二陈汤加减治疗小儿毛细支气管炎临床疗效观察

目的:研究二陈汤加减(橘红痰咳液)对毛细支气管炎患儿的痰量、咳嗽、咳痰困难、哮鸣音、肺功能的临床疗效。方法:选择200例出生后24个月之内毛细支气管炎儿童患者,根据就诊先后顺序,采用随机数表法分为对照组和治疗组(二陈汤加减组)各100例。两组患儿均给予常规对症治疗,雾化吸入沙丁胺醇。观察组同时给予二陈汤加减(橘红痰咳液)治疗,2～5 mL/次,3次/d,口服。两组疗程均为15 d。观察患儿治疗15 d后的呼吸道症状,记录咳嗽、痰量、咳痰难易程度、肺部哮鸣音等临床表现的评分、疗效及咳嗽、哮鸣音等症状持续时间。治疗15 d后进行肺功能水平检测,记录呼吸频率(RR),每1 kg体质量潮气量(VT/kg),吸呼比(TI/TE),呼气达峰时间(TPTEF),达峰时间比(VPTEF/TE),呼气峰流速(PEF),呼气达峰容积(VPTEF),达峰容积比(PFV),呼出75%潮气量时的呼气流速/呼气峰流速(25/PF),潮气呼气中期流速/潮气吸气中期流速(ME/MI),呼吸系统阻力(Rrs),每1 kg体质量功能残气量(FRC/kg),每1 kg体质量顺应性(Crs/kg)水平。结果:在患儿痰量、咳嗽、咳痰难度、哮鸣音面,两组均得到明显的减轻;气道功能方面,两组均得到明显的提升。在治疗15 d后,治疗组在改善患儿痰量、咳嗽、咳痰困难、哮鸣音方面的疗效均优于对照组(P 0. 05)。治疗组明显缩短患儿咳嗽、哮鸣音持续时间。治疗15 d后,治疗组PFV,25/PF,ME/MI,Crs/kg,Rrs,FRC/kg与对照组比较有明显改善效果(P 0. 05)。结论:在常规治疗基础上,服用二陈汤加减(橘红痰咳液)治疗小儿毛细支气管炎能明显缓解咳痰量、咳痰难度、咳嗽、哮鸣音等临床症状、提高肺功能,提高治疗的有效性,未发生明显不良反应,值得临床推广。

Clinical Efficiency of Modified Erchentang on Children Bronchiolitis

Objective:To observe the clinical efficacy and safety of modified Erchentang (Juhong Tanke liquid) on children bronchitis with syndrome of sputum, cough, dys-expectoration, wheezing and pulmonary function. Method:A total of 200 children patients aged below 24 months were randomly divided into control group and observation group by random number table, with 100 cases in each group. Children in each group received basic clinical treatment, while children in treatment group was also given modified Erchentang (Juhong Tanke liquid), 2-5 mL each time, 3 times a day. Both groups were treated for 15 days. Clinical respiratory tract symptom and sign scores, cough, sputum, dys-expectoration and wheezing were evaluated and compared. Pulmonary function was detected before and after treatment for 15 days. Analysis parameters were respiratory rate (RR), tidal volume per kilogram (VT/kg), inspiratory/expiratory (TI/TE), peak time of expiratory flow (TPTEF), time to peak ratio (TPTEF/TE), peak expiratory flow (PEF), volume in peak time of expiratory flow (VPTEF), volume ratio in peak flow (PFV), terminal flows per peak expiratory flow (25/PF), rate of mid-expiratory to mid-inspiratory flow (ME/MI), respiratory resistance (Rrs), functional residual capacity per kilogram (FRC/kg) and compliance per kilogram (Crs/kg). Result:After treatment for 5 days, both groups have obviously alleviation in sputum, cough, dys-expectoration wheezing and airway function. After treatment for 5 days, sputum, cough, dys-expiratory and wheezing in treatment group were all alleviated comparing with those of control group (P<0.05). What''s more, treatment group had significantly short durations in cough and wheezing. Obvious alleviations were observed in pulmonary function, PFV, 25/PF, ME/MI, Crs/kg, Rrs, FRC/kg in treatment group after treatment for 15 days, with significant differences. Conclusion:Modified Erchentang (Juhong Tanke liquid) has shown marked efficacy in children bronchitis to alleviate clinical symptoms and improve pulmonary function, with no adverse reaction, and thus is worth further promotion and application in clinic.