华盖散联合二陈汤治疗变异性支气管哮喘的临床分析

Clinical analysis of Huagai powder combined with Erchen decoction in treatment of cough variant asthm

目的探讨华盖散联合二陈汤治疗咳嗽变异性哮喘的临床疗效。方法以自2016年9月-2017年9月于我院呼吸科就诊并接受治疗的116例咳嗽变异性哮喘患者为研究对象,按随机数字表方式分为对照组(n=58)和研究组(n=58)。对照组患者给予西医治疗,研究组患者在对照组治疗的基础上同时予以华盖散联合二陈汤行中医治疗。比较患者治疗前后血清嗜酸性粒细胞计数、IgE、ECP含量水平变化,检测治疗前后患者FEV1和PEF变异率,评估两组患者咳嗽变异性哮喘的疗效水平,观察患者治疗期间药物不良反应情况。结果治疗前,两组患者血清嗜酸性粒细胞计数、IgE、ECP、FEV1和PEF变异率差异均无统计学意义(t=0.196,0.625,0.248,0.536,0.313;P=0.703,0.371,0.652,0.451,0.672>0.05);治疗结束后,两组患者嗜酸性粒细胞计数、IgE、ECP和PEF变异率均较治疗前显著降低(t=5.026,8.514,7.932,6.047;P=0.000,0.000,0.000,0.000<0.05),FEV1较治疗前显著增加(t=7.251;P=0.000<0.05),且研究组患者治疗后血清嗜酸性粒细胞计数、IgE和ECP含量水平均显著低于对照组患者水平,而FEV1显著高于对照组患者水平(t=2.916,4.153,2.896,2.854;P=0.007,0.000,0.014,0.031<0.05);研究组患者咳嗽变异性哮喘治疗总体有效率(93.10%)显著高于对照组患者水平(79.31%)(χ^2=4.640,P=0.031<0.05);治疗期间,研究组患者药物不良反应总体发生率(8.62%)与对照组患者水平(10.34%)差异不具有统计学意义(χ^2=0.425,P=0.514>0.05)。结论较单纯西医治疗,加用华盖散联合二陈汤可显著降低呼吸道炎症反应和变态反应程度,改善咳嗽变异性哮喘患者肺功能,提高咳嗽变异性哮喘疗效水平,且不增加药物不良反应,值得临床推广使用。

Objective To observe the clinical effect of Huagai powder combined with Erchen decoction in the treatment of cough variant asthma. Methods A total of 116 cases of cough variant asthma were taken as the research objects who received treatment in our hospital from September 2016 to September 2017. They were divided into a control group (n=58) and a research group (n=58) by the Random Number Table. The patients in the control group were given Western medicine treatment, and the patients in the research group were given Huagai powder combined with Erchen decoction for traditional Chinese medicine treatment. The changes of serum eosinophil count, IgE and ECP levels were compared before and after treatment between the two groups. The variation rates of the forced expiratory volume in one second (FEV1) and the peak expiratory flow (PEF) before and after treatment were detected, the curative effects of the two groups were evaluated, and the adverse drug reactions of the patients during the treatment were also observed. Results Before treatment, there was no significant difference in serum eosinophil counts, IgE, ECP, FEV1 and PEF variation rates between the two groups (t=0.196, 0.625, 0.248, 0.536, 0.313, respectively;P=0.703, 0.371, 0.652, 0.451, 0.672, respectively,>0.05). After treatment, the eosinophil counts, IgE, ECP and PEF mutation rates in the two groups were significantly lower than those before treatment, and FEV1 increased significantly compared with those before treatment (t=5.026, 8.514, 7.932, 6.047, respectively;P=0.000, 0.000, 0.000, 0.000, respectively,<0.05). The serum eosinophil count, IgE and ECP levels in the research group were significantly lower than those of the control group, while the FEV1 was significantly higher than that of the control group (t=2.916, 4.153, 2.896, 2.854, respectively;P=0.007, 0.000, 0.014, 0.031, respectively,<0.05). The total effective rate of cough variant asthma in the research group (93.10%) was significantly higher than that of the control group (79.31%,χ^2=4.640, P=0.031<0.05). During the treatment, the total incidence of adverse drug reactions (8.62%) in the research group was not statistically significant (10.34%,χ^2=0.425, P=0.514>0.05). Conclusion Compared with Western medicine, Huagai powder combined with Erchen decoction can effectively inhibit bronchitis and allergic reactions, improve the lung function of the patients with cough variant asthma, improve the curative effect of cough variant bronchial asthma, and do not increase the adverse drug reactions. Therefore, it is worthy of clinical application.