益气固本法治疗儿童哮喘缓解期疗效观察

目的观察中医益气固本法治疗儿童哮喘缓解期的疗效。方法将60例门诊患儿按简单随机法分为观察组及对照组各30例。观察组口服益气固本法组方的哮喘Ⅱ号治疗,对照组常规依据GINA方案吸入激素进行阶梯治疗,总疗程半年,并在治疗后进行疗效对比。结果疗程结束后观察组总有效率为90%,对照组总有效率为80%,两组比较差异有统计学意义（P〈0.05）。结论益气固本法治疗儿童哮喘缓解期疗效显著。     

健益方治疗儿童哮喘缓解期肺脾气虚证疗效观察

目的评价健益方治疗儿童哮喘缓解期肺脾气虚证的临床疗效。方法 2015年2月至2016年4月上海市东方医院和上海市中医医院儿科收治门诊及住院的哮喘缓解期患儿80例,随机分为对照组和观察组各40例。对照组按GINA方案给予普米克令舒(布地奈德)雾化吸入;观察组用健益方加减治疗;疗程均为6个月。观察并比较两组治疗前后主要症状体征积分变化及临床疗效。结果观察组在控制哮喘发作总有效率为87.5%(35/40),与对照组92.5%(37/40)疗效相当,差异无统计学意义(P0.05);观察组在治疗前后各项主证积分值均有明显改善,明显优于对照组,差异有统计学意义(P0.05)。结论健益方治疗哮喘缓解期肺脾气虚证患儿疗效肯定,值得临床应用推广。     

哮喘补益膏加减联合三伏贴治疗儿童哮喘缓解期临床观察

目的观察哮喘补益膏加减联合三伏贴治疗儿童哮喘缓解期的临床疗效。方法选择2017年8月至2018年6月四川省中医院就诊的哮喘缓解期患儿70例为研究对象,随机分为对照组34例和观察组36例。对照组采用吸入用布地奈德混悬液及口服孟鲁司特钠咀嚼片治疗,观察组采用口服哮喘补益膏加减及三伏贴治疗。疗程3个月。治疗结束后,从哮喘症状控制水平、肺功能、中医症状积分、中医证候疗效、安全性方面对比两种方案的临床疗效。结果治疗结束后观察组脱落6例,对照组脱落4例。两组在哮喘症状控制水平和无喘息症状时间方面比较差异无统计学意义(P>0.05)。在肺功能方面,两组治疗后最大呼气流速峰值均低于治疗前,差异有统计学意义(P<0.05),治疗后两组最大呼气流速峰值比较差异无统计学意义(P>0.05)。观察组治疗后中医症状总积分低于对照组,差异有统计学意义(P<0.05)。观察组治疗后反复感冒次数、自汗、纳差、大便异常中医症状积分低于对照组,差异有统计学意义(P<0.05)。观察组总有效率为96.7%(29/30),显著高于对照组43.3%(13/30),差异有统计学意义(P<0.05)。在哮喘补益膏联合三伏贴对儿童哮喘缓解期肺脾气虚证的治疗期间、治疗结束后患儿均无明显不良反应。结论哮喘补益膏加减联合三伏贴治疗儿童哮喘缓解期的临床疗效效果好且用药安全。     

联合应用六味地黄丸治疗儿童支气管哮喘的疗效观察

目的观察联合应用六味地黄丸治疗儿童支气管哮喘的疗效及安全性。方法 50例儿童支气管哮喘患儿按抽签法随机分为联合应用组和对照组各25例,对照组单用皮质激素吸入治疗,联合应用组应用皮质激素吸入联合六味地黄丸口服治疗。观察两组的疗效及安全性。结果联合应用组最大呼气峰流速为（200.33±28.11）L/s,高于对照组（180.12±20.31）L/s,差异有统计学意义（P〈0.05）。联合应用组治疗1年时哮喘急性发作次数、因哮喘急性发作而住院的次数分别为（0.69±0.62）次、（0.07±0.23）次,均低于对照组（1.34±0.42）次、（0.15±0.32）次,差异均有统计学意义（P〈0.05）;联合应用组呼气流量峰值达正常预计值人数为25人,多于对照组19人,差异有统计学意义（P〈0.05）。结论联合应用六味地黄丸治疗儿童哮喘,其疗效显著优于单纯西医治疗。     

