Article(id=1322926973303005998, tenantId=1146029695717560320, journalId=1255847919539208197, issueId=1322926740955341011, articleNumber=null, orderNo=null, doi=10.13193/j.issn.1673-7717.2025.10.043, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=null, receivedDateStr=null, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1793339969230, onlineDateStr=2026-10-30, pubDate=1760025600000, pubDateStr=2025-10-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793339969230, onlineIssueDateStr=2026-10-30, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793339969230, creator=13701087609, updateTime=1793339969230, updator=13701087609, issue=Issue{id=1322926740955341011, tenantId=1146029695717560320, journalId=1255847919539208197, year='2025', volume='43', issue='10', pageStart='1', pageEnd='258', issueExtLink='null', onlineDate='null', pubDate='1760025600000', pubDateStr='2025-10-10', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=0, createTime=1793339913834, creator='13701087609', updateTime=1793340753123, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1322930261259846420, tenantId=1146029695717560320, journalId=1255847919539208197, issueId=1322926740955341011, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1322930261259846421, tenantId=1146029695717560320, journalId=1255847919539208197, issueId=1322926740955341011, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=228, endPage=231, ext={EN=ArticleExt(id=1322926973504332591, articleId=1322926973303005998, tenantId=1146029695717560320, journalId=1255847919539208197, language=EN, title=Clinical Effect of Yiqi Jianpi Decoction(益气健脾方)in Treatment of Adenoid Hypertrophy in Children, columnId=1256183365644968140, journalTitle=Chinese Archives of Traditional Chinese Medicine, columnName=Platform of Provincial Project, runingTitle=null, highlight=null, articleAbstract=
Objective

To observe the clinical effect of Yiqi Jianpi Decoction(益气健脾方)in the treatment of spleen deficiency and phlegm obstruction type of children with adenoid hypertrophy(AH).

Methods

From September 2022 to September 2023,70 children with spleen deficiency and phlegm obstruction type of AH treated in the hospital were selected and divided into Western medicine group and comprehensive group,with 35 cases in each,using a computer-generated random number table method.The western medicine group was treated with mometasone furoate nasal spray and montelukast sodium chewable tablets,while the comprehensive group was additionally treated with Yiqi Jianpi Decoction.The two groups were compared in terms of TCM syndrome integral,adenoid grading,treatment effects,quality of life and adverse reactions.

Results

After treatment,the scores for snoring,nasal congestion,mouth breathing,apnea,pale complexion,loss of appetite and loose stool as well as the total scores were reduced in both groups(P<0.05),with the comprehensive group showing greater reduction than the western medicine group(P<0.05).The proportion of grade1 adenoid grading in the comprehensive group increased compared to that in the western medicine group(P<0.05),while the proportion of grade 2 decreased(P<0.05).The distribution of treatment effect grades and the overall effectiveness rate were higher in the comprehensive group than those in the western medicine group(P<0.05).After treatment,the scores for sleep disturbance,physical symptoms,emotional symptoms,daytime function and impact on caregivers as well as total scores were reduced in both groups(P<0.05),with the comprehensive group showing greater reduction than the western medicine group(P<0.05).There were no significant adverse reactions in either group,with one case of mild diarrhea in the comprehensive group that improved without treatment.

Conclusion

Yiqi Jianpi Decoction can alleviate symptoms of spleen deficiency and phlegm obstruction type of AH in children,improve the treatment effects and quality of life,and is highly safe.

