養陰克敏方對兒童氣喘療效之研究

The Effect of Yang-Yin-Ke-Min-Fang in Asthmatic Children

33例陰虛肝肺熱型外因性氣喘患者，實驗組23例，對照組10例，在氣喘緩解期間，實驗組服用養陰克敏方，對照組服用安慰劑，服中藥三個月後，比較治療前後臨床症狀評分、西藥用藥劑量、早晨及夜間最高呼氣流量，血清 lgE，過敏原專一性 IgE、體外淋巴球介白質 -2 產生濃度及體外嗜中性白血球組織胺產生濃度之變化。我們獲得以下的結果：一、實驗組臨床症狀評分較對照組明顯降低(p<0.05)。二、實驗組西藥服用劑量較對照組明顯減少(p<0.05)。三、雖然實驗組最高呼氣流量增加程度較對照組高，但未具統計學意義，惟早晨最高呼氣流量在第2個月時，兩組有顯著差異(p<0.05)。四、實驗紅血清 IgE濃度在治療後，明顯降低(p<0.01)，但兩組間並無顯著差異。五、血清DPteronyssinus-specific IgE. D farinae-specific IgE 及 D microceras- Specific IgE在治療後兩組比較，實驗組之濃度顯著降低(各為 p<0.05、p< 0.01、p<0.05)。六、體外淋巴球介白質 -2 產生濃度，實驗組在未使用 PHA 誘發時，治療後淋巴球介白質-2產生濃度明顯減少(p<0.01)，但兩組間無顯著差異。七、使用 PHA 誘發時，體外淋巴球介白質-2產生濃度，實驗組顯著減少(p<0.05)。八、體外嗜中性白血球組織胺產生濃度，兩組間無顯著差異性。綜合以上結果得知，養陰克敏方有改善陰虛體質氣喘患者臨床症狀、減少西藥服用劑量、 抑制 lgE、specific IgE 的形成及抑制活化T-淋巴球產生介白質-2的作用。養陰克敏方可能具有調整 T- 細胞的免疫功能異常。其作用有待進一步的研究。

In this clinical research, 33 cases of Yin-Deficiency Liver and Lung Heat type extrinsic bronchial asthmatics most commonly often found in Taiwan were studied during the symptom-reducing period. Twenty-tbreeexperimental cases were given Yang-Yin-Ke-Min-Fang (養陰克敏方) in order to modu- late their Yin-Deficiency constitution while the control, 10 cases, took placebo. Three months later, the symptom scores, medication scores and peak expiratory flow rate were evaluated. At the same time, the immunological changes were also observed. The pharmacia CAP PAST FEIA method was used to measure the five.allergen-specific lgE change in serum before and after treatment, and the enzyme- linked immunosorbent assay (ELISA) was used to examine the production of interleukin-2 in lympho- cyte andhistamipein neutrophil in vitro. And the findings are: Aftel'takmgYang-Yin-Kt@Mm-Fang the symptom leores, medication scores,Dermatophagoidespteronysinus-specificlgE,Dennatophagoides farinae-specific IgE and Dermatophagoides microceras-spedficlgE. concentration in experiment group were markedly lower that of the control group (p < 0.05, p < 0.05, p < 0.05, p < 0.01, p < 0.05 respec- tively). As to the total serum IgE, House dust-specific IgE, Blatella gennanica-specific IgE, there was no statisitical difference between the two groups. The production of Phytohemagglutinin-induced inter- leukin-2(IL-2) in lymphocyte singnificantly decreased in experiment group compared with control group (R< 0.05), and the production ofhistamine in neutrophil shows no difference. The conclusion is that Yang-Yin-Ke-Min-Fang can decrease asthmatic symptoms, medication dose and inhibit the formation of allergen-specific lgE and inhibit activated T-lymphocyte to produce IL-2 in the asthmatics of Ying-Deficiency body quality. The precise mechanism of action of Yang-Yin-Ke-Min- Fang in asthma remains to be elucidated.