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目的:观察中医药疗法分期论治小儿咳嗽变异性哮喘(CVA)的临床疗效。方法:将纳入研究的120例患儿随机分为观察组和对照组各60例。对照组使用西替利嗪和雾化治疗。观察组使用中药分期论治,急性发作期以泻白散合定喘汤加减,慢性持续期以沙参麦冬汤加减,临床缓解期以生脉饮合枳术丸加减。观察患儿治疗后临床症状、T淋巴细胞亚群、嗜酸性粒细胞计数(EOS)、血清IgE改变情况。随访6月,统计患儿复发率。结果:观察组临床控制率和总有效率分别为46.67%、88.33%,高于对照组的28.33%、78.33%。2组临床控制率比较,差异有显著性意义(P<0.05),2组总有效率比较,差异无显著性意义(P>0.05)。2组患儿治疗后CD4/CD8比值、EOS和血清IgE均较治疗前降低(P<0.05),以观察组降低更明显,2组CD8均较治疗前升高(P<0.05);治疗后2组CD8、CD4/CD8比值、EOS和IgE分别比较,差异均有显著性意义(P<0.05)。观察组复发率17.86%,对照组复发率76.47%,2组比较,差异有非常显著性意义(P<0.01)。结论:中医分期论治有助于降低CVA患儿的CD4/CD8比值、EOS和血清IgE,提高临床疗效,降低近期复发率。
Objective: To observe the clinical effect of traditional Chinese medicine therapy on children with cough variant asthma (CVA). Methods: 120 children enrolled in the study were randomly divided into observation group and control group of 60 cases. The control group was treated with cetirizine and nebulization. Observation group using traditional Chinese medicine staging theory, acute exacerbation of Xiebai Sanjie Dingchuan addition and subtraction, chronic duration of Sha Shen Mai Maidang addition and subtraction, clinical remission Shengmai Yin together Zhizhu Pills. The clinical symptoms, T lymphocyte subsets, eosinophil count (EOS) and serum IgE were observed in children after treatment. Follow-up in June, statistics of child relapse rate. Results: The clinical control rate and total effective rate in the observation group were 46.67% and 88.33%, respectively, which were higher than those in the control group (28.33% and 78.33%). There was significant difference between the two groups in clinical control rate (P <0.05). There was no significant difference in total effective rate between the two groups (P> 0.05). After treatment, the CD4 / CD8 ratio, EOS and serum IgE in both groups were significantly lower than those before treatment (P <0.05), and the levels of CD8 in the two groups were significantly lower than those before treatment (P <0.05) The differences of CD8, CD4 / CD8 ratio, EOS and IgE between the two groups were significant (P <0.05). The recurrence rate was 17.86% in the observation group and 76.47% in the control group. There was significant difference between the two groups (P <0.01). Conclusion: The staged treatment of Chinese medicine helps to reduce the CD4 / CD8 ratio, EOS and serum IgE in children with CVA, improve the clinical efficacy and reduce the recent recurrence rate.