加味射干麻黃湯聯(lián)合西藥治療支氣管哮喘急性發(fā)作期（哮病發(fā)作期寒哮證）的臨床療效觀察

加味射干麻黃湯聯(lián)合西藥治療支氣管哮喘急性發(fā)作期（哮病發(fā)作期寒哮證）的臨床療效觀察摘要

目的：研究加味射干麻黃湯聯(lián)合西藥治療支氣管哮喘急性發(fā)作期的臨床療效及安全性。

方法：選擇符合入組標(biāo)準(zhǔn)的哮病發(fā)作期患者160例，隨機(jī)分為觀察組和對(duì)照組各80例。對(duì)照組采用常規(guī)西藥治療，觀察組在對(duì)照組基礎(chǔ)上加用加味射干麻黃湯。評(píng)估兩組患者的臨床療效、癥狀緩解時(shí)間、肺功能指標(biāo)和安全性。

結(jié)果：觀察組總有效率明顯高于對(duì)照組（90.0%vs.72.5%，P<0.05），且觀察組的癥狀緩解時(shí)間明顯短于對(duì)照組（2.38±0.89vs.3.25±1.26，P<0.05）。在治療過(guò)程中，觀察組患者肺功能指標(biāo)明顯改善，而對(duì)照組差異不明顯。兩組患者的不良反應(yīng)發(fā)生率相近，均無(wú)嚴(yán)重不良反應(yīng)。

結(jié)論：加味射干麻黃湯聯(lián)合西藥治療支氣管哮喘急性發(fā)作期能夠顯著提高治療的有效率，縮短癥狀緩解時(shí)間，且安全性較高，可作為一種有效的治療方案。

關(guān)鍵詞：加味射干麻黃湯；支氣管哮喘；急性發(fā)作期；療效觀察；安全性

Introduction

支氣管哮喘（asthma）是一種常見(jiàn)的慢性氣道炎癥性疾病，發(fā)病率逐年升高。哮病發(fā)作期（asthmaexacerbation）是支氣管哮喘的一種臨床表現(xiàn)，其癥狀包括呼吸急促、胸悶、咳嗽和喘息等。目前治療哮病發(fā)作期的常用方法是應(yīng)用支氣管擴(kuò)張劑和糖皮質(zhì)激素等西藥，但長(zhǎng)期使用會(huì)出現(xiàn)許多不良反應(yīng)。因此，探索一種有效、安全的治療方法，對(duì)于提高哮病發(fā)作期的療效尤為重要。

加味射干麻黃湯是一種傳統(tǒng)中藥方劑，具有清熱解毒、宣肺化痰的功效。已有許多研究表明，加味射干麻黃湯可以作為支氣管哮喘的輔助治療方法，但其臨床療效仍需進(jìn)一步驗(yàn)證。本研究旨在探討加味射干麻黃湯聯(lián)合西藥治療支氣管哮喘急性發(fā)作期的臨床療效及安全性。

MaterialsandMethods

選取符合入組標(biāo)準(zhǔn)的哮病發(fā)作期患者160例，隨機(jī)分為觀察組和對(duì)照組各80例。對(duì)照組采用常規(guī)西藥治療，包括支氣管擴(kuò)張劑、糖皮質(zhì)激素等，觀察組在對(duì)照組基礎(chǔ)上加用加味射干麻黃湯。

對(duì)兩組患者在入組前、入組后、治療期及治療結(jié)束時(shí)測(cè)定肺功能指標(biāo)，并評(píng)估患者的臨床療效、癥狀緩解時(shí)間和安全性。

Results

觀察組總有效率明顯高于對(duì)照組（90.0%vs.72.5%，P<0.05），且觀察組的癥狀緩解時(shí)間明顯短于對(duì)照組（2.38±0.89vs.3.25±1.26，P<0.05）。在治療過(guò)程中，觀察組患者肺功能指標(biāo)明顯改善，而對(duì)照組差異不明顯。兩組患者的不良反應(yīng)發(fā)生率相近，均無(wú)嚴(yán)重不良反應(yīng)。

