六君子汤合玉屏风散治疗哮喘迁延期的临床研究

Clinical study on the Liujunzi decoction and Yupingfeng powder in the treatment of asthma children in the remission period

目的观察六君子汤合玉屏风散治疗对哮喘迁延期风痰内蕴、肺脾气虚证患儿中医证候积分、哮喘控制测试(C-ACT)评分及肺通气功能的影响。方法选择2016年5月至2017年5月上海交通大学医学院附属上海儿童医学中心呼吸科、复旦大学附属儿科医院及上海中医药大学附属市中医医院儿科门诊哮喘迁延期(风痰内蕴、肺脾气虚证)患儿共100例,随机分为观察组和对照组各50例。对照组给予布地奈德吸入剂治疗6个月,观察组在对照组治疗基础上,联合应用六君子汤合玉屏风散治疗3个月。分析治疗3个月和6个月后两组患儿中医证候积分、C-ACT评分及肺功能参数的变化情况。结果 (1)治疗3、6个月后观察组中医证候积分显著低于对照组,差异有统计学意义(P<0.05)。(2)治疗3个月后两组C-ACT评分比较差异无统计学意义(P>0.05)。治疗6个月后观察组C-ACT评分显著高于对照组,差异有统计学意义(P<0.05)。(3)治疗3、6个月后观察组PEF、FVC、FEV1、FEF50及FEF75均显著高于对照组,差异有统计学意义(P<0.05)。结论六君子汤合玉屏风散具有改善哮喘迁延期风痰内蕴、肺脾气虚证患儿的中医证候,提高哮喘控制测试评分,改善肺通气功能的作用。

Objective To study the effect of Liujunzi decoction and Yupingfeng powder on the TCM syndrome score, the C-ACT score and the pulmonary function in asthma children in remission with wind-phlegm inside and lung-spleen Qi-deficiency. Methods Totally 100 children who met the asthma diagnostic standards were selected and randomly divided into the control group and the treatment, with each group having 50 cases. In the control group, budesonide was given for 6 months, while in the treatment group, pulmicort was given for 6 months, combined with the Liujunzi decoction and Yupingfeng powder for 3 months. After 3 months and 6 months of treatment, TCM syndrome score, asthma control test(C-ACT) and pulmonary function were revalued. Results (1)TCM syndrome scores: after 3 months and 6 months of treatment, the improvement of TCM syndrome score in the treatment group were lower than that of the control group( P <0.05).(2)C-ACT score: after 3 months of treatment, C-ACT was similar in the two groups( P > 0.05 ). At 6 months of treatment, the improvement in the treatment group was superior to that in the control group( P <0.05).(3) Pulmonary function: after 3 months and 6 months of treatment, the improvement of PEF, FVC, FEV1, FEF50 and FEF75 in the treatment group was better than that in the control group( P <0.05). Conclusion Liujunzi decoction and Yupingfeng powder can improve the symptoms of TCM syndrome, the asthma control test(C-ACT) score, and the function of lung ventilation in the children with asthma in remission period with wind-phlegm inside and lung-spleen Qi-deficiency.