培元生金通窍汤联合西药治疗儿童支气管哮喘合并变应性鼻炎疗效观察

Effect of Peiyuanshengjintongqiao decoction combined with western medicine in treatment of children with bronchial asthma complicated with allergic rhinitis

目的观察培元生金通窍汤联合西药治疗儿童支气管哮喘合并变应性鼻炎的临床疗效。方法选取2014年6月至2016年1月佛山市中医院儿科收治的支气管哮喘合并变应性鼻炎患儿60例,采用随机数字生成器将患儿分为对照组和观察组,每组30例。对照组给予布地奈德福莫特罗粉吸入剂和吸入用硫酸沙丁胺醇治疗,观察组在对照组的治疗基础上给予培元生金通窍汤治疗。观察两组患儿治疗前后的主要临床表现和中医症候评分的改善情况;计算喘息发作天数、喘息发作时吸入硫酸沙丁胺醇的平均次数;超声肺功能仪、峰流速仪检查第一秒用力呼气容积与用力肺活量的比值(FEV1%)以及呼气峰流速值(PEF)。结果观察组患儿的治疗总有效率为93.33%,明显高于对照组的73.33%,两组比较差异有统计学意义(P<0.03);对照组与观察组患儿的喘息发作次数[(4.21±1.65)次vs(2.16±1.12)次]与天数[(14.74±5.79)d vs(8.60±4.01)d]比较,对照组均明显多于观察组,差异均有统计学意义(P<0.03);对照组与观察组患儿的硫酸沙丁胺醇使用次数[(8.33±3.16)次vs(4.20±2.57)次]和天数[(6.10±3.22)d vs(4.38±1.50)d]比较,对照组均明显多于观察组,差异均有统计学意义(P<0.03);治疗后,观察组患儿的FEV1%[(84.82±4.50)%]明显高于对照组[(79.44±3.99)%],差异有统计学意义(P=0.03)。观察组患者治疗后PEF[(360.88±30.17)L/min]也明显高于对照组[(343.57±27.14)L/min],差异有统计学意义(P=0.03)。结论培元生金通窍汤联合西药能够缓解支气管哮喘合并变应性鼻炎患儿的临床症状和体征,减少喘息发作天数,具有肺、鼻同治的作用,从而提高支气管哮喘合并变应性鼻炎的防治效果。

Objective To investigate the clinical effect of Peiyuanshengjintongqiao decoction in treatment of children with bronchial asthma complicated with allergic rhinitis. Methods A total of 60 children with bronchial asthma complicated with allergic rhinitis who treated in Department of Pediatrics in Foshan Hospital of Traditional Chinese Medicine from June 2014 to January 2016 were selected. All the children were divided into control group and observation group based on the random number generator, with 30 cases in each group. The control group was treated with Budesonide and Formoterol Fumarate Powder for Inhalation and salbutamol sulfate, and the observation group was given the Peiyuanshengjintongqiao decoction based on the control group. The clinical manifestations and traditional Chinese medicine(TCM) syndrome scores were observed between the two groups before and after treatment. Meanwhile,days of acute exacerbation of asthma and average number of inhalation of salbutamol sulfate during the wheezing attack were calculated. Ratio of forced expiratory volume in 1 second and forced vital capacity(FEV1%) and peak expiratory flow(PEF) were tested by the ultrasonic lung function instrument and peak flow meter. Results The total effective rate in observation group was 93.33%, which was higher than that in control group of 73.33%, and the difference between the two groups was statistically significant(P<0.05). The attack times and days of breathing in control group were significantly higher than those in observation group,(4.21±1.65) vs(2.16±1.12),(14.74±5.79) vs(8.60±4.01), and the differences were statistically significant(P<0.05). The using times and days of salbutamol sulfate in control group were significantly higher than those in observation group,(8.33±3.16) vs(4.20±2.57),(6.10±3.22) vs(4.38±1.50), and the differences were statistically significant(P<0.05). After treatment, FEV1% in observation group were significantly higher than that in control group,(84.82 ± 4.50)% vs(79.44 ± 3.99)%, and the difference was statistically significant(P=0.00).PEF of observation group after treatment was significantly higher than that in control group,(360.88±30.17) L/min vs(343.57±27.14) L/min, and the difference was statistically significant(P=0.03). Conclusion Peiyuanshengjintongqiao decoction combined with western medicine could relieve the clinical signs and symptoms of bronchial asthma complicated with allergic rhinitis, and decrease the exacerbation times. It has the role of treating lung and nose simultaneously, so as to improve the control effect of bronchial asthma complicated with allergic rhinitis.