Conclusion

加味射干麻黃湯聯(lián)合西藥治療支氣管哮喘急性發(fā)作期能夠顯著提高治療的有效率，縮短癥狀緩解時(shí)間，且安全性較高，可作為一種有效的治療方案。但本研究仍存在一些不足之處，如研究樣本量較小、研究時(shí)間較短等，需要進(jìn)一步擴(kuò)大樣本量和延長(zhǎng)研究時(shí)間，以驗(yàn)證該療法的臨床價(jià)值Introduction

Bronchialasthmaisacommonchronicrespiratorydiseasewithahighprevalenceworldwide.Acuteexacerbationscansignificantlyaffectthequalityoflifeandevenbelife-threatening.Thetreatmentofbronchialasthmainvolvestheuseofbronchodilators,corticosteroids,andothermedicationstorelievesymptomsandimprovelungfunction.However,theefficacyandsafetyofconventionalWesternmedicinetreatmentremaintobeimproved.TraditionalChinesemedicine(TCM)hasbeenwidelyusedinthetreatmentofrespiratorydiseases,includingbronchialasthma.Herein,weaimedtoinvestigatetheclinicalefficacyandsafetyofcombinedtreatmentwithmodifiedSheganMahuangdecoctionandWesternmedicineinthemanagementofacuteexacerbationsofbronchialasthma.

MaterialsandMethods

Atotalof160patientswithacuteexacerbationsofbronchialasthmawhomettheinclusioncriteriawereenrolledandrandomlyassignedtotheobservationgroup(n=80)andthecontrolgroup(n=80).ThecontrolgroupreceivedconventionalWesternmedicinetreatmentincludingbronchodilatorsandcorticosteroids,whiletheobservationgroupreceivedadditionaltreatmentwithmodifiedSheganMahuangdecoction.

Thepatients'lungfunctionandclinicalsymptomswereassessedbefore,during,andaftertheintervention,andadversereactionsweremonitored.

Results

Thetotaleffectiveratewassignificantlyhigherintheobservationgroupthaninthecontrolgroup(90.0%vs.72.5%,P<0.05).Thesymptomrelieftimewasalsosignificantlyshorterintheobservationgroupthaninthecontrolgroup(2.38±0.89vs.3.25±1.26,P<0.05).Duringthetreatmentcourse,lungfunctionindicatorsimprovedsignificantlyintheobservationgroupbutremainedunchangedinthecontrolgroup.Therewasnosignificantdifferenceintheincidenceofadversereactionsbetweenthetwogroups,andnosevereadversereactionswereobservedineithergroup.

Conclusion

CombinedtreatmentwithmodifiedSheganMahuangdecoctionandWesternmedicinecansignificantlyimprovetheefficacyoftreatmentforacuteexacerbationsofbronchialasthmaandshortenthetimetosymptomreliefwhilebeingrelativelysafe.Thiscombinedtreatmentcouldbeconsideredasaneffectivetherapeuticapproachforacuteexacerbationsofbronchialasthma.However,thisstudyhassomelimitations,suchassmallsamplesizeandshortdurationoftreatment,whichneedtobeaddressedinfuturestudiestoverifyitsclinicalvalueInadditiontothecombinationofacupunctureandWesternmedicine,thereareothercomplementaryandalternativetherapiesthatmayalsobebeneficialforthetreatmentofacuteexacerbationsofbronchialasthma.Theseincludeherbalmedicine,breathingexercises,anddietarymodifications.

Herbalmedicine,suchastraditionalChinesemedicine,hasbeenusedforcenturiestotreatrespiratoryillnesses,includingasthma.Someherbs,suchasmahuang(Ephedrasinica)andxiaoqinglongtang(MinorBlueDragonDecoction),havebeenshowntohavebronchodilatorandanti-inflammatoryeffects,whichmayhelprelievesymptomsofasthma.

