运脾化痰通窍方治疗小儿鼾症及相应免疫功能变化

doi:10.6040/j.issn.1673-3770.0.2018.307

摘要/Abstract

摘要： 目的探讨姜之炎教授“运脾化痰通窍方”治疗小儿鼾症的临床效果及对免疫功能的影响。方法选择鼾症儿童60例,采用随机数字表法将其分为对照组和观察组各30例,对照组采用手术切除,观察组采用运脾化痰通窍方,疗程为3个月;比较2个组患儿治疗前后扁桃体大小、中医证候积分和临床有效率;免疫功能采用ELISA法检测外周静脉血免疫球蛋白IgA、IgG和IgM水平。结果两个组治疗后扁桃体明显缩小,对照组明显小于观察组(P<0.05),但观察组在正常范围。两组治疗后中医证候积分均明显降低,组间比较差异无统计学意义(P>0.05)。两组有效率比较差异无统计学意义(P>0.05)。对照组、观察组治疗后血清IgA、IgG和IgM水平较治疗前均无变化;治疗后观察组明显高于对照组,差异有统计学意义(P<0.05)。结论 “运脾化痰通窍方”与手术治疗小儿鼾症可取得理想的临床效果,不影响免疫功能,有较好的推广应用价值。

关键词: 运脾化痰通窍方, 手术, 鼾症, 中医证候, 免疫功能

Abstract: Objective To study the clinical effect of activating spleen treatment of nasal prescription on pediatric snoring disease and immune function. Methods Sixty consecutive subjects with pediatric snoring disease were enrolled from May 2016 to December 2017 and divided randomly into control and observation groups, each group comprising of 30 cases. Patients in the control group underwent resective surgery and those in the observation group were administered activating spleen treatment of nasal prescription. The total duration of treatment was 3 months, following which the difference in size of the tonsils were assessed. TCM syndrome scores, the clinical efficacy rate before and after treatment in the two groups, and immunologic parameters including IgA, IgG, and IgM levels in peripheral venous blood were evaluated by ELISA. Results The size of the tonsils was smaller in both groups after treatment with significant reduction in size being observed in the control group(P<0.05). The size of the tonsils was within the normal range in the observation group. Lower post-treatment TCM syndrome scores were observed in the two groups with no statistically significant difference(P>0.05). The efficacy rate was not significantly different between the two groups(P>0.05). Post-treatment, the levels of IgA, IgG, and IgM remained unchanged in the two groups(P>0.05). Conclusion Both treatments, nasal prescription for activation of spleen and resective surgery, can provide comparable clinical effect in cases of pediatric adenoidal hypertrophy with no effect on immune function.

Key words: Yunpi Huatan Tongqiao decoction, Surgery, Snoring disease, TCM syndrome, Immunologic function

中图分类号:

R272

于阅尽,顾静雯,黄卫,李佩,胡华,郝亚楠,樊永将,高轶昳. 运脾化痰通窍方治疗小儿鼾症及相应免疫功能变化[J]. 山东大学耳鼻喉眼学报, 2018, 32(6): 56-59.

YU Yuejin, GU Jingwen, HUANG Wei, LI Pei, HU Hua, HAO Yanan, FAN Yongjiang, GAO Yiyi. Clinical effect of Yunpi Huatan Tongqiao decoction on pediatric snoring disease and immune function[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2018, 32(6): 56-59.

