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[目的]观察辨证分期联合西药治疗支气管哮喘疗效。[方法]使用随机平行对照方法,将94例门诊及住院患者按抛硬币法简单随机分为两组。对照组47例急性发作期:轻度发作予沙丁胺醇,2.4~4.8mg/次,3次/d,口服;酮替酚,1.38mg/次,2次/d,口服;中度发作,0.25g氨茶碱+250m L 50%葡萄糖,1~2次/d,40滴/min,静滴;泼尼松,10mg/次,3次/d,口服;哮喘持续:吸氧,维持水、电解质平衡,0.25g氨茶碱+250m L 50%葡萄糖,1~2次/d,40滴/min,静滴;地塞米松,1~2次/d,10~20mg/次,静注;缓解期:祛除病因、脱敏治疗及加强锻炼。治疗组47例辨证分期:急性发作期-定喘汤(麻黄炙、杏仁、白果、款冬花、蝉蜕各10g,生甘草、黄芩、葶苈子、苏子、白术炒、地龙各15g,桑白皮、瓜蒌、生石膏、黄芪各30g,半夏6g;寒哮去桑白皮、黄芩,加细辛3g、桂枝10g;热哮加生石膏30g;痰湿内盛加白芥子10g,猪牙皂3g;气虚自汗加人参10g;阴虚去麻黄,加沙参30g,麦冬15g);1剂/d,水煎200m L,早晚口服;缓解期-补肺汤(山药、熟地黄、黄芪、白术各15g,防风、紫菀、瓜蒌各12g,桑白皮、苏子、麻黄炙、杏仁各10g,党参30g,甘草6g),1剂/d,水煎200m L,早晚口服;西药治疗同对照组。连续治疗15d为1疗程。观测临床症状、FEV1、PEF、FEV1%、EOS、IgE、不良反应。治疗1疗程,判定疗效。[结果]治疗组临床控制29例,显效11例,有效4例,无效3例,总有效率93.62%。对照组临床控制12例,显效10例,有效15例,无效10例,总有效率78.72%。治疗组疗效优于对照组(P<0.05)。相关指标两组均有改善(P<0.01)。[结论]辨证分期联合西药治疗支气管哮喘疗效满意,无严重不良反应,值得推广。
[Objective] To observe the therapeutic effect of syndrome differentiation and western medicine on bronchial asthma. [Methods] Using randomized parallel control method, 94 outpatients and inpatients were randomly divided into two groups according to the coin-tossing method. The control group of 47 cases of acute exacerbation: mild attack to salbutamol, 2.4 ~ 4.8mg / times, 3 times / d, oral; ketotech, 1.38mg / times, 2 times / d orally; moderate attack, 0.25g Aminophylline + 250 m L 50% glucose, 1 or 2 times / d, 40 drops / min, intravenous infusion; prednisone, 10 mg / time, 3 times / d orally; Asthma continued: oxygen, water, electrolytes 0.25g aminophylline + 250m L 50% glucose, 1 ~ 2 times / d, 40 drops / min, intravenous drip; dexamethasone, 1 ~ 2 times / d, 10 ~ 20mg / times, intravenous; Period: eliminate the cause, desensitization therapy and strengthening exercise. Treatment group, 47 cases of syndrome differentiation stage: acute exacerbation - Dingchuan soup (ephedra sunburn, almonds, ginkgo, flowers, cicada slough each 10g, raw licorice root, Scutellaria baicalensis, Suzi, White skin, melon, plaster, Astragalus each 30g, Pinellia 6g; cold to mulberry white skin, skullcap, asarum 3g, cassia twig 10g; hot gypsum plus gypsum 30g; 1g / d, decoction 200m L, morning and evening oral; remission - Bufei Tang (Chinese yam, Rehmannia, Radix Astragali , Atractylodes each 15g, wind, aster, melon 蒌 each 12g, Morus alba, Suzi, ephedra sunburn, almond 10g, Codonopsis 30g, licorice 6g), 1 / d, decoction 200m L, morning and evening oral; With the control group. Continuous treatment 15d for a course of treatment. Clinical symptoms, FEV1, PEF, FEV1%, EOS, IgE, adverse reactions were observed. Treatment of a course of treatment to determine the efficacy. [Results] In the treatment group, 29 cases were clinically controlled, 11 cases were markedly effective, 4 cases were effective and 3 cases were ineffective. The total effective rate was 93.62%. The control group, clinical control in 12 cases, markedly effective in 10 cases, effective in 15 cases, ineffective in 10 cases, the total effective rate was 78.72%. The treatment group was better than the control group (P <0.05). Related indicators improved in both groups (P <0.01). [Conclusion] Syndrome differentiation staging combined with western medicine is effective in treating bronchial asthma with no serious adverse reactions and is worth promoting.