加味沙参麦冬汤治疗咳嗽变异性哮喘的临床研究

Clinical study of Modified Shashen Maidong Decoction in patients with cough variant asthma

目的 观察加味沙参麦冬汤治疗咳嗽变异性哮喘（CVA）的临床效果。方法 选择2011年1月-2013年12月北京市房山区中医院收治的CVA发作期患者120例,按照随机数字表法将其分为治疗组和对照组。对照组60例给予孟鲁司特钠片10 mg口服,1次/d,必要时吸入短效激素（布地奈德）,2周为1个疗程。治疗组60例在对照组治疗基础上给予加味沙参麦冬汤口服,1剂/d,2次/d,2周为1个疗程。治疗后观察患者主要症状、证候积分情况,测定患者呼气峰流量变异率（PEFR）和血清白细胞介素-2（IL-2）、白细胞介素-6（IL-6）和肿瘤坏死因子-α（TNF-α）的含量。结果 1个疗程后,治疗组与对照组CVA治疗有效率分别为91.67%和53.33%,差异有高度统计学意义（P〈0.01）。单项症状改善方面,咳嗽症状治疗组有效率为95.00%,对照组为63.33%;咽痒症状治疗组有效率为91.67%,对照组为55.00%;气急症状治疗组有效率为98.33%,对照组为55.00%;咳痰症状治疗组有效率为86.67%,对照组为56.67%。两组差异均有统计学意义（均P〈0.05）。治疗组治疗后PEFR为（10.41±1.45）%,显著低于对照组[（17.22±2.18）%],差异有统计学意义（P〈0.05）。治疗组治疗后IL-2为（12.18±2.28）μg/m L,显著高于对照组[（9.46±1.12）μg/m L],差异有高度统计学意义（P〈0.01）。治疗组治疗后IL-6为（43.22±14.29）μg/m L,显著低于对照组[（62.64±15.21）μg/m L],差异有高度统计学意义（P〈0.01）。治疗组治疗后TNF-α为（0.59±0.24）μg/m L,显著低于对照组[（0.89±0.23）μg/m L],差异有统计学意义（P〈0.05）。结论 加味沙参麦冬汤治疗CVA可显著提高疗效,值得临床推广。

Objective To observe the clinical efficacy of Modified Shashen Maidong Decoction in the treatment of patients with cough variant asthma（CVA）. Methods One hundred and twenty cases of patients with CVA at the stage of attack admitted to Fangshan Traditional Medical Hospital of Beijing from January 2011 to December 2013 were selected. According to random number table, patients were divided into treatment group and control group. 60 cases of control group were given 10 mg Montelukast Sodium Tablets orally, once a day, a short-acting hormone（Budesonide） was added when necessary, 2 weeks was as a course. 60 cases of treatment group were given Modified Shashen Maidong Decoction on basis of control group, one dose a day, twice a day, 2 weeks was as a course. After treatment, the main symptoms and syndrome scores were observed, the contents of peak expiratory flow rate variability（PEFR）, serum interleukin-2（IL-2）, interleukin-6（IL-6） and tumor necrosis factor-α（TNF-α） were detected. Results After a course of treatment, the efficacy rate of treatment group and control group was 91.67%, 53.33%, the difference was highly statistically significant（P〈0.01）. On aspect of single symptom improvement, cough symptoms： efficiency of the treatment group was 95.00%, which of control group was 63.33%; throat itching symptoms： efficiency of the treatment group was98.33%, which of control group was 55.00%; shortness of breath symptoms： efficiency of the treatment group was91.67%, which of control group was 55.00%; expectoration symptoms： efficiency of the treatment group was 86.67%,which of control group was 56.67%. The differences between the two groups were all statistically significant（all P〈0.05）. After treatment, PEFR of treatment group [（10.41 ±1.45）% ] was significantly lower than that of control group[（17.22 ±2.18）% ], the difference was statistically significant（P〈0.05）. The level of IL-2 in treatment group was（12.18±2.28） μg/m L, which was significantly higher than that of control group [（9.46±1.12） μg/m L], the difference was highly statistically significant（P〈0.01）. The level of IL-6 in treatment group was（43.22±14.29） μg/m L,which was significantly lower than that of control group [（62.64±15.21） μg/m L], the difference was highly statistically significant（P〈0.01）. The level of TNF-α in treatment group was（0.59±0.24） μg/m L, which was significantly lower than that of control group [（0.89±0.23） μg/m L], the difference was statistically significant（P〈0.05）. Conclusion Modified Shashen Maidong Decoction in the treatment CVA can obviously improve clinical efficacy, which is worthy of clinical promotion.