variant asthma（CVA）. Methods A randomized and positive-drug parallel-controlled clinical trial was designed. Sixty CVA patients were randomly divided into treatment group and control group,30 cases in each group. The treatment group was given oral use of modified Xuanfu Xia Ma Shao Cao Decoction,and the control group received budesonide powder inhalation and oral use of montelukast sodium chewable tablets. The treatment of both groups covered 3 months. Therapeutic effect and efficacy of traditional Chinese medical syndromes were evaluated after treatment,and the incidence of recurrence was observed after a follow-up for 6 months. Before and after treatment,we detected the levels of serum eosinophil cationic protein（ECP） and urine leukotriene E4（LTE4）. Results After treatment for 3 months,the program was completed in 28 patients of the treatment group and in 27 of the control group. The results of per-protocol（PP）analysis showed that the total effective rate was 89.3% and the markedly effective and cured rate was 64.3% in the treatment group,and was85.2%,51.9% respectively in the control group,the differences being insignificant between the two groups（P 0.05）. Efficacy of TCM syndromes was 85.7% and the markedly-controlled rate was 57.1% in the treatment group,and was 81.5%,40.8% respectively in the control group,the differences being insignificant between the two groups（P 0.05）. The results of 6-month follow-up showed that the recurrence rate of the treatment group was 8.0%, and that of the control group was 30.4%, the difference being insignificant（P 0.05）. After treatment, the treatment group had better effect than the control group on relieving expectoration, cough-vomiting,profuse sweating,abnormal tongue and blue lower eyelids（P 0.01）. The levels of serum EC
出处
《广州中医药大学学报》
CAS
2017年第1期21-27,共7页
Journal of Guangzhou University of Traditional Chinese Medicine
基金
国家中医药管理局中医大师传承人才培养项目(编号:国中医药函[2008]185)
上海市进一步加快中医药事业发展三年行动计划.中医药专门人才计划(编号:ZY3-RCPY-3-1010)
关键词
儿童
咳嗽变异性哮喘
国医大师
朱良春
旋覆夏麻芍草汤
children
cough variant asthma
traditional Chinese medical practitioner master
Zhu Liang-Chun
Xuanfu Xia Ma Shao Cao Decoction
