祛风宣肺汤联合西药治疗咳嗽变异性哮喘(风邪犯肺)随机平行对照研究

Randomized Parallel Controlled Study of Qufeng Xuanfei Decoction Combined with Western Medicine in Treatment of Cough-induced Asthma( Wind Evil Attaking the Lung)

[目的]观察祛风宣肺汤联合西药治疗咳嗽变异性哮喘(风邪犯肺)疗效。[方法]使用随机平行对照方法,将104例门诊患者按随机数字表法随机分为两组。对照组52例沙美特罗替卡松粉吸入剂,1吸/次,2次/d;多索茶碱,400mg/次,2次/d。治疗组52例祛风宣肺汤(麻黄、蜜枇杷叶、炒紫苏子各15g,蝉蜕、前胡、荆芥、炒牛蒡子、浙贝母、五味子、桔梗各10g,甘草8g,鱼腥草30g),水煎400mL,早晚温服,兼夹风寒者,加防风、紫菀、百部;兼夹风热者,加桑叶、菊花、薄荷、连翘;兼夹风燥者,加桑叶、杏仁、沙参;西药治疗同对照组。连续治疗3周为1疗程。观测临床表现、FEV1、FEV1%、用力肺活量(FVC)、最大呼气流量(PEF)、中医证候积分、不良反应。连续治疗2疗程(6周),判定疗效。[结果]治疗组痊愈26例,显效16例,有效7例,无效3例,总有效率94. 23%;对照组痊愈20例,显效13例,有效9例,无效10例,总有效率80. 77%;治疗组疗效优于对照组(P <0. 05)。FEV1、FEV1%、FVC、PEF、中医证候积分两组均有改善(P <0. 01),治疗组改善优于对照组(P <0. 05,P <0. 01)。[结论]祛风宣肺汤联合西药治疗咳嗽变异性哮喘(风邪犯肺),疗效满意,无严重不良反应,值得推广。

[Objective]To observe the curative effect of Qufeng Xuanfei Decoction combined with western medicine on cough-induced asthma( wind evil attacking the lung).[Method]A total of 104 outpatients were randomly divided into two groups by random number table method. In the control group,52 patients received salmeterol and fluticasone powder inhalation,twice a day,and doxofylline 400 mg/time,twice a day. The treatment group’s 52 cases were given Qufeng Xuanfei Decoction[Mahuang( Ephedra) 15 g,Pipaye( Loquat Leaf) 15 g,Zisuzi( Perilla) 15 g,Cantui( Cicada Slough) 10 g,Qianhu( Hogfennel Root) 10 g,Jingjie( Fi neleaf Schizonepeta Herb) 10 g,Niubangzi( Great Burdock Achene) 10 g,Zhebeimu( Thunberg Fritillary Bulb) 10 g,Wuweizi( Chinese Magnoliavine Fruit) 10 g,Jiegeng( Platycodon Root) 10 g,Gancao( Liquorice Root) 8 g,Yuxingcao( Heartleaf Houttuynia Herb) 30 g],400 mL for decocting,taking in the morning and evening. If there is wind-cold,the formula should add Fangfeng( Divaricate Saposhnikovia Root),Ziwan( Tatarian Aster Root),Baibu( Stemona Root). If there is wind-heat,the formula should add Sangye( Mulberry Leaf),Juhua( Chrysanthemum Flower),Bohe( Peppermint) and Lianqiao( Weeping Forsythia Capsule). If there is wind-dryness,the formula should add Sangye( Mulberry Leaf),Xingren( Apricot Seed) and Shashen( Adenophora stricta). The Western medicine treatment was the same as the control group. Continuous 3 weeks was a course of treatment. Clinical manifestations,FEV1,FEV1%,forced vital capacity( FVC),maximum expiratory flow( PEF),integral of TCM syndromes and adverse reactions were observed. After continuous treatment for 2 courses( 6 weeks),we determined the efficacy.[Result]In the treatment group,26 cases were cured,16 cases were markedly effective,7 cases were effective and 3 cases were ineffective and the total effective rate was 94. 23%. In the control group,20 cases were cured,13 cases were markedly effective,9 cases were effective and 10 cases were ineffective. The total effective rate was 80. 77%. The curative effect of the treatment group was better than that of the control group( P <0. 05). FEV1,FEV1%,FVC,PEF and TCM syndrome scores were improved in both groups( P < 0. 01),and the improvement in treatment group was better than that in control group( P < 0. 05,P < 0. 01).[Conclusion]Qufeng Xuanfei Decoction combined with western medicine is effective in treating cough variant asthma( wind evil attacking the lung). It has no serious adverse reactions and is worthy of promotion.