, authors=Long YE, Fang FANG, Xiaofen QIU, authorsList=Long YE, Fang FANG, Xiaofen QIU, authorCompany=null, correspAuthors=null, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1322926974410302262, articleId=1322926973303005998, tenantId=1146029695717560320, journalId=1255847919539208197, language=CN, title=益气健脾方治疗儿童腺样体肥大的临床效果观察, columnId=1256183369033965799, journalTitle=中华中医药学刊, columnName=省级项目平台, runingTitle=null, highlight=null, articleAbstract=
目的

观察益气健脾方治疗儿童脾虚痰阻型腺样体肥大(adenoid hypertrophy,AH)的临床效果。

方法

选取2022年9月—2023年9月医院收治的脾虚痰阻型AH患儿70例,经计算机随机数字生成表法分为西药组、综合组,各35例。西药组采用糠酸莫米松鼻喷雾剂、孟鲁司特钠咀嚼片治疗,综合组另采用益气健脾方治疗。比较两组中医证候积分、腺样体分级、治疗效果、生活质量及不良反应。

结果

治疗后两组打鼾、鼻塞、张口呼吸、呼吸暂停、面色萎黄、食欲不振、大便溏泄积分及总分均较治疗前降低(P<0.05),综合组均较西药组降低(P<0.05);综合组腺样体分级1级构成比较西药组升高(P<0.05),2级构成比较西药组降低(P<0.05);综合组治疗效果等级分布及总有效率均较西药组升高(P<0.05);治疗后两组睡眠干扰、身体症状、情绪症状、日间功能、对监护人的影响评分及总分均较治疗前降低(P<0.05),综合组均较西药组降低(P<0.05);两组均无明显不良反应,综合组轻度腹泻1例,未经处理即好转。

结论

益气健脾方可减轻脾虚痰阻型AH患儿症状,提高治疗效果及患儿生活质量,且安全性高。

, authors=叶龙, 方芳, 裘晓芬, authorsList=叶龙, 方芳, 裘晓芬, authorCompany=null, correspAuthors=null, authorNote=

叶龙(1988-),女,浙江永嘉人,副主任中医师,硕士,研究方向:儿科常见病及多发病的诊治。

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叶龙(1988-),女,浙江永嘉人,副主任中医师,硕士,研究方向:儿科常见病及多发病的诊治。

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组别例数打鼾鼻塞张口呼吸呼吸暂停
治疗前治疗后治疗前治疗后治疗前治疗后治疗前治疗后
西药组353.96±0.791.98±0.53a3.61±0.492.33±0.41a3.71±0.541.87±0.69a3.71±0.542.35±0.65a
综合组353.65±0.861.52±0.61ab3.80±0.672.05±0.47ab3.46±0.891.43±0.81ab4.15±1.022.01±0.49ab
t值1.5703.3681.3542.6561.4212.4461.5632.471
P值0.1210.0010.1800.0100.1600.0170.1230.016
组别例数面色萎黄食欲不振大便溏泄总分
治疗前治疗后治疗前治疗后治疗前治疗后治疗前治疗后
西药组352.31±0.721.86±0.71a1.96±0.541.63±0.41a2.25±0.611.40±0.32a21.58±4.3313.42±3.16a
综合组352.57±0.651.43±0.65ab2.23±0.871.36±0.49ab2.06±0.491.23±0.24ab21.92±6.7711.03±3.09ab
t值1.5862.6431.5602.5001.4372.5140.2503.199
P值0.1170.0100.1230.0150.1550.0140.8030.002
), ArticleFig(id=1322926981142160213, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322926973303005998, language=CN, label=表1, caption=

两组脾虚痰阻型腺样体肥大患儿治疗前、后两组中医证候积分比较()

