加减定喘汤治疗难治性哮喘的临床研究

The clinical study of the addition and subtraction on Dingchuan decoction in the treatment of refractory asthma

目的以难治性哮喘为基础疾病,探讨中医辨证论治联合激素治疗该病的经验。方法选取2010年1月～2012年1月于本院接受治疗的难治性哮喘患者63例进行回顾性研究,其中,中医组20例使用定喘汤加减中医辨证论治,西医组20例给予糖皮质激素、β2受体激动剂及氨茶碱治疗,中西医组23例在西医组基础上加用加减定喘汤治疗。比较3组患者的治疗有效率。结果中医组治疗总有效率明显小于西医组和中西医组,差异有统计学意义(P<0.05),西医组总有效率低于中西医组,但差异无统计学意义(P>0.05)。西医组FVC与FEV1低于中西医组(P<0.05);6个月后随访,西医组哮喘发病次数高于中西医组。结论采用加减定喘汤联合糖皮质激素、β2受体兴奋剂治疗难治性哮喘效果明显,适宜临床推广。

Objective To explore the experience of Chinese traditional clinical therapy according to syndrome differentiation combined with hormone by taking refractory asthma as the base disease. Methods Sixty three cases of refractory asthma patients who had been treated in our hospital from January 2010 to January 2012 were selected and retrospectively studied. 20 cases of patients who had used addition and subtraction on Dingchuan decoction were selected as the traditional Chinese medicine group, 20 cases of patents treated by glucocorticoids, β2 agonists and aminophylline were selected as the western medicine group and 23 cases treated by glucocorticoids, β2 agonists and aminophylline and Dingchuan decoction as western and Chinese traditional medicine group. The treatment efficiency of 3 groups were compared. Results The treatment efficiency of traditional Chinese medicine group was significantly smaller than the western and Chinese traditional medicine group, the difference was significant （P 0.05）, the total effectiveness of western medicine group was lower than western and Chinese traditional medicine group, but the difference was not significant （P 0.05）. FVC and FEV1 of the western medicine group were much lower than western and Chinese traditional medicine group （P 0.05）; after follow-up for 6 months, reoccurrence of the western medicine group was higher than western and Chinese traditional medicine group. Conclusion The therapy effect of addition and subtraction of Dingchuan decoction combined with glucocorticoid, β2 receptor agonists on refractory asthma is obvious and it is suitable for clinical promotion.