调肺运脾小儿推拿法联合二陈汤加减治疗痰湿蕴肺型小儿慢性咳嗽临床研究

Clinical Study on Infantile Tuina Method of Regulating Lung and Transporting Spleen Combined with Modified Erchen Tang for Infants with Chronic Cough of Phlegm-Dampness in the Lung Type

目的:观察调肺运脾小儿推拿法联合二陈汤加减治疗痰湿蕴肺型小儿慢性咳嗽的疗效及对血清肿瘤坏死因子-α (TNF-α)、白细胞介素-6 (IL-6)、白细胞介素-8 (IL-8)水平的影响。方法:选取痰湿蕴肺型慢性咳嗽患儿110例,按随机数字表法分为对照组和观察组各55例。对照组给予阿奇霉素干混悬剂治疗,观察组在对照组的基础上给予调肺运脾小儿推拿法联合二陈汤治疗。治疗2周后,比较2组咳嗽评分、中医证候评分、临床疗效及血清炎症因子水平。结果:观察组总有效率为98.18%,对照组为83.64%,2组比较,差异有统计学意义(P<0.05)。治疗后,2组日间、夜间咳嗽症状评分均较治疗前明显降低(P<0.05),且观察组日间、夜间咳嗽症状评分均低于对照组(P<0.05)。治疗后,2组咳嗽、咯痰、胸闷、脘胀、纳差等中医证候评分均较治疗前明显降低(P<0.05),且观察组各项中医证候评分均低于对照组(P<0.05)。治疗后,2组血清TNF-α、IL-6、IL-8水平均较治疗前降低(P<0.05);且观察组上述炎症因子水平均低于对照组(P<0.05)。结论:调肺运脾小儿推拿法联合二陈汤加减治疗痰湿蕴肺型小儿慢性咳嗽可提高临床疗效,下调血清TNF-α、IL-6、IL-8水平,有效改善患者临床症状。

Objective: To observe the curative effect of infantile tuina method of regulating lung and transporting spleen combined with modified Erchen tang for infants with chronic cough of phlegmdampness in the lung type and its effect on levels of tumor necrosis factor-α(TNF-α), interleukin-6(IL-6) and interleukin-8(IL-8) in serum. Methods: A total of 110 cases of infants with chronic cough were selected and divided into the control group and the observation group according to the random number table method, with 55 cases in each group. The control group was treated with azithromycin for suspension,and the observation group was treated with infantile tuina method of regulating lung and transporting spleen combined with Erchen tang based on the treatment of the control group. After two-week treatment,the cough scores,the Chinese medicine syndrome scores,the clinical effects and the levels of inflammatory factors in serum in the two groups were compared. Results:The total effective rate was 98.18% in the observation group and 83.64% in the control group, the difference being significant(P<0.05). After treatment,the symptom scores of cough during daytime and at night in the two groups were significantly decreased when compared with those before treatment(P<0.05), and the symptom scores of cough during daytime and at night in the observation group were significantly lower than those in the control group(P<0.05). After treatment, Chinese medicine syndrome scores of cough, expectoration, chest discomfort, stomach swelling and poor appetite in the two groups were significantly decreased when compared with those before treatment(P<0.05),and the above Chinese medicine syndrome scores were significantly lower than those in the control group(P<0.05). After treatment,the levels of TNF-α,IL-6 and IL-8 in serum in the two groups were decreased when compared with those before treatment(P<0.05),and the above levels of inflammatory factors in the observation group were significantly lower than those in the control group(P<0.05). Conclusion:Infantile tuina method of regulating lung and transporting spleen combined with modified Erchen tang in the treatment of infants with chronic cough of phlegm-dampness in the lung type can improve clinical effects,down-regulate the levels of TNF-α,IL-6 and IL-8 in serum,and effectively improve clinical symptoms.