小青龙汤联合穴位游走罐治疗儿童支气管哮喘发作期的临床疗效观察

Clinical observation of Xiaoqinglong Decoction combined with acupoint walking pot in the treatment of children with bronchial asthma attack

目的观察小青龙汤联合穴位游走罐治疗儿童支气管哮喘发作期(寒哮证)的临床疗效。方法本研究为前瞻性、随机、平行、对照研究。选取2020年4月至2022年1月于首都医科大学附属北京潞河医院保健科就诊的72例支气管哮喘发作期儿童患者作为研究对象,采用随机数字表法将患者分为干预组(n=36)和对照组(n=36)。对照组予布地奈德福莫特罗粉吸入治疗,干预组在对照组基础上给予小青龙汤联合穴位行游走罐辅助治疗,疗程均为14 d。对比分析两组患儿的临床疗效、治疗前后中医症状积分、肺功能[第一秒用力肺活量(FEV1)和最大呼气流速(PEF)]、哮鸣音消失时间及胸片结果、前白蛋白、视黄醇结合蛋白(RBP)、转铁蛋白、白蛋白、游离脂肪酸(FFA)。结果干预组临床总有效率为80.56%,显著高于对照组(58.33%),差异有统计学意义(P<0.05)。治疗14 d后,两组患儿中医症状积分均较治疗前降低,其中干预组的咯痰、清涕、畏寒肢冷、舌质和舌苔症状积分分别为(0.84±0.39)、(0.18±0.11)、(0.14±0.11)、(0.26±0.12)、(0.08±0.10)分,显著低于对照组[(1.42±0.52)、(0.92±0.40)、(0.36±0.14)、(0.58±0.34)、(0.38±0.43)分],差异均有统计学意义(P<0.05)。治疗14 d后,两组患儿的FEV1、PEF水平显著高于治疗前,差异均有统计学意义(P<0.05),但两组间比较差异无统计学意义(P>0.05),干预组的哮鸣音消失时间显著短于对照组,差异有统计学意义(P<0.05)。干预组患儿胸片呈现纹理增强率为38.89%,显著高于对照组(13.88%),差异均有统计学意义(P<0.05)。治疗14 d后,干预组的前白蛋白和转铁蛋白为(21.20±1.54)mg/dL、(267.8±16.565)mg/mL,高于对照组[(19.75±1.45)mg/dL、(251.56±19.56)mg/mL],差异均有统计学意义(P<0.05),RBP、RF及FFA比较差异无统计学意义(P>0.05)。结论小青龙汤联合穴位游走罐辅助治疗儿童支气管哮喘发作期(寒哮证)可显著提高临床疗效,改善中医证候积分,缩短病程,并有助于改善患儿的肺功能,提升患儿营养水平。

Objective To observe the clinical effect of Xiaoqinglong Decoction combined with acupoint walking pot in the treatment of children with bronchial asthma attack(cold asthma syndrome).Methods This study was a prospective,randomized,parallel and controlled study.A total of 72 children with bronchial asthma attack who were treated in the Department of Health Care,Beijing Luhe Hospital,Capital Medical University from April 2020 to January 2022 were selected as research objects.The patients were randomly divided into intervention group(n=36)and control group(n=36).The control group was treated with budesonide formoterol powder inhalation,and the intervention group was treated with Xiaoqinglong Decoction combined with acupoint walking pot on the basis of the control group,course of treatment 14 days.The total clinical effective rates,TCM symptom scores,the lung function[forced expiratory volume in 1 second(FEV1),peak expiratory flow(PEF)],wheezing disappearance time and chest film results,prealbumin,retinol binding protein(RBP),transferrin,albumin,free fatty acid(FFA)of the two groups before and after treatment were compared and analyzed.Results The total clinical effective rate of the intervention group was 80.56%,which was significantly higher than that of the control group(58.33%),the difference was statistically significant(P<0.05).After 14 days of treatment,the scores of TCM symptom scores of the two groups were significantly lower than those before treatment,the scores of sputum expectoration,nasal discharge,chilly limbs,tongue texture and tongue coating in the intervention group were(0.84±0.39),(0.18±0.11),(0.14±0.11),(0.26±0.12),(0.08±0.10)points,respectively,which were significantly lower than those in the control group[(1.42±0.52),(0.92±0.40),(0.36±0.14),(0.58±0.34),(0.38±0.43)points],the difference was statistically significant(P<0.05).After 14 days of treatment,the levels of FEV1 and PEF in the two groups were significantly higher than those before treatment(P<0.05),but there was no significant difference between the two groups(P>0.05),the disappearance time of wheezing in the intervention group was significantly shorter than that in the control group(P<0.05).The rate of texture enhancement in chest films of children in the intervention group was 38.89%,which was significantly higher than that in the control group(13.88%),and the difference was statistically significant(P<0.05).After 14 days of treatment,prealbumin and transferrin in the intervention group were(21.20±1.54)mg/dL,(267.8±16.565)mg/mL,which were higher than those in the control group[(19.75±1.45)mg/dL,(251.56±19.56)mg/mL],and the differences were statistically significant(P<0.05),while there was no significant difference in RBP,RF and FFA between the two groups(P>0.05).Conclusion Xiaoqinglong Decoction combined with acupoint walking pot can significantly improve the clinical efficacy,improve the TCM syndrome score,shorten the course of disease,and help to improve the digestive function of children,improve the nutritional level of children with bronchial asthma attack(cold asthma syndrome).