金敏汤辅助治疗小儿咳嗽变异性哮喘风痰阻肺证50例临床观察

Clinical observation on Jinmin Tang(金敏汤)in adjuvant treatment of 50 cases of cough variant asthma in children with wind-phlegm obstructing lung syndrome

目的观察金敏汤辅助治疗小儿咳嗽变异性哮喘的临床疗效及对免疫功能和肺功能的影响。方法选取2018年11月至2019年11月烟台市中医医院莱山扶正堂分院门诊收治的咳嗽变异性哮喘风痰阻肺证患儿100例,按随机数字表法分为治疗组和对照组,各50例。对照组给予常规西医治疗,治疗组在对照组治疗方法的基础上联合金敏汤治疗,2组均治疗14 d后统计临床疗效、中医证候积分、肺功能和免疫水平。结果治疗组总有效率为92%(46/50),显著高于对照组的74%(37/50),2组比较,差异有统计学意义(P<0.01)。治疗前,2组中医证候积分比较,差异无统计学意义(P>0.05),具有可比性;治疗后,2组中医证候积分均较同组治疗前下降(P<0.05),且治疗组下降更显著,差异有统计学意义(P<0.01)。治疗前,2组嗜酸性粒细胞(EOS)、血清免疫球蛋白E(IgE)、γ-干扰素(IFN-γ)水平比较,差异无统计学意义(P>0.05),具有可比性;治疗后,2组EOS、IgE均较同组治疗前下降(P<0.05),IFN升高(P<0.05),且治疗组下降/升高更显著,差异有统计学意义(P<0.05)。治疗前,2组用力肺活量(FVC)、第1秒用力呼气容积(FEV1)、最大呼气流量(PEF)水平比较,差异无统计学意义(P>0.05),具有可比性;治疗后,2组上述指标均较同组治疗前升高(P<0.05),且治疗组升高更显著,差异有统计学意义(P<0.05)。结论金敏汤辅助治疗小儿咳嗽变异性哮喘风痰阻肺证疗效显著,不仅可明显缓解患儿的临床症状、体征,降低中医证候积分,而且能提高免疫功能及肺功能,值得临床推广应用。

Objective To observe the clinical efficacy of Jinmin Tang(金敏汤)in adjuvant treatment of cough variant asthma(CVA)in children with wind-phlegm obstructing lung syndrome and its effects on immunity function and pulmonary function.Methods From November 2018 to November 2019,100 cases of CVA in children with wind-phlegm obstructing lung syndrome admitted into outpatient service in Laishan Fuzhengtang Branch of Yantai Municipal Hospital of TCM were divided into treatment group and control group according to random number table method,with 50 cases in each.The control group was given routine Western medicine treatment,on this basis,the treatment group was combined with Jinmin Tang.We kept statistics about the clinical efficacy,TCM symptom scores,pulmonary function and immune level of the 2 group after treatment for 14 days.Results The total effective rate of the treatment group was 92%(46/50),which was significantly higher than 74%(37/50)of the control group,and the difference between the 2 groups was statistically significant(P<0.01).Before treatment,the difference was not statistically significant in TCM symptom scores between the 2 groups(P>0.05),and they were comparable.After treatment,the symptom scores of the 2 groups all significantly decreased compared with the same group before treatment(P<0.05),moreover,the treatment group decreased more significantly,and the difference between the 2 groups was statistically significant(P<0.01).Before treatment,the difference was not statistically significant in eosinophil(EOS),serum immunoglobulin E(IgE),γ-interferon(IFN-γ)level between the 2 groups(P>0.05),and they were comparable.After treatment,the levels of EOS,IgE of the 2 groups all decreased compared with the same group before treatment(P<0.05),IFN-γincreased(P<0.05),moreover,the treatment group or increased decreased more significantly,and the difference was statistically significant(P<0.05).Before treatment,the difference was not statistically significant in forced vital capacity(FVC),forced expiratory volume in one second(FEV1),peak expiratory flow(PEF)levels between the 2 groups(P>0.05),and they were comparable.After treatment,the above-mentioned indexes of the 2 groups all increased compared with the same group before treatment(P<0.05),moreover,the treatment group increased more significantly,and the difference was statistically significant(P<0.05).Conclusion It has marked clinical efficacy to use Jinmin Tang in adjuvant treatment of CVA in children with wind-phlegm obstructing lung syndrome,which can not only markedly alleviate the clinical symptoms and signs of children patients,reduce TCM syndrome scores,but also improve immune function and pulmonary function.It deserves clinical promotion and application.