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数打鼾鼻塞张口呼吸呼吸暂停
治疗前治疗后治疗前治疗后治疗前治疗后治疗前治疗后
西药组353.96±0.791.98±0.53a3.61±0.492.33±0.41a3.71±0.541.87±0.69a3.71±0.542.35±0.65a
综合组353.65±0.861.52±0.61ab3.80±0.672.05±0.47ab3.46±0.891.43±0.81ab4.15±1.022.01±0.49ab
t值1.5703.3681.3542.6561.4212.4461.5632.471
P值0.1210.0010.1800.0100.1600.0170.1230.016
组别例数面色萎黄食欲不振大便溏泄总分
治疗前治疗后治疗前治疗后治疗前治疗后治疗前治疗后
西药组352.31±0.721.86±0.71a1.96±0.541.63±0.41a2.25±0.611.40±0.32a21.58±4.3313.42±3.16a
综合组352.57±0.651.43±0.65ab2.23±0.871.36±0.49ab2.06±0.491.23±0.24ab21.92±6.7711.03±3.09ab
t值1.5862.6431.5602.5001.4372.5140.2503.199
P值0.1170.0100.1230.0150.1550.0140.8030.002
), ArticleFig(id=1322926981272183638, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322926973303005998, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数0级1级2级3级4级
西药组351(2.44)19(46.34)11(26.83)3(7.32)1(2.44)
综合组355(12.20)28(68.29)a2(4.88)a0(0.00)0(0.00)
Z值14.621
P值<0.001
), ArticleFig(id=1322926981364458327, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322926973303005998, language=CN, label=表2, caption=

两组脾虚痰阻型腺样体肥大患儿腺样体分级比较

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数0级1级2级3级4级
西药组351(2.44)19(46.34)11(26.83)3(7.32)1(2.44)
综合组355(12.20)28(68.29)a2(4.88)a0(0.00)0(0.00)
Z值14.621
P值<0.001
), ArticleFig(id=1322926981452538712, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322926973303005998, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数治愈显效有效无效总有效
西药组352(5.71)15(42.86)7(20.00)11(31.43)24(68.57)
综合组356(17.14)22(62.86)3(8.57)4(11.43)31(88.57)
Z/χ28.1914.158
P值0.0420.041
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两组脾虚痰阻型腺样体肥大患儿治疗效果比较

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组别例数治愈显效有效无效总有效
西药组352(5.71)15(42.86)7(20.00)11(31.43)24(68.57)
综合组356(17.14)22(62.86)3(8.57)4(11.43)31(88.57)
Z/χ28.1914.158
P值0.0420.041
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组别例数睡眠干扰身体症状情绪症状日间功能对监护人的影响总分
治疗前治疗后治疗前治疗后治疗前治疗后治疗前治疗后治疗前治疗后治疗前治疗后
西药组3514.65±4.328.15±2.14a12.22±2.467.86±1.85a10.37±2.946.21±1.76a11.33±3.078.12±1.69a17.43±3.9410.22±2.31a66.00±12.3440.56±8.16a
综合组3513.24±4.566.30±1.43ab13.19±2.596.75±1.57ab11.43±2.875.01±1.83ab12.29±2.975.32±1.48ab16.32±2.978.19±2.67ab66.47±10.9731.57±7.25ab
t值1.3284.2521.6072.7061.5262.7961.3307.3741.3313.4020.1684.872
P值0.189<0.0010.1130.0090.1320.0070.188<0.0010.1880.0010.867<0.001
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两组脾虚痰阻型腺样体肥大患儿治疗前、后生活质量评分比较()

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组别例数睡眠干扰身体症状情绪症状日间功能对监护人的影响总分
治疗前治疗后治疗前治疗后治疗前治疗后治疗前治疗后治疗前治疗后治疗前治疗后
西药组3514.65±4.328.15±2.14a12.22±2.467.86±1.85a10.37±2.946.21±1.76a11.33±3.078.12±1.69a17.43±3.9410.22±2.31a66.00±12.3440.56±8.16a
综合组3513.24±4.566.30±1.43ab13.19±2.596.75±1.57ab11.43±2.875.01±1.83ab12.29±2.975.32±1.48ab16.32±2.978.19±2.67ab66.47±10.9731.57±7.25ab
t值1.3284.2521.6072.7061.5262.7961.3307.3741.3313.4020.1684.872
P值0.189<0.0010.1130.0090.1320.0070.188<0.0010.1880.0010.867<0.001
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益气健脾方治疗儿童腺样体肥大的临床效果观察
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叶龙 , 方芳 , 裘晓芬
中华中医药学刊 | 省级项目平台 2025,43(10): 228-231
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中华中医药学刊 |省级项目平台 2025 , 43 (10) : 228 -231
益气健脾方治疗儿童腺样体肥大的临床效果观察
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叶龙, 方芳, 裘晓芬
作者信息
  • 温州市中西医结合医院,浙江 温州 325000
作者简介:

