董偉濤

(魯山縣中醫(yī)院，河南魯山467000）

布地奈德氣霧劑聯(lián)合復(fù)方甘草合劑治療喘息性支氣管炎42例

董偉濤

(魯山縣中醫(yī)院，河南魯山467000）

目的探討布地奈德氣霧劑聯(lián)合復(fù)方甘草合劑治療喘息性支氣管炎的療效。方法喘息性支氣管炎患者84例,隨機(jī)分為兩組。對(duì)照組42例采用鹽酸布地奈德氣霧劑治療，治療組在對(duì)照組的基礎(chǔ)上加用復(fù)方甘草合劑治療，治療7天。治療前后檢測(cè)患者的血黏度。應(yīng)用SPSS17.0軟件，所獲數(shù)據(jù)采用方差分析、t檢驗(yàn)和χ2檢驗(yàn)。結(jié)果兩組顯效率比較，P＜0.05。治療組患者顯效時(shí)間為（5.3±1.7）天，對(duì)照組患者顯效時(shí)間（12.5±2.3）天，兩組顯效時(shí)間比較P＜0.0005。兩組間全血黏度200/s、50/s、5/s,血漿黏度，紅細(xì)胞聚集指數(shù)，纖維蛋白原比較，P均＞0.05。同組治療前后比較，對(duì)照組全血黏度200/s，P＜0.005；纖維蛋白原P＜0.0005；其余P均＞0.05。觀察組全血黏度200/s和纖維蛋白原，P均＜0.0005，有非常顯著性差異；全血黏度50/s，P＜0.05；其余P均＞0.05。兩組治療后全血黏度200/s，P＜0.0005;其余P均＞0.05，無(wú)顯著性差異。結(jié)論布地奈德氣霧劑聯(lián)合復(fù)方甘草合劑治療喘息性支氣管炎具有明顯的療效，值得推廣。

布地奈德/治療應(yīng)用；復(fù)方甘草合劑/治療應(yīng)用；喘息性支氣管炎/治療；布地奈德/投藥和劑量

喘鳴明顯,但無(wú)呼吸困難現(xiàn)象出現(xiàn)，夜晚和清晨咳喘癥狀加劇，類似哮喘[3]。為此，我們自2016年1月—2016年8月間采用布地奈德氣霧劑聯(lián)合復(fù)方甘草合劑對(duì)喘息性支氣管炎進(jìn)行治療，取得了較好的療效?，F(xiàn)報(bào)道如下。

1 臨床資料

1.1 一般資料喘息性支氣管84例，男45例，女39例；隨機(jī)分為兩組。治療組42例，其中男23例，女19例，年齡為27～65歲，平均43.3歲。對(duì)照組42例，其中男22例，女20例，年齡為26～63歲，平均42.5歲。

兩組患者一般資料比較，P＞0.05，無(wú)顯著性差異，具有可比性。患者及家屬均知情同意并簽署知情同意書。

1.2 診斷標(biāo)準(zhǔn)參照中華中醫(yī)藥學(xué)會(huì)2012年出版的《呼吸科常見病診療指南》。

1.3 方法

1.3.1 治療方法對(duì)照組患者給予布地奈德氣霧劑吸入給藥，（200～1600）μ g/d，分成3次使用。治療組患者在對(duì)照組治療基礎(chǔ)上給予：復(fù)方甘草合劑口服，一次.5ml～10ml，一日3次。兩組療程均為7日。

1.3.2 療效標(biāo)準(zhǔn)（1）顯效：患者氣喘，憋悶等臨床癥狀顯著緩解，濕性啰音和喘鳴音基本消失。（2）有效：患者氣喘，憋悶等臨床癥狀有所改善，濕性啰音和喘鳴音逐漸減少。（3）無(wú)效：患者氣喘，憋悶等臨床癥狀無(wú)緩解或加重。

1.4 統(tǒng)計(jì)學(xué)處理應(yīng)用SPSS17.0軟件，所獲數(shù)據(jù)采用方差分析、t檢驗(yàn)和χ2檢驗(yàn)。