糖皮质激素吸入治疗持续时间对咳嗽变异性哮喘患儿预后的影响

目的探讨咳嗽变异性哮喘患儿使用糖皮质激素吸入治疗的疗程对其疗效及预后的影响。 方法选择2004-02—2005-04就诊于深圳妇幼保健院的84例咳嗽变异性哮喘患儿，应用糖皮质激素吸入治疗，用量250~375μg/d，分2~3次，按应 用激素治疗的疗程随机分为超短期组、半年期组和1年期组等三组，超短期组患儿用药1个月。分别在治疗前后测定患儿最大呼气峰流速(PEF)。 并观察治疗后2年内患儿的复发情况。 结果三组患儿测定的PEF值用药后均较用药前明显改善：超短期组由65.06±8.93上升到90.74±5.43，半年期组由65.68±8.92上升到90.71± 3.60，1年期组由65.91±8.50上升到89.88±5.89(P<0.001)。经治疗后，2年内超短期组复发25例，占71.43%；半年期组复发6例，占22.22%；1 年期组复发2例，占9.09%，组间比较差异具有显著性(P<0.001)。 结论对咳嗽变异性哮喘患儿，应早期规范使用糖皮质激素吸入治疗，疗效明显。坚持长期吸入治疗可以有效降低患儿远期复发率。     

中西医结合治疗儿童支气管哮喘缓解期的临床观察

目的观察中西医结合治疗儿童支气管哮喘(简称哮喘)缓解期的疗效。方法将85例哮喘缓解期患儿随机分成两组,其中对照组43例给予糖皮质激素规律吸入,≤6岁用丙酸氟替卡松吸入气雾剂(辅舒酮);6岁用沙美特罗替卡松粉吸入剂(舒利迭);并按需吸入沙丁胺醇(万托林);有过敏性鼻炎者给予氯雷他定口服。观察组42例在对照组基础上给予自拟中药海参地龙散治疗。治疗后6个月和2年对所有病例临床控制及综合疗效进行比较。结果治疗后6个月观察组临床控制率为52%(22/42),总有效率为93%(39/42),对照组分别为26%(11/43),72%(31/43),两组比较差异均有统计学意义(P0.05);治疗后2年观察组临床控制率为45%(19/42),总有效率为90%(38/42),对照组分别为23%(10/43),67%(29/43),两组比较差异均有统计学意义(P0.05,0.01)。结论中西医结合对儿童哮喘缓解期的治疗效果优于单纯西医治疗,值得临床推广。     

中西医综合干预治疗儿童支气管哮喘80例疗效观察

目的观察中西医综合干预治疗支气管哮喘患儿的疗效。方法将80例哮喘患儿分为两组:对照组42例和观察组38例,前者采用口服阿奇霉素抗感染,吸入糖皮质激素和β2受体激动剂及对症常规治疗。后者除常规治疗外还采用心理干预,传统穴位按摩和中草药治疗。8周后,就有效率、肺功能和心理学指标3个方面进行分析比较。结果观察组临床总有效率94.8%(36/38)高于对照组76.2%(32/42),差异有统计学意义(P0.05)。用力呼出量、呼气峰流速和用力肺活量3项肺功能指标观察组均显著高于对照组,差异有统计学意义(P0.01)。4项心理学指标显示,观察组激惹、抑郁和焦虑自评量表评分值均低于对照组,差异有统计学意义(P0.01)。结论中西医综合干预治疗儿童哮喘疗效优于临床常规治疗。     

