小儿止咳方联合穴位敷贴辅助治疗儿童慢性咳嗽痰湿蕴肺证38例临床观察

Clinical observation on Xiao’er Zhike Fang(小儿止咳方)combined with acupoint application in adjuvant treatment of 38 cases of chronic cough in children with phlegm⁃dampness accumulating in the lung syndrome

目的观察小儿止咳方联合穴位敷贴辅助治疗儿童慢性咳嗽痰湿蕴肺证的临床疗效。方法选取2019年3月至2021年3月余姚市妇幼保健院儿科就诊的慢性咳嗽痰湿蕴肺证患儿73例,按照随机数字表法分为对照组35例和治疗组38例。对照组采用雾化吸入治疗,治疗组在对照组治疗方法的基础上给予小儿止咳方口服联合穴位敷贴治疗,2组均治疗7 d后统计中医证候积分、临床疗效及血清炎症因子水平。结果对照组总有效率为82.86%(29/35),治疗组为97.37%(37/38),2组比较,差异有统计学意义(P<0.05)。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组中医证候积分均明显下降,与同组治疗前比较,差异均有统计学意义(P<0.05),且治疗组下降更显著(P<0.05)。治疗前2组血清白细胞介素-4(IL-4)、γ-干扰素(TFN-γ)及肿瘤坏死因子-α(TNF-α)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IL-4、TNF-α水平明显下降,TFN-γ水平明显升高,与同组治疗前比较,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)。结论小儿止咳方联合穴位贴敷辅助治疗小儿慢性咳嗽痰湿蕴肺证,能有效改善患儿临床症状和体征,减轻炎症反应,疗效显著,值得临床推广应用。

Objective To observe the clinical efficacy of Xiao’er Zhike Fang(小儿止咳方)combined with acupoint application in adjuvant treatment of chronic cough in children with phlegm⁃dampness accumulating in the lung syndrome.Methods From March 2019 to March 2021,73 cases of chronic cough in children with phlegm⁃dampness accumulating in the lung syndrome admitted to pediatrics department of Yuyao Maternal and Child Health Hospital were divided into control group with 35 cases and treatment group with 38 cases according to random num⁃ber table method.The control group was treated with aerosol inhalation,on this basis,the treatment group was given oral administration of Xiao’er Zhike Fang combined with acupoint application.After both groups received 7 days of treatment,we kept statistics about the TCM syndrome scores,clinical efficacy and serum levels of inflammatory fac⁃tors between the 2 groups.Results The total effective rate of the control group was 82.86%(29/35),that of the treatment group was 97.37%(37/38),and the difference was statistically significant between the 2 groups(P<0.05).The difference was not statistically significant in TCM syndrome score between the 2 groups before treat⁃ment(P>0.05),indicating comparability.After treatment,TCM syndrome scores of the 2 groups both significantly decreased than those in the same group before treatment,and the difference was statistically significant(P<0.05),moreover,the decrease was more significant in the the treatment group(P<0.05).Before treatment,the differences were not statistically significant in serum levels of interleukin⁃4(IL⁃4),γ⁃interferon(TFN⁃γ)and tumor necrosis factor⁃α(TNF⁃α)between the 2 groups(P>0.05),indicating comparability.After treatment,the levels of IL⁃4 and TNF⁃αin the 2 groups decreased significantly,whereas the level of TFN⁃γincreased significantly than those in the same group before treatment(P<0.05),moreover,the decrease or increase in the treatment group was more signifi⁃cant(P<0.05).Conclusion It can effectively alleviate clinical symptoms and signs and reduce inflammatory reac⁃tions of the children patients with marked efficacy to use Xiao’er Zhike Fang combined with acupoint application in adjuvant treatment of chronic cough in children with phlegm⁃dampness accumulating in the lung syndrome,which deserves clinical promotion and application.