中医辨证辅助治疗重症哮喘临床观察

Clinical Observation of Adjuvant Therapy of Severe Asthma Differentiated by TCM

目的:探讨中医辨证施治联合糖皮质激素吸入治疗重症哮喘的临床疗效。方法:选取87例重症哮喘患者,应用随机数字表法分为观察组(43例)与对照组(44例)。对照组给予常规抗感染、支气管扩张、止咳平喘等对症治疗。观察组依照中医辨证分型,分为瘀塞证组11例,肺实证组8例,寒包火证组12例,重寒证组12例,并在对照组治疗基础上联合中医辨证治疗,共治疗1个月。对比两组临床疗效,治疗前后肺功能指标、心率、呼吸频率、血氧饱和度的变化情况。结果:总有效率观察组[90.70%(39/43)]高于对照组[72.73%(32/44)](P<0.05);瘀塞证、肺实证、寒包火证、重寒证等各证型总有效率组间比较,差异无统计学意义(P>0.05);治疗后观察组肺一氧化碳扩散量、残余量与总肺容积之比,以及第一秒用力呼气量与用力肺活量之比明显优于对照组(P<0.05);治疗后两组心率、呼吸频率均有所改善,但差异无统计学意义(P>0.05);两组血氧饱和度均升高,且观察组高于对照组(P<0.05)。结论:通过中医辨证施治联合吸入糖皮质激素法治疗重症哮喘,能够提升治疗效果,而且对于不同辨证分型重症哮喘患者均有显著效果,能够提升患者的肺功能,提升氧饱和度。

Objective:To investigate the clinical efficacy of TCM syndrome differentiation and treatment combined with glucocorticoid inhalation in the treatment of severe asthma.Methods:Eighty-seven patients with severe asthma were selected and divided into the observation group(43 cases)and the control group(44 cases)by applying the method of randomized numerical table.The control group was given symptomatic treatment including routine anti-infection,bronchodilator,relieving cough and asthma.The observation group was divided into 11 cases in the stasis group,eight cases in the lung excess group and 12 cases in the cold-embracing fire group and 12 cases in the severe cold group according to the traditional Chinese medicine syndrome differentiation and patterns,combined with traditional Chinese medicine syndrome differentiation and treatment on the basis of the treatment of the control group,and the observation group was treated for one month in total.To compare the clinical efficacy of the two groups,the changes of lung function indexes,heart rate,breathing rate and oxygen saturation before and after treatment.Results:The total effective rate of the observation group was[90.70%(39/43)],higher than[72.73%(32/44)]of the control group(P<0.05);the difference had no statistical meaning in the comparisons of total effective rates between the stasis group,lung excess group,cold-embracing fire group and the severe cold group(P<0.05);after the treatment,diffusion capacity of lung carbon monoxide,the residual volume to the total lung volume ratio,forced expiratory volume in the first second to forced vital capacity ratio of the observation group were significantly better than those of the control group(P<0.05);heart rate and respiratory rate improved in both groups after treatment,but the difference was not statistically significant(P>0.05);blood oxygen saturation increased in both groups,and the observation group was higher than the control group(P<0.05).Conclusion:The treatment of severe asthma with TCM syndrome differentiation and treatment combined with inhaled glucocorticoid method can enhance the therapeutic effect,and it has significant effect on patients with severe asthma of different patterns,and it can enhance the lung function and oxygen saturation of patients.