布地耐德联合福莫特罗与双倍剂量布地耐德干粉吸入疗法对儿童轻度持续性哮喘的疗效观察

目的观察布地耐德(BUD)联用福莫特罗(FOM)与单用双倍剂量BUD干粉吸入疗法对轻度持续性哮喘患儿的有效性和安全性，探讨儿童轻度持续性哮 喘的理想治疗方案。 方法选取2005-01—2005-06在广州医学院附属第一医院呼研所专科门诊就诊的轻度持续哮喘患儿50例，采取开放、随机、平行对照方法把50例 患儿分为两组，分别吸入BUD联用FOM(B+F组)或双倍剂量BUD(Double B组)8周，药物均用都保干粉吸入装置吸入。8周的观察期内由患儿或家长 记录哮喘日记，包括日间和夜间症状评分、无症状天数、其它平喘药物(包括应急用速效β2-受体激动剂、长效缓释茶碱、口服长效β2-受体激 动剂、全身用糖皮质激素)使用情况，同时以简易峰流速仪监测其呼气峰流速值(PEF)作为主要肺功能指标。 结果B+F组和Double B组在治疗8周后，日间症状及PEF均较治疗前明显改善，无症状天数明显增加，差异具有统计学意义(均P<0.05)；与治疗前 比较，B+F组在治疗8周后夜间症状评分明显下降(P<0.05)，而Double B组治疗前后比较差异无统计学意义(P>0.05)；两组间日间症状评分、夜 间症状评分、无症状天数及PEF治疗前及治疗后比较差异均无统计学意义(均P>0.05)。两组间病情反复发作次数、需联合应用速效β2-受体激动 剂次数及口服强的松、长效缓释茶碱或口服长效β2-受体激动剂的天数均无统计学意义(均P>0.05)。 结论低剂量吸入糖皮质激素(ICS)联用长效β2-受体激动剂(LABA)与单用双倍剂量ICS治疗儿童轻度持续性哮喘的疗效相当。但从减少或避免ICS 潜在的全身性副反应方面考虑，联用低剂量ICS＋LABA可能是更好的选择。     

中西医结合治疗小儿哮喘合并抽动症19例

目的观察中西医结合治疗小儿哮喘合并抽动症的疗效。方法对19例哮喘合并抽动症患儿进行中西医结合治疗(在哮喘发作期吸入激素平喘,缓解期口服中药治疗抽动症、预防哮喘发作)后进行疗效观察。结果哮喘有效率100%(19/19),抽动症有效率89.5%(17/19)。结论吸入激素配合中药口服可控制或减少哮喘发作,减轻症状,且副反应小,停药后不易复发。     

口服维生素AD制剂预防及治疗婴幼儿哮喘

目的：探讨口服维生素AD制剂对婴幼儿哮喘反复发作的防治作用。方法：全部病例均符合婴幼儿哮喘诊断标准。患者随机分为治疗组与对照组，①治疗组在缓解期间给予口服维生素AD软胶囊（商品名：维生素AD软胶囊，江西天海药业有限公司生产，批准文号：国药准字H20065859,其中每粒胶囊中维生素D2含量为500U，维生素A含量为1500U），剂量为一日一次；对照组不给予维生素AD制剂，均按GINA方案给予辅舒酮吸入治疗。②发作期间，在抗感染及支气管舒张剂的应用的基础上，治疗组及对照组均不给予维生素AD制剂。两组均于90天后随访。结果：治疗组有效29例，无效14例，有效率67.4%；对照组有效34例，无效9例，有效率79%。结论：维生素AD有助于预防及治疗婴幼儿哮喘的发作。     

Effect of gestational age and position on peak expiratory flow rate: a longitudinal study