2 結(jié)果

2.1 兩組療效比較治療組42例，顯效22例，有效18例，無(wú)效2例，總有效率為95.2％。對(duì)照組42例，顯效10例，有效15例，無(wú)效7例，總有效率為83.3％。

兩組顯效比較，χ2=7.2692，P＜0.05。

2.2 兩組治愈時(shí)間比較治療組患者顯效時(shí)間為（5.3±1.7）天，對(duì)照組患者顯效時(shí)間（12.5±2.3）天，兩組顯效時(shí)間比較，t=11.157,P＜0.0005。

2.3 兩組治療前后血紅細(xì)胞黏度、紅細(xì)胞聚集指數(shù)和纖維蛋白原的比較見表3。

表3 兩組治療前后血紅細(xì)胞粘度、紅細(xì)胞聚集指數(shù)和纖維蛋白原的比較(±s)

表3 兩組治療前后血紅細(xì)胞粘度、紅細(xì)胞聚集指數(shù)和纖維蛋白原的比較(±s)

兩組間全血黏度200/s、50/s、5/s,血漿黏度，紅細(xì)胞聚集指數(shù)，纖維蛋白原比較，t=0.04002～1.1163，P均＞0.05。同組治療前后全血黏度200/s、50/s、5/s,血漿黏度，紅細(xì)胞聚集指數(shù)，纖維蛋白原比較，對(duì)照組全血黏度200/s,t=2.7738，P＜0.005；纖維蛋白原t= 14.265，P＜0.0005；全血黏度50/s、5/s,血漿黏度，紅細(xì)胞聚集指數(shù)比較，t=0.41659～1.1472,P＞0.05。觀察組全血黏度200/s和纖維蛋白原t=9.0343，14.917，P均＜0.0005；全血黏度50/s，t=1.9224,P＜0.05；全血黏度5/s、血漿黏度和紅細(xì)胞聚集指數(shù)比較，t= 0.41659～1.1472,P均＞0.05。兩組治療后全血黏度200/s,t=8.0913，P＜0.0005;全血黏度50/s、5/s,血漿黏度，紅細(xì)胞聚集指數(shù)，纖維蛋白原比較，t=0.22614～1.1094，P＞0.05。

組別n全血黏度全血黏度全血黏度血漿黏度紅細(xì)胞聚集指數(shù)纖維蛋白原200/s(mpa.s）50/s（mpa.s）5/s（mpa.s）（mpa.s）(g/L)對(duì)照組治療前425.01±0.415.91±2.5111.25±4.121.67±0.475.22±2.304.91±0.78治療后424.79±0.315.30±0.6810.31±3.351.62±0.425.01±2.323.12±0.23治療組治療前425.09±0.525.83±2.5711.26±4.091.69±0.515.24±2.284.98±0.81治療后424.26±0.295.18±0.5410.02±3.111.60±0.394.89±2.263.07±0.18

3 討論

喘息性支氣管炎為上呼吸道感染病毒引起，病毒在上呼吸道又成為支氣管炎的致病原，導(dǎo)致感染往下蔓延，導(dǎo)致支氣管管壁的發(fā)炎，黏膜充血水腫、管壁肌肉組織痙攣，支氣管炎癥部位變得狹窄[4]。部分患者因外邪侵入肺部，導(dǎo)致肺部的疏解不徹，患者亂服寒涼收澀的藥品，長(zhǎng)時(shí)間亂用抗生素藥物。邪氣滯留肺部，宣泄不暢，肺氣阻滯，肺失宣發(fā)宿降，氣逆引起咳。咽喉是肺的門戶，是人體和外界氣體交換通道[5]。肺失宣肅，肺不能正常散布津液，聚津成痰，痰阻礙氣道通暢，影響肺氣之升降出入，上逆導(dǎo)致咳。其病機(jī)為肺氣壅遏經(jīng)絡(luò)，氣郁痰阻氣道[6]。布地奈德氣霧劑可以治療哮喘性兼并慢性的支氣管炎癥和支氣管性食物哮喘，復(fù)方甘草合劑鎮(zhèn)咳祛痰、抗過敏、止喘。

