世界中医药

目的：观察用止嗽散化裁而成的中药治疗风寒犯肺证咳嗽变异性哮喘的临床效果。方法：选取2012年4月至2014年10月于我院就诊的经中医辨证为风寒犯肺证咳嗽变异性哮喘患者104例，将其随机分为对照组和治疗组各52例。对照组给予沙美特罗替卡松粉吸入剂治疗；治疗组则给予止嗽散化裁而成的中药治疗治疗，15 d为1个疗程，连续治疗2个疗程。治疗后观察患者咳嗽、憋闷等主要症状的缓解情况，对证候给予评分，并记录其消失时间，计算有效率；观察肺功能改善情况；检测治疗前后炎性因子C反应蛋白（hs CRP）、肿瘤坏死因子（TNF α）、白细胞介素 8（IL 8）、白细胞介素 13（IL 13）水平变化。结果：患者咳嗽、憋闷症状经治疗后明显缓解，证候积分与治疗前相比降低，治疗组患者的症状更快消失，组间比较有统计学意义（P<0.05）；对照组的有效率为73.1%，与治疗组的有效率90.4%相比明显较低，组间比较有统计学意义（P<0.05）；患者肺功能较治疗前提高，治疗组患者的最大呼气峰流速百分比（PEF%）、用力肺活量（FVC）、第1 s用力呼气容积（FEV1）水平与对照组比升高更明显，组间比较有统计学意义（P<0.05）；2组患者的炎性因子hs CRP、TNF α、IL 8、IL 13水平较治疗前降低，治疗组患者降低幅度较对照组变化更明显，组间比较有统计学意义（P<0.05）。结论：止嗽散化裁而成的中药汤剂能更快缓解风寒犯肺证咳嗽变异性哮喘的临床症状，缩短病程，改善肺功能，疗效突出，抗炎作用显著，值得临床深入推广。

English Summary:

To investigate the clinical efficacy of treating wind cold violating lung syndrome cough variant asthma with Zhisousan decoction. Methods:A total of 104 patients with cough variant asthma were randomly divided into a control group of 52 cases and an observation group of 52 cases. Patients in the control group were treated with salmeterol xinafoate and fluticasone propionate powder for inhalation; while patients in the observation group were treated with zhisousan decoction. The treatment course lasts for 30 days and 15 days as a course. This paper observed the improvement of cough and chest distress symptom, evaluated the main symptom scores, recorded the symptoms disappear time, and calculated the effective clinical treatment. Moreover, The paper focused on observing the changes of lung function, testing the level change of inflammatory cytokines, such as hs CRP, TNF α, IL 8 and IL 13. Results:After treatment, the main clinical symptoms of the patients in both of the two groups, such as cough and chest distress, were improved clearly compared with before. Besides, the symptom scores went down clearly. The patients improvement time of cough and chest distress in the observation group was shorter than that of the control group, and the difference is significant (P<0.05); The efficiency for patients in the control group was 73.1%, which was lower than that of the observation group (90.4%), and the difference is significant (P<0.05). The patients lung function was improved after, and the degree of change in the observation group was more pronounced as well as the level change of PEF%, FVC and FEV1were more obvious than that of the control group, and the difference is significant (P<0.05). The levels of hs CRP, TNF α,IL 8 and IL 13 in two groups went down compared with before, and the degree of change in the observation group was more pronounced, and the difference is significant (P<0.05). Conclusion:Zhisosan Decoction can relieve the clinical symptoms more quickly, shorten the duration of symptoms and improve lung function. The therapy has curative effect and prominent anti inflammatory effects, which is worthy of clinical promotion.

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