运脾化痰通窍方联合鼻部按摩治疗儿童腺样体肥大的临床疗效及免疫调节作用
Clinical Effect and Immune Regulation of Yunpi Huatan Tongqiao Decoction Combined with Nasal Massage for Child Adenoid Hypertrophy
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摘要: 目的 探究运脾化痰通窍方联合鼻部按摩治疗儿童腺样体肥大（CAH）的临床疗效及对免疫的调节。方法 选择90例CAH病例，随机分为对照组（辛芩颗粒），中医内治组（运脾化痰通窍方），内外合治组（运脾化痰通窍方加鼻部按摩操），评价运脾化痰通窍方治疗CAH的临床疗效及对免疫的调节作用。结果 临床疗效比较，中医内外合治组、中医内治组、对照组的总有效率为96.7%、90.0%、66.6%；中医证候疗效比较，中医内外合治组、中医内治组、对照组的总有效率为96.7%、93.3%、76.7%，3组临床总疗效、中医证候比较差异有统计学意义（P<0.05~0.01）。内外合治组和中医内治组对鼻塞、打鼾、张口呼吸、睡眠不安、磨牙、注意力不集中、反应迟钝、易感（感冒、支气管炎次数）的改善均优于对照组（P<0.05~0.01）;内外合治组缓解张口呼吸、睡眠不安的疗效优于中医内治组(P<0.01)。3组治疗后组间及治疗前后辅助检查积分（鼻咽侧位片积分）比较，差异有统计学意义（P<0.01），3组治疗前后辅助检查A/N值，差异有统计学意义（P<0.05），内外合治组和中医内治组的改善均优于对照组（P<0.05）。内外合治组和中医内治组治疗前后CD3+、CD8+、CD4+/CD8+比较，具有统计学意义（P<0.01），与对照组比较，P<0.05。结论 运脾化痰通窍方结合鼻部按摩操内外合治，能提高CAH的临床疗效，明显改善患儿的临床症状，同时对细胞免疫具有调节作用。Abstract: OBJECTIVE To study the clinical and immune regulation effects of Yunpi Huatan Tongqiao decoction combined with nasal massage for child adenoid hypertrophy (CAH). METHODS 90 CAH cases were randomly divided into the control group (Xinqin granules)， TCM internal treatment group (Yunpi Huatan Tongqiao Decoction)， and the TCM internal and external combined treatment group (Yunpi Huatan Tongqiao decoction combined with nasal massage). Clinical and immune regulation effects of Yunpi Huatan Tongqiao decoction in the treatment of CAH were evaluated. RESULTS In terms of the curative effect， the total effective rates in the TCM internal and external combined treatment group， TCM internal treatment group and the control group were 96.7%， 90.0% and 66.6%， respectively. In terms of TCM Syndrome curative effect， the total effective rates in the TCM internal and external combined treatment group， TCM internal treatment group and the control group were 96.7%， 93.3% and 76.7%， respectively. There were significant differences among three groups in clinical total effects and TCM syndromes (P<0.05，P<0.01). Improvements of nasal congestion， snoring， mouth-open breathing， sleep uneasiness， molars， impaired concentration， slow reaction and susceptibility (colds and bronchitis frequencies) in the TCM internal and external combined treatment group and the TCM internal treatment group were better than those in the control group (P<0.05， P<0.01). The curative effects of the TCM internal and external combined treatment group in improving mouth-open breathing and sleep uneasiness were better than those of the TCM internal treatment group (P<0.01). There were significant differences in accessory examination scores (nasopharyngeal lateral projection score) among three groups before and after the treatment (P<0.01). There were significant differences in accessory examination A/N values among three groups before and after the treatment (P<0.05)， the TCM internal and external combined treatment group and the TCM internal treatment group were better than that of the control group(P<0.05). There were significant differences in CD3+， CD8+ and CD4+/CD8+ in the TCM internal and external combined treatment group and the TCM internal treatment group before and after the treatment (P<0.01)， and P<0.05， compared with the control group. CONCLUSIONS Yunpi Huatan Tongqiao decoction combined with nasal massage works internally and externally， can improve the clinical effect of CAH， obviously improve the children's clinical symptoms， and also has a regulatory effect on cell immunity at the same time.
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