中医辨证施护联合子午流注穴位贴敷对痰热壅肺型急性支气管炎患儿心理韧性、呼吸功能及炎症因子的影响

Impacts of Syndrome Differentiation and Nursing Combined with Midnight-noon and Ebb-flow Acupoint Application on Psychological Resilience,Respiratory Function and Inflammatory Factors in Children with Acute Bronchitis of Phlegm-heat Obstructing Lung Pattern

目的:探讨中医辨证施护联合子午流注穴位贴敷对痰热壅肺型急性支气管炎患儿心理韧性、呼吸功能及炎症因子的影响。方法:将82例痰热壅肺型急性支气管炎患儿采用随机数字表法分为对照组和观察组各41例,两组患儿均行常规支持治疗,对照组采取子午流注穴位贴敷治疗,观察组在对照组的基础上增加中医辨证施护,并随访1周。观察两组患儿治疗前后心理韧性水平、呼吸功能[用力肺活量(forced vital capacity,FVC)、第1秒用力呼气末容积(forced expiratory volume in one second,FEV_(1))、最大呼气流速(peak expiratory flow rate,PEF)]、血气指标[动脉血氧分压(arterial partial pressure of oxygen,PaO_(2))、动脉血二氧化碳分压(partial pressure of carbon dioxide in arterial,PaCO_(2))]、炎症因子[肿瘤坏死因子α(tumor necrosis factorα,TNF-α)、白细胞介素6(interleukin-6,IL-6)]水平及中医症状评分等变化情况,评估两组患儿临床疗效和不良反应发生情况。结果:1)治疗后两组患儿乐观、自强和坚韧评分较治疗前提高,观察组心理韧性评分高于对照组(P<0.05);2)治疗后两组患儿FVC、FEV_(1)和PEF水平较治疗前提高,观察组高于对照组(P<0.05);3)治疗后两组患儿PaO_(2)水平较治疗前升高,PaCO_(2)水平较治疗前降低,观察组PaO_(2)高于对照组(P<0.05),PaCO_(2)低于对照组(P<0.05);4)治疗后两组患儿血清IL-6、TNF-α水平较治疗前下降,观察组低于对照组(P<0.05);5)治疗后两组患儿中医症状评分较治疗前下降,观察组低于对照组(P<0.05);6)观察组总有效率为95.12%(39/41),高于对照组的78.05%(32/41);7)不良反应发生率两组比较差异无统计学意义(P>0.05)。结论:中医辨证施护联合子午流注穴位贴敷可有效抑制痰热壅肺型急性支气管炎患儿炎症反应,改善血气指标,增强呼吸功能,提高心理韧性水平,降低中医症状评分,并且安全性较高。

Objective:To discuss the influence of syndrome differentiation and care and midnight-noon and ebb-flow acupoint application on psychological resilience,respiratory function and inflammatory factors in children with acute bronchitis of phlegm-heat obstructing lung pattern.Methods:All 82 children were allocated to the control group and the observation group using random number table method,the children in both groups accepted routine supportive therapy,the control group was treated by midnight-noon and ebb-flow acupoint application,and the observation group syndrome differentiation and care on the foundation of the therapy the control group adopted,and they were followed up for one week.To observe the levels of psychological resilience,respiratory function[FVC,FEV_(1) and PEF],blood-gas indexes[PaO_(2),PaCO_(2)],the levels of inflammatory factors[TNF-αand IL-6]and TCM symptom scores before and after the treatment between both groups,and to assess clinical effects and the incidence of adverse reaction in the two groups.Results:1)After the treatment,the scores of optimism,self-improvement and tenacity of the two groups raised than before the treatment,the scores of psychological resilience of the observation group were higher than these of the control group(P<0.05);2)after the treatment,the levels of FVC,FEV_(1) and PEF of the children in the two groups lifted than before the treatment,the observation group were higher than the control group(P<0.05);3)after the treatment,the levels of PaO_(2) elevated in the two groups than these before the treatment,the levels of PaCO_(2) were lowered compared with these before the treatment,the levels of PaO_(2) of the observation group were higher than these of the control group(P<0.05),the levels of PaCO_(2) were lower than these of the control group(P<0.05);4)after the treatment,the levels of serum IL-6 and TNF-αin the two groups were lower than these before the treatment,the observation group were lower than the control group(P<0.05);5)after the treatment,TCM symptoms scores of both groups were lowered than these before the treatment,the observation group were lower than the control group(P<0.05);6)Total effective rate of the observation group was 95.12%(39/41),higher than 78.05%(32/41)of the control group;7)The difference had no statistical meaning in the incidence of adverse reaction between both groups(P>0.05).Conclusion:Syndrome differentiation and care and midnight-noon and ebb-flow acupoint application in the treatment of children with acute bronchitis of phlegm-heat obstructing lung pattern could effectively inhibit inflammatory reaction,improve blood-gas indexes,enhance respiratory function,raise the levels of psychological resilience,and decrease TCM symptoms scores with higher safety.