Question

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目的：应用小青龙加石膏汤治疗小儿哮喘发作期（外寒内热证），观察治疗前后患儿临床症候改善情况，评价小青龙加石膏汤治疗小儿哮喘发作期（外寒内热证）的有效性及安全性，进一步探讨其临床用药规律。
方法：本研究选取60例临床符合小儿哮喘发作期外寒内热证诊断，且年龄在1至14岁的患儿为研究对象，按1:1的比例随机分为治疗组与对照组各30例，治疗组按年龄不同给予不同剂量的小青龙加石膏汤加减口服，对照组按年龄不同给予不同剂量的哮宁口服液口服。根据服药前后两组患儿症状及体征的变化从统计学方面分析并评估临床疗效及安全性。
结果：1. 两组患者综合疗效的比较，试验组总有效率93.3％；对照组总有效率83.3％。两组疗效差异无统计学意义(P＞0.05)。两组患者中医症状疗效的比较，试验组总有效率96.67％，对照组总有效率70.00％，两组比较，试验组疗效优于对照组疗效(P<0.05)。
2.两组患者治疗前后哮喘主要症状体征：两组治疗后哮喘主要症状体征较治疗前均有明显改善（P<0.05）。组间比较显示，有关于减少肺部哮鸣音、减缓喘息方面无显著差异，减轻咳嗽、气促、喉间痰鸣有显著差异，说明小青龙加石膏汤对于缓解咳嗽，减轻喉间痰鸣及气促的症状方面优于对照组，对于平喘的疗效与对照组相当。
3.两组患者治疗前后哮喘各次症比较：两组治疗后，在喷嚏、流涕、口渴、恶寒发热、大便的改善上均有明显疗效（P<0.05），在减轻流涕、恶寒发热，改善大便性状方面治疗组优于对照组。
4.两组患者治疗后哮喘症状积分情况:两组患儿白天和夜间哮喘的症状如喘息、气促、咳嗽、咯痰等与治疗前比较均有明显降低（P＜0.05），说明两者用于控制哮喘症状日常发作均有效。两组治疗后的哮喘症状评分无明显差异（P＞0.05），说明两组在缓解哮喘症状上无明显差异。
5.两组患者在治疗期间未见明显不良事件。
结论：本次临床研究证实了小青龙加石膏汤的平喘、化痰、止咳效果显著，对于小儿支气管哮喘急性发作期（外寒内热证）的治疗效果确定，不良反应率低，具有临床广泛应用及进行深入科学研究的价值。

关键词：小儿哮喘 小青龙加石膏汤 发作期 外寒内热证

Answer 1

目的：应用小青龙加石膏汤治疗小儿哮喘发作期（外寒内热证），观察治疗前后患儿临床症候改善情况，评价小青龙加石膏汤治疗小儿哮喘发作期（外寒内热证）的有效性及安全性，进一步探讨其临床用药规律。
方法：本研究选取60例临床符合小儿哮喘发作期外寒内热证诊断，且年龄在1至14岁的患儿为研究对象，按1:1的比例随机分为治疗组与对照组各30例，治疗组按年龄不同给予不同剂量的小青龙加石膏汤加减口服，对照组按年龄不同给予不同剂量的哮宁口服液口服。根据服药前后两组患儿症状及体征的变化从统计学方面分析并评估临床疗效及安全性。
结果：1. 两组患者综合疗效的比较，试验组总有效率93.3％；对照组总有效率83.3％。两组疗效差异无统计学意义(P＞0.05)。两组患者中医症状疗效的比较，试验组总有效率96.67％，对照组总有效率70.00％，两组比较，试验组疗效优于对照组疗效(P<0.05)。
2.两组患者治疗前后哮喘主要症状体征：两组治疗后哮喘主要症状体征较治疗前均有明显改善（P<0.05）。组间比较显示，有关于减少肺部哮鸣音、减缓喘息方面无显著差异，减轻咳嗽、气促、喉间痰鸣有显著差异，说明小青龙加石膏汤对于缓解咳嗽，减轻喉间痰鸣及气促的症状方面优于对照组，对于平喘的疗效与对照组相当。
3.两组患者治疗前后哮喘各次症比较：两组治疗后，在喷嚏、流涕、口渴、恶寒发热、大便的改善上均有明显疗效（P<0.05），在减轻流涕、恶寒发热，改善大便性状方面治疗组优于对照组。
4.两组患者治疗后哮喘症状积分情况:两组患儿白天和夜间哮喘的症状如喘息、气促、咳嗽、咯痰等与治疗前比较均有明显降低（P＜0.05），说明两者用于控制哮喘症状日常发作均有效。两组治疗后的哮喘症状评分无明显差异（P＞0.05），说明两组在缓解哮喘症状上无明显差异。
5.两组患者在治疗期间未见明显不良事件。
结论：本次临床研究证实了小青龙加石膏汤的平喘、化痰、止咳效果显著，对于小儿支气管哮喘急性发作期（外寒内热证）的治疗效果确定，不良反应率低，具有临床广泛应用及进行深入科学研究的价值。
英文：
Objective : application of small Qinglong Decoction plus gypsum treatment of pediatric asthma ( cold, heat syndrome) were observed before and after treatment in children with clinical symptom improvement, evaluation of small Qinglong Decoction plus gypsum treatment of pediatric asthma ( cold / heat ) the validity and security, further investigate the clinical medication rule.Methods: This study selected 60cases of infantile asthma at attack stage with cold and heat syndrome diagnosis, age 1 to14 years were as the research object, according to the1: 1 ratio were randomly divided into treatment group and control group with 30 cases in each group, the treatment group according to age gives different doses of small Qinglong Decoction plus gypsum oral, controls by age gives different dose Xiaoning liquid oral. According to the two groups before and after medication in children with symptoms and signs of change from the statistics analysis and evaluation of clinical efficacy and safety.Results:1of two groups of patients comprehensive curative effect comparison of experimental group, the total efficiency of 93.3%; control group total effective rate83.3%. The effect of two groups have no significant difference ( P > 0.05). In two groups of patients with symptoms of traditional Chinese medicine curative effect comparison between experimental group, the total efficiency of 96.67%, control group, the total efficiency of 70%, in two groups, experimental group is better than that of control group (P < 0.05) efficacy.2groups of two patients before and after treatment of asthma: two groups of main symptoms and signs after treatment than before treatment of asthma main symptoms were obviously improved ( P < 0.05). Between group comparisons revealed, on the reduction of pulmonary wheeze, slow breathing and no significant difference, relieve a cough, shortness of breath, throat sputum have significant difference, small Qinglong Decoction plus gypsum for relieving cough, reducing the throat sputum wheezing and shortness of breath symptoms than the control group, the curative effect for relieving asthma matched.3groups of two patients before and after treatment of asthma in comparison: the two groups after the treatment, sneezing, runny nose, in thirst, cold and fever, stool improvement has obvious curative effect ( P < 0.05), in reducing the runny nose, cold and fever, improve stool traits in treatment group than in control group.4of two groups of patients after treatment of asthma symptom score : two patients of daytime and nocturnal asthma symptoms such as wheezing, shortness of breath, cough, phlegm, compared with before treatment were obviously decreased ( P < 0.05), the two used to control asthma symptoms daily episodes were effectively. In two groups after the treatment of asthma symptom scores showed no significant difference (P > 0.05), two groups of in relief of asthma symptoms without obvious difference.5groups of two patients during the treatment no significant adverse events.Conclusions: the clinical studies have confirmed the Xiaoqinglong Decoction plus gypsum antiasthmatic, antitussive expectorant, remarkable effect, for children with acute exacerbation of bronchial asthma ( cold heat card ) treatment effect, low rate of adverse reactions, has widespread clinical application and in-depth scientific research value.Key words: pediatric asthma Xiaoqinglong Decoction plus gypsum during episodes of cold heat syndrome .

