补肺健脾散结法治疗肺脾气虚型儿童腺样体肥大的临床研究

目的观察补肺健脾散结法治疗肺脾气虚型儿童腺样体肥大的临床疗效。方法将肺脾气虚型腺样体肥大的患者72例随机分为治疗组(38人),对照组(34人),治疗组以补肺健脾散结中药配合孟鲁司特钠片、糠酸莫米松鼻用喷雾剂治疗,对照组用孟鲁司特钠片、糠酸莫米松鼻用喷雾剂治疗,共3个疗程,每个疗程为4周。观察治疗前后电子鼻咽镜评分对比,并根据症状积分分析临床疗效。结果治疗组总有效率为91.18%,对照组为83.87%。两组鼻塞、打鼾、张口呼吸、呼吸暂停症状积分治疗后比治疗前减少,两组电子鼻咽镜评分较前相比较明显减少,差异有统计学意义。结论补肺健脾散结法可以明显改善肺脾气虚型儿童腺样体肥大患者临床症状,可提高患儿的生活质量,其疗效优于单纯西药治疗,值得推广。     

冬病夏治穴位敷贴配合火罐治疗变应性鼻炎的疗效观察

目的观察冬病夏治穴位敷贴对变应性鼻炎的疗效。方法于夏季三伏天即每年的7~8月,选择特定的穴位(大椎、双侧肺腧、双侧定喘、天突、膻中)拔罐后再敷贴药物,每周一次,每次敷贴2~8小时,每年五次,共3年为一疗程,观察其对变应性鼻炎患者的临床症状控制情况、体征变化以确定其疗效。结果冬病夏治穴位敷贴配合火罐治疗变应性鼻炎三年后显效为98例(46.7%),有效76例(36.2%),无效36例(17.1%)。结论冬病夏治穴位敷贴配合火罐印证了中医"春夏养阳"理论,对变应性鼻炎的治疗达到满意的疗效。     

鼻渊汤鼻腔冲洗配合西药治疗肺脾气虚型儿童慢性鼻-鼻窦炎的临床观察

目的 观察鼻渊汤鼻腔冲洗配合西医疗法治疗肺脾气虚型儿童慢性鼻-鼻窦炎的临床疗效.方法 肺脾气虚型慢性鼻-鼻窦炎患儿随机分为治疗组和对照组,每组各30例.治疗组在常规西医治疗基础上加用鼻渊汤鼻腔冲洗,对照组在常规西医治疗基础上加用生理盐水鼻腔冲洗,疗程均为4周.分别在治疗前、治疗4周及治疗后12周,采用视觉模拟量表评估其症状,鼻内镜观察评估鼻腔病变情况,糖精法测量鼻黏液纤毛传输速率;治疗前及治疗后12周时采用Lund-Mackay评分法评估鼻窦CT影像,比较两组疗效.结果 虽然两组病例均显示明显疗效,治疗后症状视觉模拟量表评分、鼻内镜评分均明显下降,黏液纤毛传输速率均较治疗前明显加快,但治疗组疗效更优于对照组,差异具有统计学意义(P＜0.05).结论 鼻渊汤鼻腔冲洗对肺脾气虚型儿童慢性鼻-鼻窦炎有辅助治疗意义.     

自拟健脾通窍汤在治疗肺脾气虚型变应性鼻炎患儿中的临床分析

目的分析健脾通窍汤在肺脾气虚型变应性鼻炎中的治疗效果。方法收集本院2019年1月~2020年3月就诊的75例肺脾气虚型变应性鼻炎患儿的临床资料进行回顾性分析,根据患儿采用的治疗方案分对照组(n=38)和观察组(n=37),检测两组血清炎性因子水平[超敏C-反应蛋白(hsCRP)、白介素6(IL-6)、肿瘤坏死因子-α(TNF-α)],观察两组临床疗效。结果治疗后,相较于对照组,观察组hsCRP、IL-6、TNF-α平均水平较低,差异有统计学意义(P<0.05);对照组、观察组治疗总有效率分别为73.68%、91.89%,相较于对照组,观察组治疗总有效率较高,差异有统计学意义(P<0.05)。结论将自拟健脾通窍汤应用于肺脾气虚型变应性鼻炎的治疗当中,有助于改善患儿的炎性反应,疗效显著。     

