小青龍湯霧化吸入配合心理干預治療小兒哮喘的臨床研究

The Clinical Effect of Xiaoqinglong-aerosol Combined with Mental Intervene on Childhood Asthma (Exterior Cold and Interior Water Syndrome)

陳冠岳(Guan-Yue Chen)

《台灣中醫臨床醫學雜誌》 16卷4期 (2010/12) Pp. 258-277

https://doi.org/10.6968/TJCCM.201012.0258

摘要

支氣管哮喘屬祖國醫學“哮證”和“喘證”範疇，是小兒時期常見的呼吸系統疾病，本病常反復發作，遷延難愈。哮喘多屬本虛標實之證，緩解期以正虛爲主，多表現爲肺、脾、腎不足的徵象，宜扶正氣，可用補肺、健脾、益腎之法。發作期以邪實爲主，痰瘀爲患，肺失宣降，且有寒熱之別，宜攻邪爲急，可用化痰通瘀、降氣平喘的方法。現代醫學認爲支氣管哮喘是由嗜酸性粒細胞、肥大細胞和T淋巴細胞等多種炎性細胞引起的氣道慢性炎症。其發病機制十分複雜，涉及了變態反應、炎症、氣道痙攣等一系列病理變化過程，臨床表現爲反復發作的喘息和呼吸困難。中醫學認爲西醫學的支氣管哮喘、喘息性支氣管炎以及其他急性肺部過敏性疾患所致的以哮喘爲主要表現者，可根據哮病來進行辨證論治。哮病是由於宿痰伏肺，遇誘因或感邪引觸，以致痰阻氣道，肺失肅降，氣道攣急所致發作性的痰鳴氣喘疾患。發作時喉中哮鳴有聲，呼吸氣促困難，甚則喘息不能平臥爲主要表現，是內科臨床上的常見病和多發病之一。中藥治療哮喘的作用機理研究涵蓋了氣道慢性炎症的起因、調控及後果等諸多環節，中醫藥重視整體調節，治療本病有潛在優勢，近10年來中醫藥治療支氣管哮喘取得了滿意療效。本研究目的觀察小青龍湯霧化吸入配合心理干預治療兒童哮喘（外寒內飲型）的臨床療效。爲臨床上綜合治療哮喘，提高哮喘患兒心理健康水準，更好的控制哮喘發作提供依據。而研究結果也證明小青龍湯霧化吸入配合心理干預能明顯緩解哮喘（外寒內飲型）兒童的臨床症狀，療效顯著，並且對哮喘患兒兼次症及焦慮症狀的改善明顯優於小青龍合劑，能更好的提高患兒生活品質。

關鍵字

小青龍湯 ； 霧化吸入 ； 心理干預 ； 小兒哮喘

並列摘要

Objective: To observe the clinical effect of Xiaoqinglong-aerosol combined with mental intervene on childhood asthma (exterior cold and interior water syndrome), so as to improve the level of mental health of children with asthma, and to control the outbreak of asthma better.
Methods: 40 children with asthma were randomly divided into two groups: 20 patients in experimental group, 20 patients in control group. The patients in experimental group received Xiaoqinglong-aerosol combined with mental intervene, the patients in control group received only xiaoqinglong mixture treatment. The effect of therapy on emotion and body symptoms were assessed before and after 7 days treatment in both groups.
Results: (1)Before treatment, there were no significant difference between two group in general state of health and symptoms of asthma. (2) Before treatment, there were no significant difference between two group in the score of Conners. There were 13 children's anxiety value、7 children's impulsion value、3 children's study value in experimental group which were higher than reference value; there were 12 children's anxiety value、6 children's impulsion value、2 children's study value in control group which were higher than reference value. (3) After treatment, the effect of therapy in both groups was significance, and the difference had no statistical significance. But the effect of relieving cough and asthma in experiment group were better than that in control group, and the effect of relieving wheezing cough was no significant between experimental group and control group. (4) After treatment, the anxiety value in both groups were decreased, but only the value of experimental group was significantly and the decrease rate in experimental group was larger than that in control group. But the impulsion and study value in both groups had no significantly improvement.
Conclusion: The effect of Xiaoqinglong-aerosol combined with mental intervene on childhood asthma (exterior cold and interior water syndrome) was significantly. And the effect of improving symptoms of asthma and anxiety in experimental group were better than that in control group.

並列關鍵字

Xiaoqinglong Tang ； Aerosol ； Mental Intervene ； Children Bronchial Asthma