Answer 2

Objective : application of small Qinglong Decoction plus gypsum treatment of pediatric asthma ( cold, heat syndrome) were observed before and after treatment in children with clinical symptom improvement, evaluation of small Qinglong Decoction plus gypsum treatment of pediatric asthma ( cold / heat ) the validity and security, further investigate the clinical medication rule.Methods: This study selected 60cases of infantile asthma at attack stage with cold and heat syndrome diagnosis, age 1 to14 years were as the research object, according to the1: 1 ratio were randomly divided into treatment group and control group with 30 cases in each group, the treatment group according to age gives different doses of small Qinglong Decoction plus gypsum oral, controls by age gives different dose Xiaoning liquid oral. According to the two groups before and after medication in children with symptoms and signs of change from the statistics analysis and evaluation of clinical efficacy and safety.Results:1of two groups of patients comprehensive curative effect comparison of experimental group, the total efficiency of 93.3%; control group total effective rate83.3%. The effect of two groups have no significant difference ( P > 0.05). In two groups of patients with symptoms of traditional Chinese medicine curative effect comparison between experimental group, the total efficiency of 96.67%, control group, the total efficiency of 70%, in two groups, experimental group is better than that of control group (P < 0.05) efficacy.2groups of two patients before and after treatment of asthma: two groups of main symptoms and signs after treatment than before treatment of asthma main symptoms were obviously improved ( P < 0.05). Between group comparisons revealed, on the reduction of pulmonary wheeze, slow breathing and no significant difference, relieve a cough, shortness of breath, throat sputum have significant difference, small Qinglong Decoction plus gypsum for relieving cough, reducing the throat sputum wheezing and shortness of breath symptoms than the control group, the curative effect for relieving asthma matched.3groups of two patients before and after treatment of asthma in comparison: the two groups after the treatment, sneezing, runny nose, in thirst, cold and fever, stool improvement has obvious curative effect ( P < 0.05), in reducing the runny nose, cold and fever, improve stool traits in treatment group than in control group.4of two groups of patients after treatment of asthma symptom score : two patients of daytime and nocturnal asthma symptoms such as wheezing, shortness of breath, cough, phlegm, compared with before treatment were obviously decreased ( P < 0.05), the two used to control asthma symptoms daily episodes were effectively. In two groups after the treatment of asthma symptom scores showed no significant difference (P > 0.05), two groups of in relief of asthma symptoms without obvious difference.5groups of two patients during the treatment no significant adverse events.Conclusions: the clinical studies have confirmed the Xiaoqinglong Decoction plus gypsum antiasthmatic, antitussive expectorant, remarkable effect, for children with acute exacerbation of bronchial asthma ( cold heat card ) treatment effect, low rate of adverse reactions, has widespread clinical application and in-depth scientific research value.Key words: pediatric asthma Xiaoqinglong Decoction plus gypsum during episodes of cold heat syndrome