宣肺通絡平喘湯合穴位敷貼治療對小兒支氣管哮喘發作期的效果研究

王春華 林潔 尹嫚麗

摘 要 目的：觀察宣肺通絡平喘湯合穴位敷貼治療小兒支氣管哮喘發作期的臨床效果。方法：納入2019年2月至2020年8月就診于上海中醫藥大學附屬市中醫醫院兒科門診的支氣管哮喘急性發作期患兒120例，隨機分為湯藥組、敷貼組和湯藥合敷貼組，每組40例。所有患兒給予霧化吸入硫酸沙丁胺醇溶液聯合布地奈德混懸液基礎治療，湯藥組在此基礎上加用宣肺通絡平喘湯內服，敷貼組加用黃芩咳喘散（院內制劑）穴位敷貼，湯藥合敷貼組為加用湯藥合穴位敷貼治療，療程均為7 d。觀察治療后三組中醫證候積分的變化，評價療效。結果：治療后，三組主癥單項中的咳嗽、咯痰積分間差異有統計學意義（P<0.05），三組次癥各單項積分差異均有統計學意義（P<0.05），三組中醫證候總積分、主癥積分和次癥積分間的差異均有統計學意義（P<0.05）。湯藥組中醫證候總有效率為67.5%（27/40），敷貼組為75.0%（30/40），湯藥合敷貼組為80.0%（32/40），三組總有效率差異具有統計學意義（P<0.05）。三組患兒治療期間均未出現明顯不良反應。結論：在常規西藥基礎治療上加用宣肺通絡平喘湯合穴位敷貼治療小兒支氣管哮喘發作期的效果確切，值得臨床進一步推廣使用。

關鍵詞 支氣管哮喘；宣肺通絡平喘湯；穴位敷貼；發作期

中圖分類號：R47 文獻標志碼：A 文章編號：1006-1533（2022）08-0032-04

引用本文 王春華， 林潔， 尹嫚麗. 宣肺通絡平喘湯合穴位敷貼治療對小兒支氣管哮喘發作期的效果研究[J]. 上海醫藥， 2022， 43（8）： 32-35， 54.

Research of effect of Xuanfei Tongluo Pingchuan decoction combined with acupoint application on children with bronchial asthma in the attack stage

WANG Chunhua， LIN Jie， YIN Manli

（Outpatient Department of Shanghai Traditional Chinese Medicine Hospital， Shanghai 200700， China）

ABSTRACT Objective： To observe the clinical effect of Xuanfei Tongluo Pingchuan decoction combined with acupoint application in the treatment of bronchial asthma in children. Methods： A total of 120 children with bronchial asthma in the acute attack stage who visited the Pediatric Outpatient Department of Shanghai Traditional Chinese Medicine Hospital Affiliated to Shanghai Traditional Chinese Medicine University from February 2019 to August 2020 were included， and randomly divided into a decoction group， an application group and a decoction combined application group with 40 cases in each group. All the children were given aerosol inhalation salbutamol sulfate solution combined with budesonide suspension basic treatment， on this basis， the decoction group additionally took Xuanfei Tongluo Pingchuan decoction for oral administration， the application group was treated with Huangqin Kechuan powder（hospital preparation） acupoint application， and the decoction combined with application group was treated with decoction combined with acupoint application， and the course of treatment was 7 days. The changes of TCM syndrome scores in the three groups after treatment were observed to evaluate the curative effect. Results： After treatment， there were significant differences in the scores of cough and expectoration among the three groups of main symptoms（P<0.05）. There were statistically significant differences in the individual scores of the three groups of secondary symptoms（P<0.05）. The differences among the three groups of TCM syndrome total score， main symptom score and secondary symptom score were statistically significant（P<0.05）. The total effective rate of TCM syndrome in the decoction group was 67.5%（27/40）， that in the application group was 75.0%（30/40）， and that in the decoction combined application group was 80.0% （32/40）， and the difference of total effective rate among the three groups was statistically significant（P<0.05）. There were no obvious adverse reactions in the three groups during the treatment. Conclusion： On the basis of conventional western medicine treatment， the addition of Xuanfei Tongluo Pingchuan decoction and acupoint application in the treatment of children with bronchial asthma during the attack stage is effective， which is worthy of further clinical application.DDC2CF81-50FD-4550-A4DD-F1CA906B31D5

KEY WORDS bronchial asthma； Xuanfei Tongluo Pingchuan decoction； acupoint application； attack stage

哮喘是一種極為普遍的呼吸道疾病，臨床上常出現喘促、陣發性咳嗽、少痰或者無痰等癥狀，易引起氣道變應性以及高反應性[1-2]。冬春、春夏季節交換時容易發作。據相關資料顯示，我國小兒支氣管哮喘的發病率正逐年升高[3]，該病易反復發作且病程長，嚴重影響患兒日常生活，加重患兒家庭經濟負擔[4]。傳統中醫認為此病乃小兒臟腑嬌嫩，肺、脾、腎三臟功能失常，對津液的運化失常，凝液成痰，阻于氣道而發[5]。西醫治療本病主要在于控制急性癥狀，采用的常規止咳平喘藥物不良反應相對較多，家長擔心其副作用，依從性差[6]。……