5岁以下儿童哮喘缓解期维持控制的治未病方案研究

Research on Maintaining Control of Under-5-Year-Old Children with Asthma in Remission by TCM Prevention

目的比较不同中医治未病方案对5岁以下儿童哮喘缓解期的临床疗效。方法选取280例5岁以下哮喘缓解期患儿随机分为对照组、中药组、穴位注射组、综合治疗组各70例。各组均给予哮喘日常防护教育管理及季节穴位贴等基础治疗,中药组、穴位注射组、综合治疗组在基础治疗同时分别给予培元生金方、维D2果糖酸钙注射液及维生素B12穴位注射、中药加穴位注射综合治疗的治未病方案,治疗1年。治疗前后记录患儿日间症状、夜间憋醒、喘息发作次数和中医证候评分,测定外周血嗜酸性粒细胞(EOS),治疗后评定各组临床疗效。结果中药组临床疗效总有效率为83.3%,穴位注射组为80.0%,综合治疗组为94.0%,对照组为64.5%,中药组、穴位注射组和综合治疗组总有效率均明显高于对照组(P<0.05);综合治疗组总有效率明显高于中药组和穴位注射组(P<0.05)。治疗后中药组、穴位注射组、综合治疗组日间症状、夜间症状、喘息发作次数均优于对照组(P<0.05);中药组、穴位注射组、综合治疗组组间比较,综合治疗组优于中药组及穴位注射组(P<0.05)。各组患儿治疗后EOS、中医证候评分均较治疗前明显下降(P<0.01)。治疗后中药组、穴位注射组和综合治疗组中医证候评分均明显低于对照组(P<0.01);综合治疗组中医证候评分明显低于中药组和穴位注射组(P<0.05或P<0.01)。结论中医治未病方案治疗儿童哮喘缓解期患者疗效确切,可有效维持控制,其中以中药+穴位注射方法的疗效为优。

Objective To observe the clinical effect of TCM prevention for under-5-year-old children with asthma in remission. Methods Totally 280 under-5-year-old children with asthma in remission were randomized into the control group, Chinese medicinal group, acupoint injection group and combined therapy group, with 70 in each. Each group was given basic treatment including patient education and seasonal acupoint application. The three treatment groups were added with TCM prevention programs of Chinese medicinal, acupoint injection and combined therapy respectively. The treatment lasted for 1 year. The daytime symptoms, nighttime awakenings, wheezing episodes and TCM pattern scores were observed once monthly. The eosinophil （EOS） in peripheral blood was detected before and after treatment. The maintaining control level of asthma was evaluated after treatment. Results The total effective rate of the Chinese medicinal group, aeupoint injection group, combined therapy group and control group was 83.3%, 80.0%, 94.0% and 64.5% respectively. The total effective rate of the Chinese medicinal group, acupoint injection group and combined therapy group was superior to that of the control group （P〈0.05）. The total effective rate of the combined therapy group was superior to that of the Chinese medicinal group and acupoint injection group （P〈0.05）. The symptoms in three treatment groups were superior to those in the control group （P〈0.05）. The symptoms in the combined therapy group were superior to those in the Chinese medicinal group and acupoint injection group （P〈0.05）. The EOS and TCM pattern scores were significantly decreased in all groups after treatment （P〈0.01）. There was no significant difference between groups in the EOS after treatment （P〉0.05）. The TCM pattern scores in three treatment groups were significantly lower than those in the control group （P〈0. 01）. The TCM pattern scores in the combined therapy group were significantly lower than those in the Chinese medicinal group and acupoint injection group （P〈0.05 or P〈0.01）. Conclusion The TCM prevention program is effective for childhood asthma in remission. It can effectively maintain and control the disease, especially the combo therapy of Chinese medicinal and acupoint injection.