采用布地奈德氣霧劑聯(lián)合復(fù)方甘草合劑治療喘息性支氣管炎，對(duì)照組給予布地奈德氣霧劑療，治療組給予布地奈德氣霧劑聯(lián)合復(fù)方甘草合劑治療。兩組血流變學(xué)各指標(biāo)治療前均有一定的變化，治療后均有一定的恢復(fù)，變化較明顯的全血黏度200/s和纖維蛋白原，說明喘息性支氣管炎由于缺氧所致血黏度升高，治療后趨于正常。兩組治療后差異不大，只有全血黏度200/s較明顯。與Vera G等[7]研究報(bào)道的關(guān)于喘息性支氣管炎進(jìn)行治療的血液指標(biāo)基本吻合，臨床療效相符，血液指標(biāo)優(yōu)于Elena AD[8]用報(bào)道的治療前后血紅細(xì)胞粘度、紅細(xì)胞聚集指數(shù)和纖維蛋白原的研究。表明布地奈德氣霧劑聯(lián)合復(fù)方甘草合劑治療喘息性支氣管炎臨床效果顯著。

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Budesonide Aerosol Joint Compound Licorice Mixture to Treat 42 Cases of Asthmatic Bronchitis

Dong Weitao
(Hospital of Traditional Chinese Medicine of Lushan County,Lushan 467000,Henan)

Objective To investigate the budesonide aerosol joint compound licorice mixture curative effect for the treatment of asthmatic bronchitis.Methods 84 cases with asthmatic bronchitis patients,randomly divided into two groups.Control group of 42 patients with budesonide aerosol hydrochloric acid treatment,the treatment group in the con?trol group treated with compound licorice mixture,on the basis of treatment of 7 days.Test before and after treatment in patients with blood viscosity.Application SPSS17.0 software,the data obtained using analysis of variance,t test and χ2test.Results Two groups show efficiency comparison,P＜0.05.Treatment group patients was（5.3±1.7）days were markedly effective,control group patients were（12.5±2.3）days,compared two groups of time had marked effect,P＜0.0005.Whole blood viscosity,200/s between the two groups,50/s,5/s,blood plasma viscosity,erythrocyte aggregation in?dex,fibrinogen,P＞0.05.Group comparison before and after the treatment,control group whole blood viscosity,200/s，P＜0.005.Fibrinogen P＜0.0005,there is a very significant difference.The rest of the P＞0.05.Observation group 200/s whole blood viscosity and fibrinogen 14.917,P＜0.0005,there is a very significant difference.Whole blood viscosity,50/s,P＜0.05,there is significant differ ence.The rest of the P＞0.05.Whole blood viscosity in the two groups after treatment, 200/s，P＜0.0005,there is a very significant difference.The rest of the P＞0.05.Conclusion Budesonide aerosol joint compound licorice mixture in the treatment of asthmatic bronchitis has significant curative effect,is worth promoting.

Budesonide/therapeutic use;Brown mixture/therapeutic use;Asthmatic bronchitis/therapy;Budesonide/ administration＆amp;dosage喘息性支氣管(Asthmatic bronchial)又稱哮喘性支氣管炎，為常見的一種過敏性支氣管疾病[1]。其發(fā)病原因常常為呼吸道感染引起，多數(shù)患者同時(shí)伴有ij濕疹和過敏史，在肥胖者中多發(fā)，患者病程較長(zhǎng)且有反復(fù)的發(fā)作史[2]。臨床表現(xiàn)為上呼吸道感染，患者咳嗽為刺激性的干咳，不咳時(shí)候喉部常常伴有痰鳴音，

R562.25

：A

：1008-4118（2016）04-0038-03

10.3969/j.issn.1008-4118.2016.04.012

2016-11-20