肖露 金朝晖

【摘 要】 目的：观察柴胡疏肝散联合孟鲁司特纳治疗胸闷变异性哮喘肝郁气滞证的临床疗效。方法：将42例胸闷变异性哮喘肝郁气滞患者按随机数字法分为对照组和治疗组各21例，对照组口服孟鲁司特纳，治疗组予以孟鲁司特纳和柴胡疏肝散联合治疗。结果：治疗后两组肺功能指标FEV1/ FVC、PEF（%）均得到改善，差异具有统计学意义（P<0.05）;但与对照组相比，治疗组改善率明显高于对照组，差异具有统计学意义（P<0.05）;对照组总有效率为76.2%，治疗组为90.5%，治疗组明显优于对照组（P<0.05）。结论：柴胡疏肝散联合孟鲁司特纳治疗胸闷变异性哮喘肝郁气滞证能有效缓解患者症状，改善肺功能，值得临床推广。

【关键词】 柴胡疏肝散;胸闷变异性哮喘;肝郁气滞证

【中图分类号】R256.12【文献标志码】 A 【文章编号】1007-8517（2021）07-0108-03

Chaihushugansan Combined with Montelukastner in the Treatment of 21 Patients with Chest Tightness Variant Asthma

XIAO Lu1 JIN Zhaohui2*

1.Hunan University of Traditional Chinese Medicine， Changsha 410208， China;

2.The First Affiliated Hospital of Hunan University of Traditional Chinese Medicine， Changsha 410007， China

Abstract：Objective To observe the clinical efficacy of Chaihu Shugan Powder in treating chest tightness variant asthma. Methods According to random number method， 42 Patients with chest tightness variant asthma were divided into treatment grouP and control grouP， 21 cases each. The control grouP received oral montelukast， and the treatment grouP received combined treatment of montelukast and Chaihu Shugan Powder. Results After treatment， the lung function indexes FEV1/ FVC and PEF （%） of the two grouPs were imProved， the difference was statistically significant （P<0.05）; but comPared with the control grouP， the imProvement rate of the treatment grouP was significantly higher than that of the control grouP， The difference was significant （P<0.05）; after adding Chaihu Shugan Powder， the total effective rate of the control grouP was 76.2%， and that of the treatment grouP was 90.5%. The treatment grouP was significantly better than the control grouP（P<0.05）. Conclusion Chaihu Shugan Powder can effectively imProve the symPtoms of Patients with chest tightness variant asthma and liver qi stagnation syndrome， and it deserves clinical attention.

Key：words：Chaihu Shugan Powder; Chest Tightness Variant Asthma; Liver DePression and Stagnation Syndrome

胸悶变异性哮喘是一种新的哮喘亚型[1]，以胸闷为唯一或主要临床表现，无典型哮喘喘息气促的症状，肺部亦未能闻及哮鸣音，易被误诊、漏诊[2-3]。以支气管扩张剂和吸入性糖皮质激素为手段的治疗方案有其真菌易感性等副作用，且部分患者夜间频繁发作，难以缓解，更甚者伴夜间憋闷窒息感，较典型哮喘更易合并焦虑抑郁状态[4]。金朝晖教授研究和从事呼吸系统疾病20余年，认为情志改变与胸闷变异性哮喘发作紧密联系，该病肝郁气滞证多见，以柴胡疏肝散联合孟鲁司特纳治疗胸闷变异性哮喘临床疗效良好，现报道如下。

1 资料与方法

1.1 一般资料 42例均选自我院呼吸内科门诊2018年12月至2020年1就诊的胸闷变异性哮喘肝郁气滞患者，按随机数字法分为对照组和治疗组各21例。对照组男11例，女10例;年龄19～60岁，平均（38.6±6.3）岁;病程3～27年，平均病程（15.4±2.9）年。治疗组男13例，女8例;年龄20～63岁，平均（39.1±5.7）岁;病程2～30年，平均病程（16.7±3.4）年。两组一般资料比较差异无统计学意义（P>0.05），具有可比性。