中西医结合治疗儿童支气管哮喘缓解期脾胃虚弱型43例临床观察

Clinical observation of therapeutic effect on combined therapy of Chinese and Western medicine in the treatment of 43 cases of children in remission phase of bronchial asthma(spleen-stomach deficiency syndrome)

目的观察中西医结合治疗儿童支气管哮喘缓解期脾胃虚弱型的临床疗效。方法将2012年8月至2016年6月于我院儿科确诊为支气管哮喘缓解期且中医证型属于脾胃虚弱型的85例患儿随机分为2组,对照组42例采用布地奈德福莫特罗粉吸入剂治疗,治疗组43例在对照组治疗方法的基础上口服四君子汤联合三子养亲汤,2组均3月为1个疗程,1个疗程后统计2组的临床疗效。结果 2组治疗后每月哮喘发作次数、每月喘息症状持续天数、每月上呼吸道感染次数明显降低,与同组治疗前比较差异有统计学意义(P<0.05),且治疗组症状改善幅度大于对照组(P<0.05);治疗后治疗组CD_3^+,CD_4^+,CD_4^+/CD_8^+水平显著升高(P<0.05),但对照组CD_3^+,CD_4^+,CD_4^+/CD_8^+水平改善不明显(P>0.05);治疗后2组IL-6水平降低,INF-γ水平升高,与同组治疗前比较,差异均有统计学意义(P<0.05),且治疗组上述指标改善幅度大于对照组;对照组总有效率为76.19%,治疗组为93.02%,经统计学分析,差异有统计学意义(P<0.05)。结论四君子汤、三子养亲汤联合西药治疗儿童支气管哮喘缓解期脾胃虚弱型疗效显著,能更好地改善患儿的炎症反应及免疫功能,值得临床推广。

Objective To observe therapeutic effect on combined treatment of Chinese and Western medicine in the treatment of 43 cases of children in remission phase of bronchial asthma （ spleen-stomach deficiency syndrome）. Methods 85 patients from August 2012 to June 2016 in our hospital diagnosed as bronchial asthma and TCM syndrome belonging to deficiency of spleen and stomach were divided into two groups,42 cases in the control group were given Budesonide Fornloterol Powder Inhalant, while 43 cases in therapy group were treated with the combination of Sijunzi Decoction and Sanzi Yangqin Decoction,3 months a course. The clinical therapeutic effects of two groups were observed after 1 course. Results After treatment, monthly episodes of asthma, wheezing days, the frequency of upper respiratory tract infection of two groups were lower, there were sigficant differences compared with before treatment （P〈0.05）. But those in therapy group improved more significantly than that in control group before treatment （P〈0.05）. After treatment, The levels of CD4＋, CD3＋, CD4＋/CDs in therapy group were improved （P〈0.05） ,while there were no obvious improvements in control group （P〉0.05） ;The level of interleukin-6 （IL-6） reduced and the level of serum interferon gamma （INF-γ） increased, there were significant differences compared with before treatment （P〈0. 05 ）, and the increasing amplitude in therapy group was significantly greater than thatin control group ; The total effective rate of therapy group （ 93.02% ） was higher than that of the control group （76.19%） with significant differences （P〈0.05）. Conclusion The combination of Sijunzi Decoction and Sanzi Yangqin Decoction treat children in remission phase of bronchial asthma （ spleen-stomach deficiency syndrome） ef-fectively by better improving the inflammatory response and immune function, which is worthy of clinical promotion.