穴位敷贴防治小儿反复呼吸道感染方案优化

Optimization of regimens of herbal ion penetration therapy in the prevention and treatment for recurrent respiratory tract infection( RRTI) in children

目的:比较夏季三伏、冬夏伏九两种敷贴方案连续3年防治小儿反复呼吸道感染的临床疗效,分析总疗效与复感儿性别、年龄、疾病类型、病程等因素的关系,总结该法的应用条件,优化复感外治方案。方法:采用多中心、随机对照、重复测量、单盲设计,临床收集240例反复呼吸道感染患儿,随机分为三伏组和伏九组各120例,借助离子导入仪,进行中药穴位敷贴,治疗并随访3年,观察呼吸道感染年发病次数、发作期病程、中医症状及体征变化,分时间点检测唾液sIgA。结果:治疗2年及治疗3年时,伏九组疗效优于三伏组(P<0.05);连续治疗3年,两组均可减少发病次数,缩短发作期病程,改善中医症状、体征,伏九组作用较三伏组更明显(均P<0.01);3年里,伏九组sIgA呈持续上升趋势,三伏组sIgA呈波浪式缓慢上升趋势,伏九组上升作用更稳定和持续(P<0.001);疗效与性别、年龄、病程、疾病类型差异无统计学意义(均P>0.05)。结论:连续3年穴位敷贴防治小儿反复呼吸道感染,冬夏伏九方案明显优于夏季三伏方案,且该外治法适应范围广,值得临床推广应用。

Objective： To compare the 3 -year clinical efficacy of two regimens treating children~ RRTI by herbal ion penetration therapy, of which one was in the dog days, and the other was in both the dog days and coldest days. In oeder to analyze the relationship be- tween the total efficacy and gender, age, type of disease, duration etc, as well as summarize the application conditions of the therapy to fi- nally optimize the regimens. Methods： This intervention was designed as a multicenter, randomized, single blind, repeated measurement design. 240 cases were randomly divided into two groups which were Sanfu group （n = 120, treated during the dog days） and Fujiu group （n = 120, treated during both the dog days and coldest days） . Each group was treated and followed up for 3 years. Before and during the treatment, the frequency of respiratory tract infection, the acute course, signs and symptoms of TCM was bserved, and the salivary sIgA was detected. Results： For 2 years and 3 years of treatment, Fujiu group was more effective than Sanfu group （ P 〈 0.05 ） . Both the 2 groups could reduce the frequency and the acute course and improve signs and symptoms of TCM. In addition, Fujiu group played a more sig- nificant role than Sanfu group （ P 〈 0. 01 ） . The salivary sIgA had continued to rise in Fujiu group, while showed slowly and wave - likely mild upward trend in Sanfu group, of which the former rose more steady and persistently （ P 〈0. 001 ） . There was no significant correlation between efficacy and gender, age, acute course, disease type （all P〉0.05） . Conclusion： During 3 years, herbal ion penetration ther- apy for children~ RRTI in both the dog days and coldest days has a more satisfied efficacy than which only in the dog days. Further more, the external treatment adapts to a wide range of child patients, which is worthy of clinical application.