小儿推拿疗法对小儿哮喘慢性持续期的临床疗效及治疗效果研究

Clinical Efficacy and Therapeutic Effect of Pediatric Tuina for Pediatric Asthma during Chronic Duration

目的:观察小儿推拿疗法对小儿哮喘慢性持续期的临床疗效并探讨其作用机制。方法:通过对我院2015年10月~2017年3月就诊收治的80例哮喘慢性持续期患儿临床资料做回顾性分析。并根据治疗方式的不同分为观察组、对照组(各40例)。比较并分析两组患儿治疗疗效及治疗前后的C-ACT评分、PEF%、哮喘发作次数、呼吸道感染次数和TLR1、TLR2、TLR4的表达水平。结果:治疗前两组患儿C-ACT评分、PEF%、哮喘发作次数、呼吸道感染次数比较,差异无统计学意义(P>0.05),治疗后两组患儿哮喘发作次数、呼吸道感染次数均较治疗前下降,C-ACT评分、PEF%均较治疗前上升差异具有统计学意义(P<0.05),且观察组C-ACT评分、PEF%、哮喘发作次数、呼吸道感染次数均较对照组改善明显,差异具有统计学意义(P<0.05),治疗后观察组患儿的治疗总有效率(92.50%)明显高于对照组(75.00%),差异具有统计学意义(P<0.05)。两组患儿治疗前外周血巨噬细胞TLR1、TLR2、TLR4表达水平比较无差异(P>0.05),治疗后两组患儿外周血巨噬细胞TLR1、TLR2、TLR4表达水平均较治疗前上升(P<0.05),且观察组各指标上升较对照组明显(P<0.05)。结论:在小儿哮喘慢性持续期患儿中应用小儿推拿疗法治疗,临床疗效显著,可有效的缓解哮喘等相关临床症状,其作用机制可能是通过上调外周血巨噬细胞中的TLR1、TLR2、TLR4表达水平来达到治疗的目的。

Objective： To discuss the therapeutic effect and action mechanism of pediatric tuina on pediatric asthma during chronic duration. Methods： The clinical data of 80 cases of pediatric asthma during chronic duration treated in our hospital from October 2015 to March 2017 were analyzed retrospectively. According to the different treatment methods,patients were divided into observation group and controlled group（ each with 40 cases）. The therapeutic effect, C-ACT score, peak expiratory flow（ PEF%）,time of asthma attack,and the incidence of respiratory infection and the expression level of TLR1,TLR2 and TLR4 before and after treatment were compared and analyzed. Results： The C-ACT score,PEF%,time of asthma attack,and the incidence of respiratory infection between the two groups before treatment had no significant difference（ P0. 05）. After treatment,the number of asthma attacks and the incidence of respiratory infection decreased,while the C-ACT score and PEF% increased（ P0. 05）. The C-ACT scores,PEF%,the number of asthma attacks and number of respiratory infections in the observation group significantly ameliorated compared with the controlled group（ P 0. 05）. After treatment,the total effective rate of the treatment group was significantly higher than that of the controlled group（ 92. 50% vs. 75. 00%）,the difference was statistically significant（ P0. 05）. The expression of TLR1,TLR2 and TLR4 in the peripheral blood macrophages of the two groups before treatment had no significant difference（ P0. 05）,but the data increased after treatment（ P0. 05）,the improvement was more obvious in the observation group than in the controlled group（ P0. 05）. Conclusion： Pediatric tuina has significant effect to alleviate the clinical symptoms for pediatric asthma during chronic duration,its mechanism may be the expression level improvement of TLR1,TLR2 and TLR4 in peripheral blood macrophages.