射干麻黄汤内服联合西药雾化治疗支气管哮喘急性发作期疗效观察

Clinical Observation of Oral Administration of Shegan Mahuang Tang Combined with Atomization Treatment of Western Medicine for Bronchial Asthma at Acute Attack Stage

目的:观察射干麻黄汤内服联合西药雾化吸入治疗支气管哮喘(BA)急性发作期的临床疗效及对血清白细胞介素6(IL-6)、肿瘤坏死因子α(TNF-α)、免疫球蛋白E(IgE)水平的影响。方法:将BA急性发作期患者80例按随机数字表法分为对照组和观察组各40例,对照组在抗感染、吸氧、补充水电解质以及止咳化痰治疗的基础上,配合布地奈德混悬液、沙丁胺醇溶液雾化吸入治疗;观察组在对照组的基础上加用射干麻黄汤口服治疗,2组均连续治疗15天为1疗程。观察2组临床疗效,治疗前后血清IL-6、TNF-α、IgE水平变化和主要临床症状体征积分变化,药物不良反应情况。结果:总有效率观察组为97.50%,对照组为77.50%,2组比较,差异有统计学意义(P<0.05)。治疗后2组IL-6、TNF-α及IgE水平均较治疗前降低(P<0.05);且观察组患者IL-6、TNF-α及IgE水平低于对照组(P<0.05)。治疗后2组患者主要症状、体征积分均较治疗前明显降低(P<0.05);且观察组患者症状体征积分低于对照组(P<0.05)。2组患者均未出现明显不良反应。结论:在西药治疗的基础上,射干麻黄汤内服联合西药雾化吸入治疗BA急性发作,可有效改善患者的临床症状,降低炎性因子水平,且不增加不良反应发生率,值得临床推广应用。

Objective： To observe the clinical effect of oral administration of Shegan Mahuang tang combined with aerosol inhalation treatment of western medicine for bronchial asthma（BA） at acute attack stage and the effect on levels of IL-6, TNF-α and IgE in serum. Methods： Divided 80 cases of patients with BA at acute attack stage into the control group and the observation group randomly by means of random number table, 40 cases in each group. The control group was treated with aerosol inhalation of budesonide suspension and salbutamol solution on the basis of anti-infection,oxygen absorption,water-electrolyte supplement and the treatment of relieving cough resolving phlegm, while the observation group was additionally given oral administration of Shegan Mahuang tang for treatment. The treatment in both groups continuously lasted for 15 days as one course. Observed the clinical effect,changes of the levels of IL-6,TNF-α and IgE in serum,changes in major clinical symptoms and signs and adverse drug reactions in the two groups. Results：The total effective rate was 97.50% in the observation group and 77.50% in the control group,difference being significant（P〈0.05）. After treatment,the changes of levels of IL-6,TNF-α and IgE in serum were lower than those before treatment（P〈0.05）,and the levels of IL-6, TNF-α and IgE in the observation group were obviously lower than those in the control group（P〈0.05）. After treatment,the major symptoms and scores of physical signs in the two groups were all clearly decreased when compared with those before treatment（P〈0.05）. The scores of symptoms and signs of patients in the observation group were lower than those in the control group（P〈0.05）. There were no obvious adverse reactions in both groups. Conclusion： On the basis of western medicine treatment,the therapy of oral administration of Shegan Mahuang tang combined with aerosol inhalation treatment of western medicine for BA acute attack can effectively improve the clinical symptoms of patients and reduce the level of inflammatory factors and it does notincrease the incidence of adverse reactions and is worthy of clinical application.