热咳散治疗痰热内蕴型哮喘患儿的临床研究

张琳 何德根 陈慧

摘要 目的：探讨痰热内蕴型哮喘婴幼儿西医常规治疗基础上使用自拟热咳散治疗的临床疗效，为其临床应用提供理论依据。方法：选取2017年3月至2018年9月中山市中医院收治的痰热内蕴型哮喘婴幼儿112例作为研究对象，根据治疗方式的不同分为对照组与观察组，每组56例。对照组采用常规治疗，观察组在对照组基础上加用自配热咳散，比较2组患儿肺功能指标（FEF25%、FEF50%、IgE）;血清生化指标（IL-6、TNF-α、CRP、Cal-3）和C-ACT和MARS-A评分的差异。结果：对照组FEF25%、FEF50%显著低于观察组，对照组IgE含量显著高于观察组，差异均有统计学意义（P<0.05）。2组患儿治疗有效率和治疗效果构成差异有统计学意义（P<0.05）。治疗后观察组IL-6、TNF-α、CRP、Cal-3含量低于对照组，观察组C-ACT评分、MARS-A评分高于对照组，差异均有统计学意义（P<0.05）。结论：相比于西医常规治疗的治疗手段，在其基础上连用自拟热咳散的治疗效果更佳，患者症状改善时间也相对较短。

关键词 哮喘;婴幼儿;痰热内蕴型;自拟热咳散;西医;肺功能;生化指标;儿童哮喘控制测试量表;支气管哮喘用药依从性量表

Abstract Objective：To explore the clinical efficacy of self-made Reke Powder on the basis of routine treatment of infantile asthma with phlegm-heat intrinsic asthma type，and to provide theoretical basis for its clinical application.Methods：From November 2016 to November 2017，a total of 112 infant patients with phlegm-heat intrinsic asthma were selected in Zhongshan Hospital of Traditional Chinese Medicine.According to the different treatment methods，they were divided into 2 groups：a control group and an observation group with 56 cases in each group.The control group was treated with conventional treatment，and the observation group was supplemented with self-made Reke Powder on the basis of the control group.Pulmonary function index （FEF25%，FEF50%，IgE） between the 2 groups were compared.Serum biochemical indexes were compared between the 2 groups.IL-6，TNF-α，CRP，Cal-3，C-ACT and MARS-A scores were also compared between the 2 groups.Results：FEF25%，FEF25% in the control group was significantly lower than that in the observation group.The content of IgE in the control group was significantly higher than that in the observation group and the difference was statistically significant （P<0.05）.After treatment，the content of IL-6 in observation group was lower than that in control group.The C-ACT score of the observation group was higher than that of control group.Conclusion：Compared with the conventional treatment of Western medicine，the combined use of self-made Reke Powder has a better therapeutic effects and a shorter time to improve the symptoms of the patients.

Keywords Asthma; Infants and young children; Phlegm heat intrinsic asthma type; Self-designed Reke Powder; Western medicine; Lung function; Biochemical index; Child asthma control test scale; Bronchial asthma medication compliance scale

中圖分类号：R272;R256.12文献标识码：Adoi：10.3969/j.issn.1673-7202.2020.13.026

哮喘又称支气管哮喘，是临床常见的异质性疾病，其病理机制主要是多因素介导的气道慢性炎症，临床表现主要为呼吸困难、三凹症、气促、胸闷等症状[1-2]。痰热内蕴型是哮喘的一种，其主要是因先天原因或因长期居住气候湿润的地区，饮食好甜等原因所造成的，病理改变主要是气道内炎性物质分泌过多而水分相对较少等，变现为干咳、痰液浓稠泛黄等[3-4]。目前部分医院采用西医常规治疗方式治疗痰热内蕴型哮喘，该治疗方法可以有效改善呼吸道炎性反应程度，因此对患者肺功能等病情有显著改善作用[5]。但是，常规西医治疗的方式由于调节气道炎性反应的程度相对较低，部分患者极易出现呼吸窘迫等不适症或并发症。……