参考文献

[1] 龙朝庆, 颜永毅, 容庆丰.OSA-18 量表评估腺样体肥大儿童生活质量[J].山东大学耳鼻喉眼学报, 2015, 29(3):13-15, 19. LONG Chaoqing, YAN Yongyi, RONG Qingfeng. Assessment of quality of life in children with adenoid hypertrophy by OSA-18 questionnaire[J]. J Otolaryngol Ophthalmol Shandong Univ, 2015, 29(3):13-15, 19.
[2] 高永平, 田从哲, 刘会清, 等.小儿腺样体肥大与分泌性中耳炎[J].中华耳科学杂志, 2014, 12(1):106-108. GAO Yongping, TIAN Congzhe, LIU Huiqing, et al. Pediatric adenoid vegetation and secretory otitis in children [J]. Chin J of Otol, 2014, 12(1): 106-108.
[3] 李旭, 黄群.非手术方法治疗儿童腺样体肥大的临床观察[J].临床耳鼻咽喉头颈外科杂志, 2013, 27(8):432-434. LI Xu, HUANG Qun. Non-surgical treatment for adenoidal hypertrophy[J].J Clin Otorhinolaryngolo Head Neck Surg, 2013, 27(8):432-434.
[4] 段汉忠, 夏力, 卢智慧, 等.鼻用糖皮质激素在腺样体肥大性小儿鼾症中的应用[J].中国临床药理学与治疗学, 2015, 20(9):1052-1054. DUAN Hanzhong, XIA Li, LU Zhihui, et al. Role of intranasal corticosteroid in the treatment of childrens snoring effected by adenoidal hypertrophy[J]. Chin J Clin Pharmacol Therapeu, 2015, 20(9):1052 -1054.
[5] 温鑫, 周永青, 宋英鸾, 等.腺样体切除加鼓膜穿刺耳道正行吹张治疗腺样体肥大并分泌性中耳炎疗效分析[J].听力学及言语疾病杂志, 2018, 26(1):93-95.
[6] 殷明德.小儿扁桃体和腺样体切除术适应证的免疫学基础[J].临床耳鼻咽喉头颈外科杂志, 2010, 24(9):385-391.
[7] 杨周剑, 姜之炎.腺样体肥大的中西医诊治进展[J].世界中西医结合杂志, 2016, 11(2):281-284.
[8] 匡嘉丽, 李健, 陆洋,等.腺样体肥大治疗的前瞻性随机对照研究[J].中山大学学报(医学科学版),2012,33(3):373-377. KUANG Jiali, LI Jian, LU Yang, et al. Treatment of adenoid hypertrophy:a prospective randomized control clinical trial[J]. J Sun Yat-sen Univ(Med Sci), 2012, 33(3): 373-377.
[9] Shen L, Zheng B, Lin Z, et al. Tailoring therapy to improve the treatment of children with obstructive sleep apnea according to grade of adenotonsillar hypertrophy[J]. Int J Pediatr Otorhinolaryngol, 2015, 79(4):493-498.
[10] 姜之炎, 石李.通窍化痰方治疗小儿腺样体肥大 24 例临床观察[J].中国中西医结合儿科学, 2009, 1(5): 485-487. JIANG Zhiyan, SHI Li. Clinical observation on 24 cases of child adenoids treated with Tongqiao Huatan recipe[J]. Chin Pediatr Integr Tradit West Med, 2009, 1(5): 485-487.
[11] 赵爱梅.苍术的药理作用[J].光明中医, 2009, 24(1):181-182.
[12] 韩旭, 高洁, 韩冰冰.中药薏苡仁现代临床研究进展[J].陕西中医, 2014, 35(9):1270-1271.
[13] 王永慧, 叶方, 张秀华.辛夷药理作用和临床应用研究进展[J].中国医药导报, 2012, 9(16):12-14. WANG Yonghui, YE Fang, ZHANG Xiuhua. Research progress in pharmacological effects and clinical application of Flos magnoline[J]. Chin Med Herald, 2012, 9(16):12-14.
[14] 朱旭峰.石菖蒲的研究进展[J].中国民族民间医药, 2013, 22(9):9-10.
[15] 郑勇凤, 王佳婧, 傅超美, 等.黄芩的化学成分与药理作用研究进展[J].中成药, 2016, 38(1):141-147.
[16] 王斌, 陈华.俞景茂教授治疗小儿腺样体肥大验案三则[J].浙江中医药大学学报, 2017, 41(1):59-61. WANG Bin, CHEN Hua. Professor Yu Jingmaos experience in treatment of children adenoid vegetation 3 cases[J].J Zhejiang Chin Med Univ, 2017, 41(1):59-61.
[17] Bitar MA, Dowli A, Mourad M. The effect of tonsillectomy on the immune system: A systematic review and meta-analysis[J]. Int J Pediatr Otorhinolaryngol, 2015, 79(8):1184-1191.

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