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加味射干麻黄汤与常规西医疗法治疗支气管哮喘的随机对照研究
朱唯芳,朱维佳,顾娟,杨宇
0
(同济大学附属上海市肺科医院门诊, 上海 200434
*通信作者)
摘要:
目的 分析加味射干麻黄汤在支气管哮喘中的治疗效果,并对比其与常规西医疗法的疗效差别。方法 采用随机对照试验研究方案,选取54例外寒内饮证支气管哮喘患者,随机分为两组,每组27例。中医治疗组采用加味射干麻黄汤治疗,西医治疗对照组采用常规西医疗法,连续治疗2个疗程。采用观察者盲法设计观测两组患者治疗前和治疗后的中医证候积分、肺功能、昼夜呼气峰流速(PEF)变异率、临床疗效及不良反应并进行比较。结果 中医治疗组患者中医证候积分总分及各项指标积分、昼夜PEF变异率与西医治疗对照组相比均下降,差异有统计学意义(P<0.05);中医治疗组患者1 s用力呼气容积占预计值百分比(FEV1%)、用力肺活量(FVC)、呼气峰流速百分比(PEFR%)与西医治疗对照组相比均升高,而昼夜PEF变异率降低,差异均有统计学意义(P<0.05)。中医治疗组和西医治疗对照组患者的总有效率分别为92.59%(25/27)和74.07%(20/27),差异有统计学意义(P<0.05);中医治疗组及西医治疗对照组患者的不良反应发生率分别为3.70%(1/27)和7.41%(2/27),差异无统计学意义(P>0.05)。结论 加味射干麻黄汤治疗相比常规西医疗法可更有效地改善外寒内饮证支气管哮喘患者的症状及肺功能,同时还可减少昼夜PEF变异率,具有较好的临床推广价值,其药理机制和有效成分值得进一步深入研究。
关键词:  加味射干麻黄汤  哮喘  外寒内饮证  随机对照试验
DOI:10.16781/j.0258-879x.2016.06.0771
投稿时间:2015-09-16修订日期:2016-02-26
基金项目:
Clinical effects of Jiawei Shegan Mahuang decoction vs routine western medicine for bronchial asthma: a randomized controlled trial
ZHU Wei-fang,ZHU Wei-jia,GU Juan,YANG Yu
(Department of Outpatients, Shanghai Pulmonary Hospital, Tongji University, Shanghai 200434, China
*Corresponding author)
Abstract:
Objective To analyze the clinical effect of Jiawei Shegan Mahuang decoction for bronchial asthma and to compare its effect with that of routine western medicine therapy. Methods This was a randomized controlled clinical trial. Fifty-four patients with bronchial asthma (exterior cold and interior rheum pattern) were included and randomly divided into two groups, with 27 cases in each group. Patients in the control group were treated with routine western medicine therapy and the treatment group adopted Jiawei Shegan Mahuang decoction for two consecutive courses. The TCM syndrome integral, lung function, variation rate of peak expiratory flow (PEF), clinical efficacy and adverse reactions before and after treatment were observed and recorded based on an observer-blinding design. Results Compared with the control group, patients in the treatment group had significantly decreased total scores (and scores for each item) of TCM syndrome integral and variation rate of PEF (P<0.05) and significantly increased scores of forced vital capacity (FVC), FVC in one second (FEV1) and peak expiratory flow rate percentage (PEFR%, P<0.05). The total effective rate was 92.59% in the treatment group, which was significantly higher than that in the control group (74.07%, P<0.05). The incidence rate of adverse reactions in the treatment group was similar to that of the control group (3.70% vs 7.41%, P>0.05). Conclusion Jiawei Shegan Mahuang decoction has better clinical effect in improving the symptom and pulmonary function of patients with bronchial asthma (exterior cold and interior rheum pattern) compared with routine western medicine, and it can decrease the variation rate of PEF, indicating a promising clinical future, with its pharmacological mechanism and key components remaining to be further studied.
Key words:  Jiawei Shegan Mahuang prescription  asthma  exterior cold and interior rheum pattern  randomized controlled trial