叶龙(1988-),女,浙江永嘉人,副主任中医师,硕士,研究方向:儿科常见病及多发病的诊治。

Clinical Effect of Yiqi Jianpi Decoction(益气健脾方)in Treatment of Adenoid Hypertrophy in Children
Long YE, Fang FANG, Xiaofen QIU
Affiliations
  • Wenzhou Integrated Traditional Chinese and Western Medicine Hospital,Wenzhou 325000,Zhejiang,China
出版时间: 2025-10-10 doi: 10.13193/j.issn.1673-7717.2025.10.043
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目的

观察益气健脾方治疗儿童脾虚痰阻型腺样体肥大(adenoid hypertrophy,AH)的临床效果。

方法

选取2022年9月—2023年9月医院收治的脾虚痰阻型AH患儿70例,经计算机随机数字生成表法分为西药组、综合组,各35例。西药组采用糠酸莫米松鼻喷雾剂、孟鲁司特钠咀嚼片治疗,综合组另采用益气健脾方治疗。比较两组中医证候积分、腺样体分级、治疗效果、生活质量及不良反应。

结果

治疗后两组打鼾、鼻塞、张口呼吸、呼吸暂停、面色萎黄、食欲不振、大便溏泄积分及总分均较治疗前降低(P<0.05),综合组均较西药组降低(P<0.05);综合组腺样体分级1级构成比较西药组升高(P<0.05),2级构成比较西药组降低(P<0.05);综合组治疗效果等级分布及总有效率均较西药组升高(P<0.05);治疗后两组睡眠干扰、身体症状、情绪症状、日间功能、对监护人的影响评分及总分均较治疗前降低(P<0.05),综合组均较西药组降低(P<0.05);两组均无明显不良反应,综合组轻度腹泻1例,未经处理即好转。

结论

益气健脾方可减轻脾虚痰阻型AH患儿症状,提高治疗效果及患儿生活质量,且安全性高。

儿童腺样体肥大  /  益气健脾方  /  腺样体分级  /  治疗效果
Objective

To observe the clinical effect of Yiqi Jianpi Decoction(益气健脾方)in the treatment of spleen deficiency and phlegm obstruction type of children with adenoid hypertrophy(AH).

Methods

From September 2022 to September 2023,70 children with spleen deficiency and phlegm obstruction type of AH treated in the hospital were selected and divided into Western medicine group and comprehensive group,with 35 cases in each,using a computer-generated random number table method.The western medicine group was treated with mometasone furoate nasal spray and montelukast sodium chewable tablets,while the comprehensive group was additionally treated with Yiqi Jianpi Decoction.The two groups were compared in terms of TCM syndrome integral,adenoid grading,treatment effects,quality of life and adverse reactions.

Results

After treatment,the scores for snoring,nasal congestion,mouth breathing,apnea,pale complexion,loss of appetite and loose stool as well as the total scores were reduced in both groups(P<0.05),with the comprehensive group showing greater reduction than the western medicine group(P<0.05).The proportion of grade1 adenoid grading in the comprehensive group increased compared to that in the western medicine group(P<0.05),while the proportion of grade 2 decreased(P<0.05).The distribution of treatment effect grades and the overall effectiveness rate were higher in the comprehensive group than those in the western medicine group(P<0.05).After treatment,the scores for sleep disturbance,physical symptoms,emotional symptoms,daytime function and impact on caregivers as well as total scores were reduced in both groups(P<0.05),with the comprehensive group showing greater reduction than the western medicine group(P<0.05).There were no significant adverse reactions in either group,with one case of mild diarrhea in the comprehensive group that improved without treatment.

