中药喘敷灵三伏穴位贴敷防治儿童哮喘的临床研究

【作者】 李玉兰；

【导师】 刘昌玉；

【作者基本信息】 湖北中医学院 ， 中西医结合临床儿科， 2003， 硕士

【摘要】 目的 观察中药喘敷灵三伏穴位贴敷对缓解期哮喘儿童非特异性免疫球蛋白巨(IgE)，嗜酸性粒细胞(EOS)，白细胞介素习(IL-4)，干扰素γ(IFN-γ)浓度，体液免疫(IgA、IgG)的影响，探讨中药喘敷灵穴位贴敷防治哮喘的疗效及其可能的作用机制，为临床用药提供理论依据。 方法 选取120例缓解期哮喘患儿，随机分为四组：喘敷灵三伏穴位贴敷组(A组)30例，即分别在头伏、二伏、三伏的第一天穴位贴敷喘敷灵，共三次；西药酮替芬口服预防组(8组)30例，给予酮替芬1mg，每日两次，连服三月；普米克吸入预防组(C组)30例，给予普米克气雾剂吸入，5岁以下加用储雾罐(吸舒)；空白对照组(D组)30例，缓解期不给予任何治疗。四组患儿均于2001年及2002年三伏贴敷前测定IgA、IgG、IgE、EOS、IL-4、IFN-γ水平，比较治疗前后上述指标的变化情况。 结果 1．哮喘缓解期患儿血清体液免疫(IgA、IgG)，喘敷灵三伏贴敷组与空白对照组相比显著提高(P＜0.05)，而两西药治疗组则无此作用(P＞0.05)；2．三治疗组均能显著降低哮喘缓解期患儿异常增高的血清非特异性IgE和EOS(P＜0.01)；3．中药喘敷灵三伏穴位贴敷组在改善患儿临床症状、增高IFN-γ等方面疗效与酮替芬组、普米克+吸舒组相当(P＞0.05)；在降低患儿血清IL-4水平方面，略逊于普米克+吸舒组(P＜0.05)。 结论 1．喘敷灵可调节哮喘儿童免疫状态，增强抵抗力，减少感冒次数和哮喘发作次数，减轻哮喘发作程度。2．喘敷灵可显著抑制嗜酸性粒细胞浸润，减少炎性细胞募集，抑制炎性介质释放，抑制IgE合成，减轻气道炎症反应。4．随着储雾罐(吸舒)的使用，降低了技术上的难度，使糖皮质激素的疗效大大提高，仍是哮喘缓解期治疗的首选方法，但喘敷灵与之疗效接近，且使用经济、简便，值得临床推广应用。更多还原

【Abstract】 ObjectiveTo observe the influence of ChuanFuLing (CFL) by applying on the points (Dingchuan\Felshu\Pishu) on children patients in the asthma remission phase, to research the mechanism of CFL and provide experimental basis for clinical preventing and treating asthma effectively.Methods120 cases in asthma remission phase were randomly divided into 4 groups, and each group had 30 cases: A group was given CFL by applying on the points on dog-days; B group: ketotifen (1mg, Bid to 3 months )was given ;C group : inhaled corticosteroid and at the same time , spacer was given to the patients under 5 years old; D group : nothing was given in remission phase . The concentration of IgA, IgG, IgE, Eos, IL-4, IFN-r in blood were measured respectively before treatment and a year later to observe the change.ResultsThe level of IgA , IgG in most of cases of 4 groups decreased in asthma children .After treatment ,A group turned to higher than that of D group (p<0. 05), but B and C group didn *t show the same effect (p>0. 05) ;2.All the 3 treatment groups remarkably decreased on the level of IgE and Eos , which both were quite high in Asthma patients (p<0. 01); 3. In bettering the symptoms of asthma patients and heightening IFN-y in serum ,A group had the same effect as B and C group (p>0. 05) ;In lowering the level of IL-4, C group had a better effect as to A group (p<0.05).ConclusionThe TCM prescription of CFL applied on the points of the children patients in remission phase can control clinical symptoms of asthma , improve biochemistry indexes , and strengthen immune state . It is proved to be easily operated .economical and practical .更多还原