世界中医药

目的:探讨加减三子养亲汤辅助治疗支气管哮喘及对患者肺功能和气道重塑的影响。方法:选取2016年1月至2017年6月新疆医科大学附属中医医院收治的支气管哮喘患者78例，随机分为观察组和对照组，每组39例。2组入院后均给予常规对症支持治疗，观察组同时加用三子养亲汤加减治疗，2组均连续治疗10 d。比较2组临床疗效及治疗前后中医证候积分变化，并比较2组治疗前后肺功能及气道重塑情况的变化，观察治疗期间2组药物不良反应发生情况。结果:治疗后观察组总有效率（89.74%）较对照组（71.79%）高（P<0.05），观察组出院后6个月复发率低于对照组（P<0.05）。治疗后2组鼻塞、咳嗽、咽痒、气急评分均较治疗前降低（P<0.05），且观察组低于对照组（P<0.05）。治疗后2组第1秒用力呼气容积（FEV1），每分钟最大通气量（MVV）较治疗前高，且观察组高于对照组（P<0.05），剩余75%用力肺活量时的呼气流速（FEF75%）、气管内壁厚度（Wai）、气道平滑肌厚度（Wam）及支气管总管壁厚度（Wat）较治疗前低，且观察组低于对照组（P<0.05）。2组不良反应发生率差异无统计学意义（P>0.05）。结论:三子养亲汤加减联合西医治疗支气管哮喘可有效缓解患者临床症状，抑制气道重塑的发生及进展，提高患者肺功能，且复发率低，近远期疗效显著。

English Summary:

To investigate the effects of adjuvant therapy with modified Sanzi Yangqin Decoction on lung function and airway remodeling in patients with bronchial asthma.Methods:A total of 78 patients with bronchial asthma admitted to Affiliated Hospital of Traditional Chinese Medicine of Xinjiang Medical University from January 2016 to June 2017 were selected and randomly divided into observation group and control group,with 39 cases in each group.Both groups received conventional symptomatic supportive treatment after admission.The observation group was treated with modified Sanzi Yangqin Decoction at the same time,and both groups were continuously treated for 10 days.The clinical efficacy and the changes of Traditional Chinese Medicine (TCM) syndrome score of both groups before and after treatment were compared,and the changes of lung function and airway remodeling in both groups were detected and compared,and the adverse reactions were observed during the treatment period.Results:The total effective rate of observation group (89.74%) was higher than that of control group (71.79%) (P<0.05).The recurrence rate of observation group was lower than that of control group after 6 months discharge (P<0.01).After the treatment,the scores of nasal obstruction,cough,itchy throat,shortness of breath in both groups were decreased (P<0.01),and the above indexes of observation group decreased more than those of control group (P<0.05 or P<0.01).The FEV1 and MVV of both groups were increased after treatment,and the scores of observation group increased more than those of control group (P<0.05 or P<0.01).The FEF75%,Wai,Wam,Wat were decreased compared with before the treatment,and the scores in observation group decreased more than those of control group (P<0.05 or P<0.01).There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05).Conclusion:The combination of modified Sanzi Yangqin Decoction and conventional medicine in the treatment of bronchial asthma can effectively relieve the clinical symptoms,inhibit the happening and progress of airway remodeling and improve the pulmonary function of the patients.It has low recurrence rate,and the near and long term effects are significant.

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