Conclusion

Yiqi Jianpi Decoction can alleviate symptoms of spleen deficiency and phlegm obstruction type of AH in children,improve the treatment effects and quality of life,and is highly safe.

adenoid hypertrophy in children  /  Yiqi Jianpi Decoction(益气健脾方)  /  adenoid grading  /  treatment effect
叶龙, 方芳, 裘晓芬. 益气健脾方治疗儿童腺样体肥大的临床效果观察. 中华中医药学刊, 2025 , 43 (10) : 228 -231 . DOI: 10.13193/j.issn.1673-7717.2025.10.043
Long YE, Fang FANG, Xiaofen QIU. Clinical Effect of Yiqi Jianpi Decoction(益气健脾方)in Treatment of Adenoid Hypertrophy in Children[J]. Chinese Archives of Traditional Chinese Medicine, 2025 , 43 (10) : 228 -231 . DOI: 10.13193/j.issn.1673-7717.2025.10.043
腺样体肥大(adenoid hypertrophy,AH)是常见的耳鼻喉科疾病,多发于10岁以下儿童,近年其发病率上升趋势明显,约1%~4%的儿童深受困扰[1-2]。AH常并发慢性扁桃体炎,可造成鼻咽部气道阻塞,影响呼吸、吞咽、听力等功能,导致鼻塞、鼻音、打鼾、睡眠呼吸暂停、反复呼吸道感染、中耳炎及面部畸形等后果,甚至引起生长发育迟缓、注意力不集中、智力下降等全身症状,影响儿童生长发育[3-4]。目前药物是治疗儿童AH的方式之一,主要采用鼻用糖皮质激素和白三烯受体拮抗剂干预,通过抑制炎症反应和减少水肿,达到缩小腺样体的目的,但效果不稳定且易复发[5]。中医药治疗儿童AH具有独特的优势,能够辨证施治,调整机体整体平衡,达到治本目的。益气健脾方由太子参、黄芪、炒白术、陈皮、浙贝母、山海螺、莪术等组成,具有益气健脾、化痰散结、通窍利咽的作用,已被临床证实在脾虚痰阻型疾病治疗中具有满意效果[6]。本研究采用前瞻性随机对照试验,观察益气健脾方治疗脾虚痰阻型儿童AH的临床效果。报道如下。
选取2022年9月—2023年9月本院收治的AH患儿70例,经计算机随机数字生成表法分为西药组、综合组,各35例。西药组男17例,女18例;年龄3~11岁,平均(6.14±1.30)岁;病程1~14个月,平均(7.12±2.19)个月;腺样体分级1级、2级、3级、4级分别4例、3例、25例、3例。综合组男19例,女16例;年龄3~11岁,平均(6.28±1.47)岁;病程1~13个月,平均(6.95±2.05)个月;腺样体分级1级、2级、3级、4级分别6例、2例、23例、4例。两组基线资料均衡可比(P>0.05)。院伦理委员会批准本研究开展。
纳入标准:(1)符合儿童AH的诊断标准[7],即有鼻塞、鼻音、打鼾、呼吸暂停等症状,鼻内镜检查显示腺样体增大,阻塞后鼻孔50%以上;(2)符合中医脾虚痰阻型辨证[8],表现为鼻塞、夜寐呼噜声重、张口呼吸、面色萎黄、胃纳不佳,或伴有咳嗽,大便正常或溏泄,脉沉细,舌淡胖,苔白腻;(3)年龄3~12岁;(4)监护人签署知情同意书,愿意配合研究。
排除标准:(1)合并鼻窦炎、鼻息肉、鼻中隔偏曲等其他鼻咽部疾病,如鼻窦炎、鼻息肉、鼻中隔偏曲等;(2)合并心脏、肝、肾、血液等系统疾病;(3)合并糖尿病、病毒性肝炎、艾滋病等影响免疫功能的疾病;(4)合并出血性疾病或正在服用抗凝药物;(5)过敏体质或有药物过敏史;(6)近1个月内服用过免疫抑制剂或激素类药物;(7)已接受过腺样体切除手术或其他治疗方法者。
