加味小青龙汤治疗支气管哮喘急性发作期的疗效观察

Clinical Research on Modified Xiaoqinglong Decoction in Treating Acute Bronchial Asthma

目的探讨加味小青龙汤在临床上用于支气管哮喘急性发作期的疗效。方法选取我科室2014-08-2015-08收治的支气管哮喘轻中度急性发作期以及中医属于寒哮的66例患者,随机分为治疗组和对照组,每组33例。对照组给予常规的西医对症治疗及支持疗法,治疗组在对照组常规治疗的基础上口服加味小青龙汤,观察2组患者治疗前后临床症状、肺功能、外周血嗜酸粒细胞计数的变化。比较分析2组的疗效。结果在3周治疗之后,治疗组患者咳嗽、喘息、咯痰症状明显减轻,通过中医证候积分及疗效率得到治疗组总有效率为97.0%;高于对照组的75.8%,差异有统计学意义（P〈0.05）;同时发现加味小青龙汤具有较好的改善肺功能作用,治疗后1秒用力呼气容积（FEV1）和呼气峰值流速（PEF）的改善最明显,与治疗前比较差异具有显著性（P〈0.05）。治疗组患者外周血嗜酸粒细胞（EOS）计数较前明显降低,差异具有显著性（P〈0.05）。结论加味小青龙汤可以明显改善支气管哮喘急性发作期的临床症状,且加用加味小青龙汤比常规单用西药治疗的疗效好,值得临床推广应用。

OBJECTIVE To investigate the curative effect of modified Xiaoqinglong decoction for acute exacerbation of bronchial asthma in clinic. METHODS A total of 66 cases in the department from August 2014 to August 2015 with mild to moderate bronchial asthma acute attack were randomly divided into treatment group and control group,33 cases in each group. Patients in the control group were given conventional western medicine symptomatic therapy and supportive therapy,while patients in the treatment group received routine treatment based on oral modified Xiaoqinglong decoction. The clinical symptoms,lung function and peripheral blood eosinophils eosinophil cell count changes of patients in the 2 groups were observed before and after treatment. And the clinical efficacy of the 2 groups was also observed. RESULTS After 3 weeks of treatment,symptoms of cough,wheeze,cough in patients of the treatment group were significantly reduced. The total effective rate was 93.9% obtained by scores of TCM syndromes and treatment efficiency in the treatment group; higher than that of 72.7% of the control group,the difference was statistically significant（ P〈0. 05）. The modified Xiaoqinglong decoction had a good effect on improving pulmonary function,after treatment,improvement in forced expiratory volume in one second（ FEV1） and peak expiratory flow（ PEF） most obvious,and the difference was significant as compared with that before treatment（ P〈0.05）. The peripheral blood eosinophils（ EOS） in patients of the treatment group were significantly lower than before the treatment,and the difference was significant（ P〈0.05）. CONCLUSION The modified Xiaoqinglong decoction can obviously improve the clinical symptoms of acute exacerbation of bronchial asthma,and combined with modified small blue dragon soup than conventional single western medicine treatment curative effect is good,worthy of clinical application.