OBJECTIVE: We sought to study the effects of gestational age and maternal position on peak expiratory flow rates. METHODS: Peak expiratory flow rates were measured in the standing, sitting, and supine positions in 38 healthy pregnant women at 4-week intervals starting at less than 10 weeks until delivery and again at 6 weeks postpartum. The highest reading of 3 consecutive peak expiratory flow rate measurements for each encounter and position was used in the analysis. Repeated measures analysis of covariance was performed with subjects, gestational age, position, and gestational age times position as the model effects. Least squares mean peak expiratory flow rates were compared among positions at different gestation ages using Bonferroni-adjusted least significant difference t tests. RESULTS: Peak expiratory flow rate declined significantly throughout gestation in all positions (P < .001) with mean rate of decline of 0.65 L/min per week). The slopes of linear trends were not statistically different between positions (P = .222). However, the rate of decline for the supine position was higher than for standing and sitting positions (0.86 compared with 0.46 and 0.57 L/min per week), respectively. On average, the postpartum peak expiratory flow rate returned to 71.9% of its measurement in early gestation. Nomograms depicting mean and the 5th and 95th percentiles of peak expiratory flow rates were constructed for each position. CONCLUSION: Peak expiratory flow rate measurements are affected by maternal position and advancing gestational age, especially in the supine position. Adjustment of patient's flow rate in relation to gestational age and maternal position is recommended, especially in pregnant women with asthma. LEVEL OF EVIDENCE: III.     

Randomized trial of inhaled beclomethasone dipropionate versus theophylline for moderate asthma during pregnancy

OBJECTIVE: This study was undertaken to compare the efficacy of inhaled beclomethasone dipropionate to oral theophylline for the prevention of asthma exacerbation(s) requiring medical intervention. STUDY DESIGN: A prospective, double-blind, double placebo-controlled randomized clinical trial of pregnant women with moderate asthma was performed. RESULTS: There was no significant difference (P=.554) in the proportion of asthma exacerbations among the 194 women in the beclomethasone cohort (18.0%) versus the 191 in the theophylline cohort (20.4%; risk ratio [RR]=0.9, 95% CI=0.6-1.3). The beclomethasone cohort had significantly lower incidences of discontinuing study medications caused by side effects (RR=0.3, 95% CI=0.1-0.9; P=.016), and proportion of study visits with forced expiratory volume expired in 1 second (FEV1) less than 80% predicted (0.284+/-0.331 vs 0.284+/-0.221, P=.039). There were no significant differences in treatment failure, compliance, or proportion of peak expiratory flow rate less than 80% predicted. There were no significant differences in maternal or perinatal outcomes. CONCLUSION: The treatment of moderate asthma with inhaled beclomethasone versus oral theophylline resulted in similar rates of asthma exacerbations and similar obstetric and perinatal outcomes. These results favor the use of inhaled corticosteroids for moderate asthma during pregnancy because of the improved FEV1 and because theophylline had more side effects and requires serum monitoring.     

学龄前儿童用力肺活量测定的质量控制分析

目的探讨学龄前儿童用力肺活量测定的质量控制标准。 方法2004年4~9月，对深圳地区3~7岁正常儿童343例(男184例，女159例),采用意大利COSMED公司生产的COSMED流量传感仪,参考美国胸科协会可接受曲线标准，通过测定用力肺活量(FVC)、05s用力呼气容积(FEV05)、075s用力呼气容积(FEV075)、1s用力呼气容积(FEV1)以及05ｓ用力呼气容积占用力肺活量比值(FEV05/FVC)、075ｓ用力呼气容积占用力肺活量比值(FEV075/FVC)、1ｓ用力呼气容积占用力肺活量比值(FEV1/FVC)、外推容量(VBE)、外推容量占用力肺活量比值(VBE/FVC)、呼气时间(FET100%)及最佳2次的FVC、FEV075、FEV05、FEV1变异等指标，分析学龄前儿童用力肺活量测定的质量控制标准。 结果279名(813%)儿童能够成功完成测试。平均VBE为(4271±1361)mL，95百分位数为64mL，最大为72mL；VBE/FVC为(393±134)%，95百分位数为636%，最大为926%；52例(186%)VBE/FVC>5%；年龄越小的儿童其VBE/FVC越高；VBE/FVC与身高呈负相关(P<005)。儿童平均呼气时间为(161±052)s，5百分位数为09s，18例(65%)呼气时间<1s。儿童最佳2次的FVC、FEV1、FEV075、FEV05变异均<02L；约631%儿童最佳2次的FEV075的变异<5%；约662%最佳2次的FEV1变异<5%，各变异<01L的百分比为90%~93%。 结论建议对于中国学龄前儿童用力肺活量的质控标准为：曲线起始以VBE为标准，VBE/FVC<65%或VBE<65mL,取最大值；曲线终止以呼气时间≥09s，且呼气相时间容积曲线显示呼气容量出现平台，持续时间≥1s为标准；FEV05及FEV075需在报告中报告；曲线的重复性标准为最佳2次FVC及FEV075的变异<10%或<01L(取最大值)。     