西药组给予西药常规治疗,糠酸莫米松鼻喷雾剂(Schering-Plough Labo N.V;国药准字H20140100;50μg*140喷),每日1次,每次每个鼻孔1喷;孟鲁司特钠咀嚼片(Merck Sharp & Dohme Ltd;国药准字J20130053;4 mg×5片/盒)口服,3~5岁患儿每日1次,每次4 mg,>5岁患儿每日1次,每次5 mg。治疗组另采用益气健脾方治疗,药用:太子参10 g,黄芪10 g,炒白术10 g,陈皮6 g,浙贝母10 g,山海螺10 g,莪术6 g。水煎服,3~6岁龄每日半剂,>6岁儿童每日1剂,早晚各半。两组治疗期间均禁止使用其他中西药物或其他治疗方法,避免食用辛辣、油腻、生冷等刺激性食物,保持良好的生活习惯和情绪状态,均连续治疗3个月。
参考严道南教授[9]标准评价,主要症状包括打鼾、鼻塞、张口呼吸、呼吸暂停,根据严重程度评分,无为0分,轻度为2分,中度为4分,重度为6分;次要症状包括面色萎黄、食欲不振、大便溏泄,根据严重程度评分,无为0分,轻度为1分,中度为2分,重度为3分,症状总积分0~33分。
采用电子鼻内镜检查,将腺样体分为四级,0级为无AH;1级为腺样体占据鼻咽腔上部以下,后鼻孔通畅;2级为腺样体占据鼻腔上部;3级为腺样体占据鼻腔上部,腺样体扩展到鼻腔后端,阻塞后鼻孔及部分咽鼓管咽口;4级为腺样体占据鼻咽腔全部3/4以上,后鼻孔下缘及咽鼓管咽口均被遮挡[10]。
治愈:鼻塞、打鼾、张口呼吸等症状消失,鼻内镜检查正常,症状积分降低≥95%;显效:AH症状明显改善,鼻内镜检查腺样体占后鼻孔≤25%,70%≤症状积分降低<95%;有效:AH症状减轻,鼻内镜检查腺样体占后鼻孔≤50%,30%≤症状积分降低<70%;无效:AH症状无明显改善或加重,鼻内镜检查腺样体占后鼻孔>50%,症状积分降低<30%。总有效例数=治愈例数+显效例数+有效例数。
治疗前、后采用儿童阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea hypopnea syndrome,OSAHS)特异性生活质量调查(disease specific quality of for children with obstructive sleep apnea 18 items survey,OSA-18)评价[11]。该量表包含18个问题,涉及5个维度,分别是睡眠干扰(4个问题,评分范围为4~28分)、身体症状(4个问题,评分范围为4~28分)、情绪症状(3个问题,评分范围为3~21分)、日间功能(3个问题,评分范围为3~21分)和对监护人的影响(4个问题,评分范围为4~28分)。每个问题分别对应1~7分,总分范围18~126分,分数越高,表示生活质量受到的影响越大。
观察两组用药期间肝肾功能损伤、胃肠道反应及过敏等不良反应发生情况。
采用SPSS22.0软件进行数据处理和分析,以表示计量资料,两两样本比较采用独立样本t检验或配对t检验;以例(%)表示计数资料,用χ2检验,等级比较采用秩和Z检验。P<0.05差异存在统计学意义。
治疗后两组打鼾、鼻塞、张口呼吸、呼吸暂停、面色萎黄、食欲不振、大便溏泄积分及总分均较治疗前降低(P<0.05),综合组均较西药组降低(P<0.05)。见表1。
综合组腺样体分级1级构成比较西药组升高(P<0.05),2级构成比较西药组降低(P<0.05);两组腺样体分级0级、3级、4级构成比较,差异无统计学意义(P>0.05)。见表2。
综合组治疗效果等级分布及总有效率均较西药组升高(P<0.05)。见表3。
治疗后两组睡眠干扰、身体症状、情绪症状、日间功能、对监护人的影响评分及总分均较治疗前降低(P<0.05),综合组均较西药组降低(P<0.05)。见表4。
两组均无明显不良反应,综合组轻度腹泻1例,未经处理即好转。
