姜汁走罐联合孟鲁司特钠治疗小儿哮喘缓解期肺脾气虚证32例临床观察

Clinical observation on 32 cases of infantile asthma with asthenia of pulmonosplenic qi syndrome in remission stage treated by ginger juice mobile cupping combined with montelukast sodium

目的观察姜汁走罐联合孟鲁司特钠治疗小儿哮喘缓解期肺脾气虚证的临床疗效。方法选取2017年11月至2018年12月浦江县人民医院儿科就诊的哮喘缓解期肺脾气虚证患儿61例,按随机数字表法分为对照组29例和治疗组32例。对照组予孟鲁司特钠咀嚼片嚼服治疗,治疗组在对照组治疗方法的基础上予姜汁走罐治疗,2组均连续治疗3个月后统计疗效。结果治疗前,2组第1秒用力呼气量(FEV1)、最大呼气流量(PEF)水平比较,差异均无统计学意义(P>0.05),具有可比性。治疗后,对照组PEF水平明显增高(P<0.05),而FEV1水平无明显变化(P>0.05);治疗组FEV1、PEF水平均明显增高(P<0.05),且与对照组治疗后比较,差异均有统计学意义(P<0.05)。治疗前,2组哮喘发作次数比较,差异无统计学意义(P>0.05),具有可比性。治疗后,2组哮喘发作次数均明显减少,差异有统计学意义(P<0.05),且治疗组减少更显著(P<0.05)。治疗前,2组咳嗽、喘息、咳痰、哮鸣音症状的评分比较,差异均无统计学意义(P>0.05),具有可比性。治疗后,2组的上述积分均明显下降,差异有统计学意义(P<0.05),且治疗组下降更显著(P<0.05)。治疗前,2组肿瘤坏死因子-α(TNF-α)、白细胞介素-4(IL-4)、干扰素-γ(IFN-γ)、IgA及IgM水平比较,差异均无统计学意义(P>0.05),具有可比性。治疗后,2组TNF-α、IL-4水平均明显降低,治疗组IFN-γ、IgA及IgM水平均明显升高,对照组仅IFN-γ水平明显升高,差异均有统计学意义(P<0.05),且治疗组下降或升高更显著(P<0.05)。对照组IgA及IgM水平较治疗前无明显改善,差异无统计学意义(P>0.05)。结论姜汁走罐联合孟鲁司特钠治疗哮喘缓解期肺脾气虚证,可明显改善患儿的肺功能,有效控制哮喘急性发作,缓解咳嗽、喘息、咳痰、哮鸣音等症状,这可能与其调节炎性细胞因子及免疫球蛋白水平有关,值得临床推广应用。

Objective To observe the clinical efficacy of ginger juice mobile cupping combined with montelukast sodium in the treatment of infantile asthma with asthenia of pulmonosplenic qi syndrome in remission stage.Methods Sixty-one cases of infantile asthma with asthenia of pulmonosplenic qi syndrome in remission stage consulted in pediatrics department of Pujiang County The People’s Hospital were divided into control group with 29 cases and treatment group with 32 cases according to random number table method.The control group was given chewable administration of montelukast sodium chewable tablets,on this basis,the treatment group was given ginger juice mobile cupping.We kept statistics about the curative effects after the 2 groups were both given consecutive treatment for 3 months.Results Before treatment,the difference was not statistically significant in the levels of forced expiratory volume in first second(FEV1) and peak expiratory flow(PEF) between the two groups(P>0.05),and they were comparable.After treatment,the level of PEF in the control group significantly increased(P<0.05), while the level of FEV1 showed no significant change(P>0.05).The levels of FEV1 and PEF significantly increased in the treatment group(P<0.05),and the difference was statistically significant compared with the control group after treatment(P<0.05).Before treatment,the difference was not statistically significant in the number of asthma attacks between the two groups(P>0.05),and they were comparable.After treatment,the number of asthma attacks significantly decreased,and the difference was statistically significant between the two groups(P<0.05),moreover,the treatment group decreased more significantly(P<0.05).Before treatment,the difference was not statistically significant in scores of cough,dyspnea,expectoration and wheezing rale between the two groups(P>0.05),and they were comparable.After treatment,the above-mentioned scores of the two groups all significantly decreased,and the difference was statistically significant(P<0.05),moreover,the treatment group decreased more significantly(P<0.05).Before treatment,the difference was not statistically significant in the levels of tumor necrosis factor-α(TNF-α),interleukin-4(IL-4),interferon-γ(IFN-γ),immunoglobulin A(IgA) and immunoglobulin(IgM) between the two groups(P>0.05),and they were comparable.After treatment,the levels of TNF-α and IL-4 in the two groups all significantly decreased,while the levels of IFN-γ,IgA and IgM in the treatment group all significantly increased,in the control group only the level of IFN-γ increased significantly,and the difference was statistically significantly significant(P<0.05),moreover,the decrease or increase of the treatment group was more significant(P<0.05). IgA and IgM levels in the control group were not significantly improved compared with those before treatment,and the difference was not statistically significant(P>0.05).Conclusion It can significantly improve lung function of the children patients,effectively control the acute attack of asthma,relieve cough, dyspnea,expectoration and wheezing rale etc.symptoms to use ginger juice mobile cupping combined with montelukast sodium in the treatment of infantile asthma with asthenia of pulmonosplenic qi syndrome in remission stage,which may be related to the regulation of inflammatory cytokines and immunoglobulin levels.It deserves clinical promotion and application.