脑性瘫痪患儿合并癫疒间32例临床分析

目的探讨合并癫疒间的脑性瘫痪患儿的临床特点及癫疒间治疗效果。 方法总结1999年10月至2004年5月在西安交通大学第二医院住院的合并癫疒间的脑性瘫痪患儿的癫疒间发生率、临床类型、头颅计算机体层成像(CT)和(或)磁共振成像(MRI)、脑电图等方面的特点以及抗癫疒间治疗效果。 结果139例脑性瘫痪患儿中有32例合并癫疒间，占230%(32/139)；常见的癫疒间类型为强直 阵挛发作12例(375%)和部分性发作6例(188%)；25例(781%)癫疒间首发于1岁前；合并癫疒间脑性瘫痪儿童的头颅影像异常及脑电图异常分别占30例(938%)和27例(844%)；常见的头颅影像异常为脑发育不良11例(367%)、脑积水6例(200%)，余为脑萎缩、缺氧缺血性脑病样改变等13例(433%)；脑电图异常中局灶性和弥漫性所占比例分别为482%(13/27)和518%(14/27)；癫疒间多发生于痉挛性脑性瘫痪中(688%)；813%(26/32)的癫疒间需要2种及2种以上的抗癫疒间药物治疗。 结论脑性瘫痪患儿中癫疒间的发生率较高，其头颅影像学和脑电图分别以脑发育不良和弥漫性背景活动异常伴疒间样波发放为主；脑性瘫痪儿童的癫疒间大多为难治性，需要联合用药治疗。     

Attitudes and reactions of general practitioners and gynecologists to their patients demand for sterilization in the Rennes sanitary district

A survey was done in 1975-1976 in Rennes, France, among gynecologists and urban and rural practitioners, to study their attitudes and reactions toward their patients' requests for female or male sterilization. 88% of them, among whom 94% were gynecologists, had already suggested tubal ligation to a number of patients. Reasons given, especially by 93% of gynecologists, were multiparity and age of mother; strictly medical reasons were also considered. In 1975 physicians had received a total of 101 requests for vasectomy, 50% of which were addressed to only 5 doctors. Most of these patients were referred for the procedure to other doctors outside the Rennes sanitary region. Asked about their use of contraception 68% of doctors stated to use the pill or IUD; 25.3% used a traditional method, and 6.7% of couples had one partner sterilized, against only 2.5% of sterilized patients. Data show that contraception was used more by doctors than by the general population of Rennes, and that female sterilization was done more frequently than male sterilization. Female sterilization was usually performed postabortum, mostly in women with parity over 4 and/or between the ages of 40-45. Most sterilization acceptors belonged to the category of farmers.     

儿童重症支气管哮喘采用联合异丙托溴铵雾化吸入治疗的临床体会

目的：探讨分析采用联合异丙托溴铵雾化吸入治疗儿童重症支气管哮喘的临床效果。方法：选取我院2012年1月至2013年12月收治的120例小儿重症支气管哮喘患者为研究对象,将其随机平均分成两组,各60例。对照组患儿给予常规治疗,观察组患儿在对照组基础上联合异丙托溴铵雾化吸入治疗,观察两组临床治疗效果。结果：观察组患者总有效率为91．7％,显著高于对照组71．7％,差异具有统计学意义（P〈0．05）。结论：采用联合异丙托溴铵雾化吸入治疗儿童重症支气管哮喘的临床效果较显著,能有效提高患儿生活质量,值得临床应用推广。     