中医“治未病”之三伏天穴位敷贴治疗常年性变应性鼻炎4200例的疗效观察

目的 观察中医“治未病”之三伏天穴位敷贴治疗常年性变应性鼻炎（PAR）的临床疗效.方法 将近6年就诊于我院的4200例确诊为PAR的患者随机分为治疗组（穴位敷贴）和对照组（西药）各2100例,治疗组采用祛风散寒、宣通鼻窍、补益脾肺、温肾纳气的原则,取穴膏肓、大椎、风门、肺俞、百劳、脾俞、肾俞等.对照组采用特非那丁口服.分别观察两组的近期及远期疗效.结果 治疗组疗效明显优于对照组,治疗组总有效率近期达82.4％;远期达73.3％.对照组总有效率近期达72.9％,远期达44.8％.结论 三伏天穴位敷贴疗效稳定,复发率低且无毒副作用,可有效治疗和预防PAR。     

二仙膏之新用——治疗鼽临床观察

二仙膏由人参、拘杞、鹿角胶、龟板玻、牛鞭、黄芪、黑芝麻、核桃仁等组成,由济宁市中药厂制成膏剂.临床常以之用于气血两亏、各种虚症.我们将其引入鼽的治疗,收获可观.(一)临床资料:随机观察 50例,男29例,女21例,年龄最大65岁,最小13岁,平均36岁,病史最长10年,最短3月,给予二仙膏10ml,一天三次,半月后,观察有效率92%(有效以症状减轻或消失为准).(二)讨论:鼽,祖国医学认为脏腑功能失调,外感风寒,异气之邪侵袭鼻窍所致.以肺、脾、肾虚为主,主在肺,肺脾气虚,水湿泛鼻,肺气虚易受风寒,脾气虚则肺央宣降,肾气亏虚,肺失温煦,气不归元;肾失摄纳,     

基于整体观念变应性鼻炎的中医辨证论治

变应性鼻炎属于中医"鼻鼽"的范畴,鼻鼽的病机以肺、脾、肾三脏虚损为本,风寒异气为标,其中,肺气虚是鼻鼽的终极表现。将变应性鼻炎分为发作期、缓解期进行辨证论治,在发作期按照肺脾气虚、肺经郁热、脾肾亏虚、邪伏少阳的证型论治;在缓解期采取在关键时间节点(冬至、夏至、春分、秋分等)进行干预的方式实现变应性鼻炎的治未病,同时配合针灸、贴敷等外治,并结合饮食、起居、情志等综合调养的方式防治变应性鼻炎。     

变态反应性鼻炎的中医辨型分型与变态反应学…

本文对１０６例变应性鼻炎（鼻鼽）进行了中医辨证分型与变态反应指标的相关性研究，表明肺气虚最多见。６０例，占５５．６％，表现为单纯鼻过敏征象，兼脾气虚型合并中鼻甲息肉样变和鼻息肉的比例较多，肺肾虚型的鼻变态反应病情最重，且多合并支气管哮喘。另外对本文的研究结果进行了扼要的中西医结合临床分析。     

变态反应性鼻炎的中医辨证分型与变态反应学指标的相关性研究

本文对106例变应性鼻炎（鼻鼽）进行了中医辨证分型与变态反应指标的相关性研究，表明肺气虚型最多见，60例，占56.6％，表现为单纯鼻过敏征象；兼脾气虚型合并中鼻甲息肉样变和鼻息肉的比例较多，肺贤虚型的鼻变态反应病情最重，且多合并支气管哮喘．另外对本文的研究结果进行了扼要的中西医结合临床分析．     

三九、三伏天穴位敷贴治疗喉源性咳嗽(禀质特异型)80例疗效观察

目的观察三九、三伏天穴位敷贴治疗喉源性咳嗽(禀质特异型)的临床疗效。方法在三九、三伏天采用选定穴位中药敷贴的方法,治疗喉源性咳嗽(禀质特异型)患者80例,随机分为中药敷贴组40例及安慰剂敷贴组40例。于三九和三伏节气开始10日敷贴一次,共8次为一疗程,治疗结束半年后随访,分析比较治疗前后的疗效。结果中药敷贴组总有效率为81.54%,治疗后主要临床症状改善明显,治疗前后比较有显著性差异(P0.05);安慰剂敷贴组总有效率为50%,治疗后主要临床症状无明显改善,治疗前后比较差异无统计学意义(P0.05)。中药敷贴组与安慰剂组组间比较,有显著性差异(P0.05)。结论三九、三伏天穴位敷贴治疗喉源性咳嗽(禀质特异型)具有较好的临床疗效。且在社区医院开展大大提高其便利性及依从性,值得临床推广。     