腺样体位于鼻咽顶部,是呼吸道的第一道防线,参与机体的免疫防御。儿童AH的主要危险因素包括喂养不当、激素或抗生素滥用、上呼吸道感染、鼻窦炎及体质过敏等,其发病机制被认为与免疫反应异常、炎症反应、黏液分泌等方面相关[12-14]。AH的病因复杂,单纯的西医药物很难根除病因,仅能缓解症状,且面临着一定的复发风险[15-17]。因此,寻求一种更为安全、有效、经济的治疗方法,成为临床亟需解决的问题。
本研究显示,治疗后综合组打鼾、鼻塞、张口呼吸、呼吸暂停积分及总分均较西药组降低,腺样体分级及治疗总有效率均较西药组升高,提示益气健脾方可促进AH患儿症状改善及治疗效果的提升。中医认为,AH的病变部位在鼻咽部,属于上焦,其主要病因是脾虚生痰,痰浊上壅,阻塞鼻咽,或兼气血瘀滞,经络不畅,气机失调,导致鼻咽部气机不畅,痰湿凝滞,以致上焦瘀肿[18-20]。因此,治疗原则应以益气健脾、化痰祛瘀、通窍利咽为主,以恢复鼻咽部的通畅和机体的正常功能[21]。益气健脾方由太子参、黄芪、炒白术、陈皮、浙贝母、山海螺、莪术组成。其中太子参、黄芪益气固表,健脾升清;炒白术、陈皮健脾燥湿,理气和胃;浙贝母、山海螺软坚散结,清热解毒;莪术行气止痛,活血化瘀。各药相互配合,共奏益气、健脾、化痰、散结、通窍之效。现代药理学认为,太子参多糖可增强机体免疫功能,抗炎、抗病毒、抗氧化;黄芪提取物可提高巨噬细胞、T细胞、B细胞、自然杀伤细胞等的活性,促进抗体的产生,减轻炎症反应,并抑制肥大细胞的脱颗粒,降低组胺、白三烯等过敏介质的释放,减轻过敏反应,从而缓解腺样体的过敏性肥大[22-23]。西药与益气健脾方作用互补,可有效提高AH的治疗效果。
AH患儿常出现打鼾、呼吸暂停、睡眠不安等症状,导致睡眠质量下降,影响儿童的精神状态和身体健康,生活质量不佳[24-25]。本研究发现,治疗后综合组睡眠干扰、身体症状、情绪症状、日间功能、对监护人的影响评分及总分均较西药组降低,提示益气健脾方可促进患儿生活质量的提升,分析原因与其减轻患儿症状有关。此外,本研究发现益气健脾方的增用并不会导致不良反应的增加,表明其安全性高。益气健脾方中药物性味平和,不伤胃肠,不损阴液,不燥火,不致实热,不易产生不良反应,且配伍合理,相互协调,发挥多重的药理作用。王超等[26]也表明相似观点。
综上所述,儿童AH治疗中应用益气健脾方可减轻症状,提高治疗效果及生活质量,且安全性高。本研究为单中心研究,可能存在选择偏倚和区域差异,影响研究的普适性和代表性,可作为今后改进方向。
  • 浙江省中医药科技计划项目(2024ZR166)
  • 温州市科研项目(自筹)(Y2023275)
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2025年第43卷第10期
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doi: 10.13193/j.issn.1673-7717.2025.10.043
  • 首发时间:2026-10-30
  • 出版时间:2025-10-10
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浙江省中医药科技计划项目(2024ZR166)
温州市科研项目(自筹)(Y2023275)
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    温州市中西医结合医院,浙江 温州 325000
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2种不同金属材料的力学参数
科
Family
属数
Number of
genus
种数
Number of
species
占总种数比例
Percentage of
total species (%)
属
Genus
种数
Number of
species
占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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