中西医结合治疗对支气管哮喘患儿肺功能的影响

目的观察中西医结合治疗对哮喘患儿肺功能的影响。方法2007-07/2009-03门诊及留观的67例患儿随机分为观察组33例和对照组34例,西医药物治疗相同,观察组同时应用中药口服及外敷。采用峰流速仪定期测定峰流速值,观察患儿哮喘发作次数。结果治疗3个月后,观察组的肺功能明显提高,发作次数明显减少,与对照组相比,差异有统计学意义(P0.05)。结论中西医结合治疗较西医单独治疗更能有效提高患儿肺功能,加快哮喘的缓解。     

Health-related quality of life in Taiwanese patients with bronchial asthma.

BACKGROUND AND PURPOSE: Health-related quality of life (HRQOL) is primarily an assessment of how domains of life are affected by health. This study investigated the factors influencing HRQOL of Taiwanese patients with bronchial asthma. METHODS: A cross-sectional study was conducted to assess the factors influencing HRQOL. The sample consisted of 242 outpatients with bronchial asthma. The Chinese language version of the St. George's Respiratory Questionnaire was used to measure HRQOL. Data were analyzed using simple regression and multiple regression. RESULTS: Age, marital status, level of education, asthma severity, peak expiratory flow, and previous hospital admissions were found to be predictors of HRQOL. Gender, duration of disease, and history of emergency visits were not correlated with HRQOL. The variables entered in the HRQOL model accounted for 17.4% of the total variance (adjusted R(2)). The regression coefficients indicated that the mean scores increased 7.68 in patients with moderate to severe disease severity, and increased 7.34 in patients with a history of hospital admissions. The mean scores decreased 7.60 in married patients. CONCLUSION: This study found that marital status, asthma severity, and history of hospital admissions were major predictors of HRQOL in Taiwanese patients with bronchial asthma.     

The effect of yoga on pulmonary function in patients with asthma: A meta-analysis

BackgroundAsthma is one of the most common non-communicable diseases. Yoga with physical postures, breathing exercises, meditation, and relaxation may play an essential role in the complementary management of lower respiratory diseases. The study aimed to evaluate the impact of yoga (posture, breathing exercises, and meditation) on pulmonary function tests, asthma control tests, and health-related quality of adult asthmatic patients.MethodsMEDLINE, PubMed, Embase, Cochrane, Scopus, Google Scholar, ResearchGate, Clinical Key, and Academia electronic search engines were explored to search the relevant literature. The present study included adult asthmatic patients (age −18 and 60 years) with mild to moderate asthma, per GINA (Global Initiative for Asthma) guidelines. The effect of yoga was assessed on the following outcomes; pulmonary function tests, including FeV1 (Forced expiratory volume 1 s), FVC (Forced vital capacity), FeV1/FVC, peak expiratory flow rate (PEFR), health-related quality of life, and asthma control test. A fixed-effect model was applied to compute significance for statistical heterogeneity. P-value <0.05 was considered for statistical significance.ResultsFinally, fifteen articles were included for meta-analysis. The forest plot for overall effect of yoga intervention and usual care favors the yoga intervention for improvement in pulmonary function as FeV1 (SMD = 0.96, CI = 0.77–1.14, I² = 54%), FVC (SMD = 0.35, CI = 0.14–0.55, p = 0.11, I² = 50%), Fev1/FVC (SMD = 0.18, CI = −0.38-0.02, p = 0.02, I² = 50%), PEFR (SMD = 0.38, CI = 0.18–0.58, p = 0.0003, I² = 0%), asthma control test (SMD = 0.16, CI = 0.15–0.48, p = 0.31, I² = 86%) and health-related quality of life (SMD = 0.26, CI = 0.18–0.34, p = 0.02, I² = 51%) of asthmatic patients.ConclusionThis meta-analysis provides a moderate level of evidence regarding yoga as a complementary therapy in managing mild to moderate asthmatic patients. It also adds to the current knowledge of the same.