| The Bronchial asthma is a common and frequent airway inflammatory disease, which involved by eosinophils, mast cells, T cells, its cytokines and airway inflammatory mediators, etc. According to not complete count, about 1 billion people around the world Suffer from asthma, at least 1-2 million in china, incidence is 1%-5% in our county. The Pathological feature of bronchial asthma is repeated attacks and progressive heavier, so that patient's physical and mental health, survival quality cause serious threats. they become the important family and social economic burden. so acute episode treatments for clinical research is imperative.TCM (traditional Chinese medicine) treatment method normalization, standardization is the premise of clinical promotion, which also play an important guarantee of TCM curative effect advantage. At present in the clinical literature reports for the treatment of asthma, people think little of treating the bronchial asthma by stages and parts. "Asthma acute episode treatments clinical research" is the national 11th five-year plan, which involved in re xiao, leng xiao two syndrome clinical research in xiyuan hospital.By this paper, We summary the clinical study of Using chuan sou pian (ding chuan tang jia jian treatment in heavily bronchus asthma attack period in department of respiratory medicine of xiyuan hospital, objective to evaluate the clinical treatment of asthma attack period effect by using chuan sou pian (ding chuan tang jia jian), from clinical symptoms and signs, pulmonary function, immune index three aspects elucidate the advantage, and provides the basis for establishing a asthma attack period of TCM treatment scheme standard.Objective:In disease outcome, total score of TCM symptoms, single TCM symptom scores, pulmonary function, day PEF mutation rate aspect, beta 2 agonist used times and immune index aspect, we evaluate the clinical treatment of asthma attack period effect by using chuan sou pian (ding chuan tang jia jian), from clinical symptoms and signs, pulmonary function, immune index three aspects.Methods:According to in 2008 the diagnostic criteria of bronchial asthma and diagnostic criteria of TCM syndrome, by in net using randomized test methods, patients were divided into two groups of TCM observation group and western medicine treatment control group, the ratio of the observation group and the control group is 1:1.Chinese medicine treatment group (observation group)took chuan sou ning pian, western medicine group (control group) received ICS(200μg, bid) and theophylline (0.2g, bid). The observing time of two groups of treatment were 10±3 days. Symptoms and signs were measured, pulmonary function,day PEF mutation rate beta 2 agonist used times and immune index are detected, before and after treatment.Statistical analysis:The results were analyzed by SPSS17.0 statistical software, it was considered statistically significant when the value of p was less than 0.05. (1) The patients who has meet the inclusion criteria and the qualified patients who has completed the treatment program were classified to PP set, passing off cases and evaluation of cases can be classified as ITT set. (2) Comprehensive efficacy of disease were analysed by ITT and PP set, the efficacy evaluation of symptoms were analysed by PP set. (3) Data analysis:counting data with x2 test, measurement data with the t test, analysis of variance, mean±standard deviation (x±S), level data with the rank sum test, X2CMH test.Results:(1)Two groups of patients in the gender, age, duration, illness, is comparable, which P value by statistical analysis, are larger than 0.05, no significant.(2)Disease outcome:the treatment group in integrated clinical control 9 cases were,8 cases were powerfully,3 cases were effective, with the significant rate-control of 73.9%). The control group in clinical control 7 cases were,4 cases were powerfully,9 cases were effective, with the significant rate-control of 47.8%. Statistical analysis that two groups are uncomparable (P>0.05). In addition, according to standard outcome syndromes, two groups after treatment, in the treatment group there is 1 case in clinical cure,10 cases were powerfully,11 cases were effective, and 1 case is ineffective, with the total effective rate of 95.7%.. The control group 2 cases got clinical cure,10 cases were powerfully,9 cases were effective,2 cases were ineffective, with the total effective rate of 91.3%. The observation group total effectiveness is higher than those in the control group. Through the rank and inspection, two group are no significant difference between curative effect (P> 0.05)(3)Total score:TCM symptoms within two groups both are in significant difference, namely after treatment, the two groups of patients were significantly relieve in symptoms earlier. there is no significant difference between two groups.(4)Single TCM symptom scores:Compared before and after the treatment, The two groups were significantly different (P< 0.05). there is no significantdifference between two groups (P> 0.05).(5)Wheezing:Compared before and after the treatment, The two groups were significantly different (P<0.05). wheezing of broncihiolitis in both groups were significantly less than before. there is no significantdifference between two groups (P >0.05).(6)Pulmonary function assessment:Compared the FEV1%, FEV1 and FVC, PEFR% between groups, there are significant difference (P< 0.05), namely the observation group are significantly better than control group in improving lung function. In FEV1%, FEV1, FVC aspect compared before and after the treatment, there is significant difference between two groups (P< 0.05). In PEFR% aspect the control group is no significant difference (P>0.05), the observation group is statistically significant (P<0.05).(7)Day PEF mutation rate:there is no significantdifference between two groups (P>0.05). Compared before and after the treatment, there is significant difference (P<0.05) in the observation group, the control group is no significant difference (P > 0.05).(8)Beta 2 agonist used times during treatment:there is no significantdifference between two groups (P>0.05).(9)Immune index:In IL-8, ECP, EOS count aspect, there are no significant difference between two groups (P> 0.05). compared before and after the treatment, there are no significant difference between two groups (P> 0.05).(10)Adverse reaction:3 cases in control group appears pharyngeal discomfort, we considered that ICS cause this local irritation. Taking after An Cha Jian,1 patients was unwell in stomach, we Commanded him after meals. The observation group did not see adverse reactions.Conclusion:In disease outcome, total score of TCM symptoms, single TCM symptom scores, Pulmonary function, day PEF mutation rate aspect, the curative effect of the observation group was significant, meanwhile, the observation group are significantly better than control group in improving lung function. In immune index and beta 2 agonist used times aspect, there are no significant difference between two groups. |
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