辨证分期联合西药治疗支气管哮喘随机平行对照研究

Staging combined with Western Medicine Treatment of Bronchial Asthma in Randomized Controlled Study

[目的]观察辨证分期联合西药治疗支气管哮喘疗效。[方法]使用随机平行对照方法,将94例门诊及住院患者按抛硬币法简单随机分为两组。对照组47例急性发作期：轻度发作予沙丁胺醇,2.4-4.8mg/次,3次/d,口服;酮替酚,1.38mg/次,2次/d,口服;中度发作,0.25g氨茶碱＋250m L 50%葡萄糖,1-2次/d,40滴/min,静滴;泼尼松,10mg/次,3次/d,口服;哮喘持续：吸氧,维持水、电解质平衡,0.25g氨茶碱＋250m L 50%葡萄糖,1-2次/d,40滴/min,静滴;地塞米松,1-2次/d,10-20mg/次,静注;缓解期：祛除病因、脱敏治疗及加强锻炼。治疗组47例辨证分期：急性发作期-定喘汤（麻黄炙、杏仁、白果、款冬花、蝉蜕各10g,生甘草、黄芩、葶苈子、苏子、白术炒、地龙各15g,桑白皮、瓜蒌、生石膏、黄芪各30g,半夏6g;寒哮去桑白皮、黄芩,加细辛3g、桂枝10g;热哮加生石膏30g;痰湿内盛加白芥子10g,猪牙皂3g;气虚自汗加人参10g;阴虚去麻黄,加沙参30g,麦冬15g）;1剂/d,水煎200m L,早晚口服;缓解期-补肺汤（山药、熟地黄、黄芪、白术各15g,防风、紫菀、瓜蒌各12g,桑白皮、苏子、麻黄炙、杏仁各10g,党参30g,甘草6g）,1剂/d,水煎200m L,早晚口服;西药治疗同对照组。连续治疗15d为1疗程。观测临床症状、FEV1、PEF、FEV1%、EOS、IgE、不良反应。治疗1疗程,判定疗效。[结果]治疗组临床控制29例,显效11例,有效4例,无效3例,总有效率93.62%。对照组临床控制12例,显效10例,有效15例,无效10例,总有效率78.72%。治疗组疗效优于对照组（P〈0.05）。相关指标两组均有改善（P〈0.01）。[结论]辨证分期联合西药治疗支气管哮喘疗效满意,无严重不良反应,值得推广。

[Objective]To observe the staging combined with western medicine treatment of bronchial asthma treatment.[Methods]Randomized parallel controlled method,94 outpatients and inpatients simply by flipping a coin law randomly divided into two groups.The control group 47 cases of acute exacerbation： mild attack to albuterol,2.4-4.8mg/time,3 times/d,orally;ketotifen,1.38mg/times,2 times/d,orally;moderate attack,0.25 g Aminophylline＋250m L 50% glucose,1 or 2 times/d,40 drops/min,infusion;prednisone,10mg/time,3 times/d,orally;persistent asthma： oxygen to maintain water and electrolyte balance,0.25 g aminophylline＋250m L 50% glucose,1 or 2 times/d,40 drops/min,infusion;dexamethasone,1 or 2 times/d,10-20mg/times,intravenously.Remission： eliminate the cause,desensitization therapy and strengthening exercises.Western medicine treatment group with 47 cases in the control group.Chinese staging treatment.Acute stage： Dingchuantang（Zhimahuang,Xingren,Baiguo,Kuandonghua,Chantui each 10 g,Shenggancao,Huangqin,Tinglizi,Chaobaizhu,Dilong 15 g,Sangbaipi,Gualou,Shengshigao,Huangqi each 30 g,Banxia 6g;cold wheeze go Baipi,Huangqin,plus Xixin 3g,Guizhi 10g;heat roaring add Shengshigao 30g;phlegm filled plus Baijiezi 10 g,Zhuyazao 3g;Qi and spontaneous plus Renshen 10g;Yin to Mahaung,Shashen 30 g,Maidong 15g）;1/d,decoction 200 m L,sooner or later orally.Remission： Bufei soup（Shanyao,Shudihaung,Huangqi,Baizhu 15 g,Fangfeng,Ziyuan,Gualou 12 g,Sangbaipi,Suzi,Zhimah uang,Xingren 10 g,Dangshen 30 g,Gancao 6g）,1/d,decoction 200 m L,sooner or later orally.15 d for a course of continuous treatment.Observation of clinical symptoms,FEV1,PEF,FEV1%,EOS,IgE,adverse reactions.One course of treatment,to determine efficacy.[Results]Control treatment group,29 cases,11 cases markedly effective in 4 cases,3 cases,the total efficiency of 93.62%.Clinical control group 12 cases,10 cases markedly effective in 15 cases,10 cases,the total efficiency of 78.72%.Treatment group than the control group（P〈0.05）.Related indicators improved in both groups（P〈0.01）.[Conclusion]Staging combined with western medicine treatment of bronchial asthma results were satisfactory,no side effects,worthy of promotion.