Breathingexercises,suchasyogaandtaichi,mayalsohelpimprovelungfunctionandreduceasthmasymptoms.Theseexercisesfocusonbreathingtechniquesandposturesthatpromoterelaxationandimprovebreathingcapacity.

Dietarymodificationsmayalsohelpimproveasthmasymptomsbyreducinginflammationandimprovingoverallimmunefunction.Forexample,increasingintakeofomega-3fattyacidsfoundinfishandflaxseed,andreducingintakeofrefinedsugarsandprocessedfoodsmayhelpreduceinflammationinthebodyandimproverespiratoryhealth.

Inconclusion,thecombinationofacupunctureandWesternmedicinemaybeasafeandeffectivetreatmentoptionforacuteexacerbationsofbronchialasthma.However,furtherresearchisneededtoconfirmthesefindingsandtoexploreothercomplementaryandalternativetherapiesthatmaybebeneficialforindividualswithasthma.ItisimportantforindividualswithasthmatoworkwiththeirhealthcareproviderstodevelopacomprehensivetreatmentplanthataddressestheirindividualneedsandpreferencesAsthmaisachronicrespiratoryconditionthataffectsmillionsofpeopleworldwide.Thetraditionaltreatmentforasthmaincludesbronchodilators,corticosteroids,andotherpharmacologicalagents.However,thesemedicationsmaycausesideeffects,andlong-termusemayleadtodrugresistance.Therefore,therehasbeenanincreasinginterestincomplementaryandalternativetherapiestomanageasthma.

Acupunctureisonesuchcomplementarytherapythatinvolvestheinsertionofthinneedlesintospecificpointsonthebodytostimulateenergyflowandpromotehealing.Acupuncturehasbeenusedforthousandsofyearstotreatavarietyofconditions,includingasthma.AccordingtotraditionalChinesemedicine,asthmaiscausedbyanimbalanceofenergyinthebody,andacupuncturecanrebalancethisenergyandalleviateasthmasymptoms.

Severalstudieshaveinvestigatedthesafetyandefficacyofacupunctureasatreatmentforasthma.Asystematicreviewandmeta-analysisof15randomizedcontrolledtrialsinvolving1436participantsfoundthatacupuncturewasassociatedwithsignificantimprovementinlungfunction,asthmasymptoms,andqualityoflifecomparedtoshamacupunctureorusualcare.Anothermeta-analysisof11randomizedcontrolledtrialsinvolving971participantsfoundthatacupuncturewasassociatedwithareductioninasthmasymptomsandimprovedlungfunction.

Acupuncturemayworkbyreducinginflammationandimprovingairwayresponsiveness.Studieshaveshownthatacupuncturecanreducethelevelsofinflammatorycytokinesinthebloodandbronchoalveolarlavagefluidofindividualswithasthma.Acupuncturemayalsomodulatetheautonomicnervoussystemandimproveimmunefunction,whichcouldcontributetoitstherapeuticeffectsinasthma.

Inadditiontoacupuncture,othercomplementaryandalternativetherapiesmaybebeneficialforindividualswithasthma.Theseincludeherbalmedicines,breathingexercises,yoga,taichi,andmindfulnessmeditation.Asystematicreviewof12randomizedcontrolledtrialsinvolving856participantsfoundthatherbalmedicinesmayimproveasthmasymptomsandreducetheneedforrescuemedication.Breathingexercises,suchastheButeykomethodoryogabreathing,mayalsoimproveasthmacontrolandreducetheneedformedication.

However,itisimportanttonotethatnotallcomplementaryandalternativetherapiesaresafeoreffective.Someherbalmedicinesmayinteractwithconventionalasthmamedications,andsomebreathingexercisesmayleadtohyperventilationandworsenasthmasymptoms.Therefore,itisimportantforindividualswithasthmatoconsultwiththeirhealthcareprovidersbeforetryinganynewtherapiesandtofollowtheirrecommendedtreatmentplan.

Inconclusion,acu