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目的:观察三伏灸配合肠内营养治疗儿童咳嗽变异性哮喘(cough variant asthma,CVA)的临床疗效,并探讨其作用机制。方法:采用随机、单盲、平行对照的原则将符合纳入标准的138例CVA患儿分为观察组、三伏灸组和肠内营养组,每组46例。三伏灸组给与三伏灸治疗,肠内营养组给与肠内营养治疗,观察组给与三伏灸配合肠内营养治疗。治疗1个疗程后进行疗效评定。结果:观察组治愈率50.0%,总有效率为98.0%;三伏灸组治愈率为23.9%,总有效率为91.3%;肠内营养组治愈率为13.0%,总有效率为78.6%;观察组均明显优于其他两组,差异均有统计学意义(均P<0.05)。在症状总积分、最大呼气流量(peak expiratory flow,PEF)、一秒用力呼气容积(forced expiratory volume in one second,FEV1)、CD3~+、CD4~+、CD4~+/CD8~+和CD8~+、血红蛋白(hemoglobin,Hb)、血清总蛋白(total protein,TP)、清蛋白(albumin,ALB)、嗜酸细胞阳离子蛋白(eosinophil cationic protein,ECP)、过氧化脂质(lipid peroxide,LPO)、白三烯(leukotriene,LT)、体质量、肱三头肌皮皱厚度和上臂肌围上,观察组均优于其他两组,差异均有统计学意义(均P<0.05)。结论:三伏灸配合肠内营养能明显改善小儿CVA患者的肺功能和临床症状,可能通过调节细胞免疫,提高患者的Hb、TP、ALB、体质量、肱三头肌皮皱厚度和上臂肌围等营养状况,抑制ECP、LPO和LT的分泌等机制发挥治疗作用。
Objective: To observe the clinical curative effect of three-point moxibustion combined with enteral nutrition on children with cough variant asthma (CVA) and to explore its mechanism. Methods: One hundred and thirty-eight children with CVA meeting the inclusion criteria were randomly divided into observation group, three-volts moxibustion group and enteral nutrition group with 46 cases in each group. The three-point moxibustion group was given three-point moxibustion treatment, the enteral nutrition group was given enteral nutrition treatment, and the observation group was given three-point moxibustion combined with enteral nutrition treatment. After a course of treatment efficacy evaluation. Results: The cure rate was 50.0% in the observation group and the total effective rate was 98.0%. The cure rate in the moxibustion moxibustion group was 23.9% and the total effective rate was 91.3%. The cure rate in the enteral nutrition group was 13.0% and the total effective rate was 78.6% Group were significantly better than the other two groups, the differences were statistically significant (P <0.05). Total symptom scores, peak expiratory flow (PEF), forced expiratory volume in one second (FEV1), CD3 +, CD4 +, CD4 + / CD8 + and CD8 +, hemoglobin (Hb), total protein (TP), albumin (ALB), eosinophil cationic protein (ECP), lipid peroxide LPO), leukotriene (LT), body weight, triceps skin fold thickness and upper arm muscle circumference. The observation group were superior to the other two groups (all P <0.05). Conclusion: Sanwei moxibustion combined with enteral nutrition can significantly improve pulmonary function and clinical symptoms in pediatric patients with CVA, may improve the Hb, TP, ALB, body mass, triceps skin fold thickness and upper arm muscle circumference And other nutritional status, inhibition of ECP, LPO and LT secretion mechanism to play a therapeutic role.