中西医结合治疗儿童咳嗽变异性哮喘临床研究

Clinical Research on Chinese and Western Medicine Treatment of Cough Variant Asthma in Children

目的:观察沙参麦冬汤防联合孟鲁司特钠治疗儿童咳嗽变异性哮喘的临床疗效。方法:63例咳嗽变异性哮喘患儿随机平均分为中药组、西药组与中西医结合组,每组21例。西药组口服孟鲁司特钠片5 mg·d-1,睡前服用。中药组以沙参麦冬汤作为基本方,并随症和年龄加减,每日1剂,用水煎服,1剂·d-1。中西医结合组给予中药组与西药组联合疗法。观察3组患者症状缓解及消失时间,同时在治疗前与治疗后2个月、6个月以及停药后3个月时的PEF、FEV1值,治疗前和治疗后4个月的疗效情况,T细胞亚群和外周血嗜酸细胞的百分比以及1 a后随访疾病的复发情况。结果:中西医结合组的症状缓解及消失时间均显著少于中药组和西药组(P<0.05),有效率较高(P<0.05)。治疗前3组患者的PEF与FEV1值差异不明显(P>0.05);治疗后8周与24周中西医结合组的PEF与FEV1值较中药组及西药组明显提高(P<0.05)。中西医结合组的复发率明显低于其他两组(P<0.05)。结论:沙参麦冬汤联合孟鲁司特钠治疗儿童咳嗽变异性哮喘,可显著改善患儿的临床症状,减少咳嗽的反复发作,调节机体免疫功能,提高患儿的生活质量,提高患儿的御病能力。

Objective：To observe the clinical curative effect of shashen maidong decoction combined with montelukast sodium in the treatment of cough variant asthma in children. Methods ：63 children with cough variant asthma were randomly divided into Chinese med- icine group, western medicine group and combined Chinese and western group, each group of 21 cases. The western medicine group was treated with montelukast sodium tablets 5mg per day, before bedtime. The Chinese medicine group was treated with shashen maidong de- coction, and addition and subtraction with the symptoms and age. Daily 1 agent,water decoction. Combined Chinese and western group was given combined therapy of traditional Chinese medicine group and western medicine group. Observed with symptoms remission and disappearance time of the three groups and at the same time, PEF, FEV1 value before and after the treatment of 2 months,6 months and 3 months after stopping drugs and curative effect before and 4 months after treatment, T cell subsets and peripheral blood eosinophils percentage and the recurrence after one year. Results ： The integrative group of symptoms remission and disappearance time were signifi- cantly less than traditional Chinese medicine group and western medicine group （ P 〈 0. 05 ）, a higher efficiency （ P 〈 O. 05 ）. Before treatment, PEF and FEV1 value in patients of the three groups were not significantly different （P 〉 O. 05 ） ;PEF and FEVI value of the integrative group 8 weeks and 24 weeks after treatment compared with traditional Chinese medicine group and western medicine group increased significantly（ P 〈 0.05 ）. Recurrence of the integrative group was significantly better than the other two groups （P 〈 0.05 ）. Conclusion ：Shashen maidong decoction combined with montelukast sodium in treating cough variant asthma in children can significantly improve clinical symptoms of children, reduce the cough recurrence, regulate immune function, improve the quality of life of children, improve the ability to resist disease for children.