Hearing acuity of children with otitis media with effusion

Hearing levels are reported for a cohort of 222 infants (aged 7 to 24 months) and 540 older children (aged 2 to 12 years) with otitis media with effusion (OME). The infants had an average speech awareness threshold of 24.6 dB hearing level (HL). The older group had mean bone conduction thresholds less than 10 dB HL, and air conduction thresholds averaged 27 dB HL; however, acuity was 7 dB less impaired at 2,000 Hz. The mean three-frequency pure tone average and speech reception threshold were 24.5 and 22.7 dB, respectively. Hearing acuity was not significantly related to age or previous duration of OME. The otoscopic observation of an air-fluid level or bubbles was associated with less hearing impairment; however, a predictive relationship between hearing levels and tympanogram characteristics could not be demonstrated.     

腺样体切除加鼓室置管治疗顽固性分泌性中耳炎(附36例报告)

目的探讨腺样体切除加鼓室置管治疗顽固性分泌性中耳炎的效果.方法对36例经保守治疗反复发作的顽固性分泌性中耳炎患儿术前施行了耳部检查、鼻咽侧位片与鼻内窥镜检查,确定腺样体肥大与分泌性中耳炎的关系,然后施行腺样体切除加鼓室置管术,手术后跟踪随访.结果术后经过6个月～3年余的随访,26例在1～6个月听力恢复正常,声阻抗检查鼓室压力在40～80之间;6例听力基本正常,只是某些频率下降了10～20dB;4例遗留轻度的气导听力下降.鼻咽侧位片显示已无肥大腺样体,部分患者鼻咽镜检查示咽鼓管咽口的压迫已经解除.结论腺样体肥大压迫或接近咽鼓管咽口是顽固性分泌性中耳炎的主要原因,鼻内窥镜检查是确定二者是否有关的有效方法.鼓室置管可较快地提高听力,腺样体切除则可防止中耳炎复发.     

Treatment of otitis media with effusion in children with mucopolysaccharidoses

Otitis media with effusion (OME) is a constant finding in children with mucopolysaccharidoses (MPS). Affected children may also present the anaesthetist with a difficult airway. A 7-year retrospective review of the management of OME in individuals with MPS was carried out. Nine patients were identified. All had a number of short-term ventilation tube insertions (one to four, mean two) before a diagnosis of MPS was made. Following diagnosis three required repeated short-term ventilation tubes insertions (two to four, mean three), four had long-term ventilation tube insertions once only. Five children who had residual hearing loss were provided with hearing aids but compliance was poor in two. Once a diagnosis of MPS has been made, a hearing aid, if compliant, or a long-term ventilation tube would be a better option than a short term one in order to minimise the anaesthetic risk. A 'watch and wait' policy is not recommended.     

Middle ear pressures of children with otitis media with effusion

Middle ear (ME) pressures were measured in 30 children with chronic otitis media with effusion (OME) transtubally with the use of a catheter pressure transducer (Mikro-tip, PC-330F). They were found to range from 40 to -185 mm H2O, the average being mildly negative (-54.33 +/- 59.04 mm H2O). About two thirds of these children had pulsating changes of ME pressure; the range of the pressure change was between 10 and 50 mm H2O. The ME pressure tended to be lower in ears with serous effusion than in those with mucoid effusion, but there was no significant difference between them.     

Predictors of outcome in children with otitis media with effusion

Otitis media with effusion (OME) is the commonest cause of hearing impairment in young children. The fluctuating nature of the condition makes identification of those with persistent disease difficult without subjecting each child to a period of ‘watchful waiting’. The aim of this study was to determine if the outcome of this observation period could in any way be predicted. The study involved the retrospective analysis of 517 children, aged 3–15 years (mean 5 years and 4 months) in whom the diagnosis of OME had been established. All children had been subjected to an observation period before a decision on surgery was taken. There was a significant correlation between the degree of hearing loss at presentation and after the period of observation. Sex was not a reliable predictor of outcome, but age less than 4 years and presentation in autumn or winter were associated with a poor audiometric outcome. This study identifies a predictive influence on the resolution of OME for these three factors and points the way for future research aimed at identifying the subgroup of children with OME who would benefit from early surgical intervention.