射干麻黄汤加味治疗难治性哮喘33例临床观察

A Clinical Observation on Supplemented Shegan Mahuang Decoction for 33 Cases of Refractory Asthma

目的观察射干麻黄汤加味治疗难治性哮喘的临床疗效。方法将65例难治性哮喘患者随机分为治疗组33例和对照组32例。对照组给予舒利迭吸入剂,每次1吸50/250μm,每日两次;万托林气雾剂,每次吸入2.5mg,每日4次;茶碱缓释片,每次口服0.2g,每日两次。当哮喘症状缓解时,逐渐减少万托林及茶碱缓释片剂量以至停药。治疗组在对照组的基础上加用射干麻黄汤加味,每日1剂,早晚两次温服。两组均治疗12周。分别于治疗前和治疗后第4、8、12周进行哮喘控制测试评分(ACT评分)、一秒用力呼气容积(FEV1)检测和最大呼气峰流速(PEF)监测,并进行疗效判定。结果治疗组总有效率为78.8%,对照组总有效率为43.8%,治疗组明显优于对照组(P<0.05)。两组患者在治疗后第4、8、12周FEV1、PEF及ACT评分均较治疗前明显改善(P<0.05)。治疗组在治疗后第4、8、12周FEV1、PEF及ACT评分均明显优于对照组(P<0.05)。结论射干麻黄汤加味能有效改善难治性哮喘患者的临床症状及肺功能,是治疗难治性哮喘有效的中药方剂。

Objective To evaluate the therapeutic effect of Supplemented Shegan Mahuang Decoction （Belamcanda and Ephedra Decoction, SSMD） on refractory asthma. Methods Sixty five cases of refractory asthma were randomized into treatment group of 33 cases and control group of 32 cases. Both groups were given the basic treatment such as regular inhalation of Seretide and Ventolin and oral administration of TheophyUine Sustained-Release Tablets. In asthma remission, the dose of β2- agonists and theophylline was gradually reduced until withdrawal. The treatment group was given SSMD one dose daily in addition. Both groups were treated for 12 weeks. The asthma control test （ACT） scores, forced expiratory volume in one second （FEV1） and peak expiratory flow （PEF） were observed before and after 4-week, 8-week and 12-week treatment. The thera- peutic effect was evaluated. Results The total effective rate of the treatment group and control group was 78.8% and 43.8% respectively, with significant difference between groups （P〈0.05）. The ACT scores, FEV1 and PEF were significantly im- proved in both groups in the 4th, 8th and 12th week of treatment （P〈0.05）, especially in the treatment group （P〈0.05）. Conclusion SSMD is effective for refractory asthma and it can effectively relieve the clinical symptoms and improve the lung function.