参萸顿咳汤结合四缝穴针刺治疗小儿百日咳综合征痉咳期临床疗效及安全性研究

Clinical Efficacy and Safety of Shenyu Dunke Decoction(参萸顿咳汤)Combined with Acupuncture at Sifeng Acupoints in Treatment of Pertussis Syndrome in Children

目的探究参萸顿咳汤结合四缝穴针刺治疗小儿百日咳综合征痉咳期临床疗效及安全性。方法研究纳入107例百日咳综合征痉咳期患儿(2020年1月—2021年6月收治),以随机数字表法将患儿分成两组,对照组患儿(53例)进行西药常规(红霉素)治疗,观察组患儿(54例)西医常规(红霉素)治疗+参萸顿咳汤结合四缝穴针刺治疗,比较两组患儿临床治疗效果、治疗前后患儿中医证候积分(痉挛性咳嗽、面红耳赤、低热、精神烦躁、眼睑浮肿、痰中带血等)变化、患儿临床症状消失时间、肺部阳性体征消失时间、血常规恢复正常时间以及平均住院时间、治疗前后患儿白细胞(WBC)水平变化及C反应蛋白(CRP)水平变化、患儿不良反应情况及患儿家长对本次治疗满意度。结果与对照组患儿(84.91%,45/53)相比,观察组患儿治疗总有效率(96.30%,52/54)更高(P<0.05);与观察组患儿相比,对照组患儿临床症状消失时间、肺部阳性体征消失时间、血常规恢复正常时间以及平均住院时间均更长(P<0.05);治疗前,两组患儿中医证候积分(痉挛性咳嗽、面红耳赤、低热、精神烦躁、眼睑浮肿、痰中带血等)、WBC水平及CRP水平比较(P>0.05),治疗后各组患儿中医证候积分(痉挛性咳嗽、面红耳赤、低热、精神烦躁、眼睑浮肿、痰中带血等)、WBC水平及CRP水平均改善,观察组患儿治疗后中医证候积分(痉挛性咳嗽、面红耳赤、低热、精神烦躁、眼睑浮肿、痰中带血等)、WBC水平及CRP水平均优于对照组患儿,P<0.05;观察组与对照组患儿均存在一定不良反应,观察组1例便秘、1例皮炎,总不良反应率为3.70%(2/54),对照组1例恶心,1例呕吐,1例头痛,总不良反应率为5.66%(13/53)(P>0.05);观察组患儿家长总满意率(96.30%,52/54)显著高于对照组患儿家长(83.02%,44/53),P<0.05。结论参萸顿咳汤结合四缝穴针刺治疗小儿百日咳综合征痉咳期临床疗效显著,患儿恢复好,不良反应少,安全性高,可在临床广泛应用及推广。

Objective To investigate the clinical efficacy and safety of Shenyu Dunke Decoction(参萸顿咳汤)combined with acupuncture at Sifeng acupoints in the treatment of pertussis syndrome in children.Methods A total of 107 cases of pertussis syndrome in spasmodic cough period from January 2020 to June 2021 were divided into two groups according to the random number table.The children of the control group(53 cases)were treated with conventional western medicine(erythromycin)treatment and those of the observation group(54 cases)were treated with conventional western medicine treatment(erythromycin)+Shenyu Dunke Decoction combined with acupuncture at Sifeng acupoints.The clinical treatment effect of children in each group,the changes of traditional Chinese medicine syndrome scores(spastic cough,red face and ears,low fever,mental irritability,eyelid edema,blood in sputum,etc.)before and after treatment,the disappearance time of clinical symptoms and lung positive signs,the recovery time of blood routine and the average length of hospital stay,the levels of leukocyte(WBC)and C-reactive protein(CRP)before and after treatment were compared.Adverse reactions of children and their parents'satisfaction with this treatment were compared.Results Compared with that(84.91%,45/53)of the control group,the total effective rate(96.30%,52/54)of the observation group was higher(P<0.05).Compared with those of the observation group,the disappearance time of clinical symptoms and positive pulmonary signs,the return time of blood routine to normal and the average hospital stay in the control group were all longer(P<0.05).Before treatment,the comparisons of traditional Chinese medicine syndrome scores(spastic cough,red face and ears,low fever,mental irritability,eyelid edema,blood in sputum,etc.)and the levels of WBC and CRP between the two groups were not significant(P>0.05).After treatment,the traditional Chinese medicine syndrome scores(spastic cough,red face and ears,low fever,mental irritability,eyelid edema,blood in sputum,etc.)and the levels of WBC and CRP were all improved.And those in the observation group were better than those in the control group(P<0.05).There were certain adverse reactions in both the observation group and the control group.In the observation group,there was 1 case of constipation and 1 case of dermatitis and the total adverse reaction rate was 3.70%(2/54).In the control group,there was 1 case of nausea,1 case of vomiting and 1 case of headache and the total adverse reaction rate was 5.66%(3/53)(P>0.05).The total satisfaction rate(96.30%,52/54)of parents in the observation group was significantly higher than that(83.02%,44/53)in the control group(P<0.05).Conclusion Shenyu Dunke Decoction combined with acupuncture at Sifeng acupoints in the treatment of children with pertussis syndrome in spasmodic cough has significant clinical efficacy,good recovery of children,less adverse reactions and high safety,and can be widely used and promoted in clinical practice.