推拿疗法对小儿哮喘慢性持续期的疗效研究

Effect of Pediatric Massage on Pediatric Chronic Persistent Asthma

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及作用机制。方法对我院2015年10月—2017年3月收治的哮喘慢性持续期80例患儿的临床资料回顾性分析和研究,随机分为观察组和对照组两组,每组40例。比较并分析两组患儿治疗疗效及治疗前后的儿童哮喘控制测试C-ACT评分、PEF%(PEF为峰值呼气流速)、哮喘发作次数、呼吸道感染次数和TLR1、TLR2、TLR4(TLR指Toll样受体)的表达水平。结果治疗后,患儿出现哮喘发作的次数和呼吸道感染次数都明显比治疗前少,C-ACT评分、PEF%均较治疗前上升差异具有统计学意义(<0.05),且观察组C-ACT评分、PEF%、哮喘发作次数、呼吸道感染次数均比对照组的改善情况显著(<0.05);治疗后,观察组患儿的治疗有效率明显比对照组高(<0.05);治疗后,患儿外周血巨噬细胞TLR1、TLR2、TLR4表达水平均较治疗前上升(<0.05),且观察组各指标上升较对照组明显(<0.05)。结论小儿哮喘慢性持续期患儿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对外周血巨噬细胞中的TLR1和TLR2以及TLR4表达水平进行上调来达到治疗的目的。

Objective To observe the clinical effect and the mechanism of pediatric massage on chronic persistent asthma.Methods 80 cases of children with chronic persistent asthma were randomly divided into observation group and control group,40 cases in each group. The C-ACT scores,PEF%（peak expiratory flow rate）,the number of asthma attacks,the number of respiratory infections and the numbers of TLR1,TLR2,TLR4（TLRs）were compared and analyzed before and after treatment.Results After treatment,the number of asthma attacks and respiratory infections in both goups were significantly lower than those before treatment,and the C-ACT scores and PEF% were significantly higher than those before treatment（ P〈0.05）. CACT score,PEF%,the number of asthma attacks,the number of respiratory infections were significantly improved in observation group compared with control group,the difference was statistically significant（ P〈0.05）;the total effective rate of observation group was higher than that of control group with significant difference（ P〈0.05）. The expression levels of TLR1,TLR2 and TLR4 in peripheral blood macrophages in both groups were significantly higher than those before treatment（ P〈0.05）,and the indexes in observation group were significantly higher than those in control group（P〈 0.05）. Conclusion Pediatric massage is effective in children with chronic persistent asthma,which can effectively relieve the clinical symptoms. The mechanism may be related to increasing the expression level of TLR1,TLR2 and TLR4 in peripheral blood macrophages.