止嗽散治疗风邪犯肺型喉源性咳嗽的临床疗效研究及气道阻力分析

发布时间：2018-05-03 00:47

本文选题：喉源性咳嗽 + 风邪犯肺型　；参考：《广州中医药大学》2016年硕士论文

【摘要】：目的：本研究主要通过观察对比单纯中西医分别治疗喉源性咳嗽的病情好转情况,分析其中差异性,以明确中药治疗喉源性咳嗽的疗效,寻求中医药治疗该种疾病的临床依据,并通过对比治疗前后受试者受累气道的变化情况,寻求喉源性咳嗽治疗效果评价的客观量化指标。方法：采用随机对照的统计学原则,进行前瞻性统计分析研究,将符合喉源性咳嗽(风邪犯肺型)的并且就诊于广州中医药大学第一附属医院呼吸内科门诊的60例患者(就诊日期为2015年9月至2016年3月之间)用简单随机分组方法将之分为治疗组及对照组,每组各30例。治疗组予口服止嗽散(桔梗l0g、荆芥10g、紫菀10g、百部10g、白前l0g、甘草4g、陈皮5g),对照组予酮替芬1mg bid+咳必清25mg tid治疗,治疗5天后随诊,记录观察。比较两组患者治疗前后的证候评分、局部检查方面及IOS检查前后差异性。成果：1、中医证候评分方面：治疗5周后治疗组及对照组均能起到改善患者咽干、咽痒、咳嗽等临床症状的效果。治疗组能显著改善患者咽干、咽痒、咳嗽等症状(P0.01)；对照组能改善患者咽干、咽痒、咳嗽等症状(P0.01)。治疗组较对照组在改善患者临床症状方面疗效更佳(P0.05)。2、局部检查方面：治疗5周后治疗组及对照组均能起到改善患者局部体征(咽部粘膜慢性充血、咽部粘膜色淡水肿、咽后壁淋巴滤泡增生)的效果。治疗组能显著改善患者局部体征(P0.01)；对照组能改善患者局部体征(P0.01)。治疗组较对照组在改善患者临床症状方面疗效更佳(P0.05)。3、IOS检查方面：治疗组及对照组在治疗前后测量呼吸阻抗指标均在正常值范围内,但皆有显著下降。两组经卡方检验,有统计学显著性差异(P0.05)。治疗后,治疗组与对照组各项呼吸阻抗指标均显著下降,治疗组与对照组差异不明显；两组统计学上无显著差异(P0.05)。说明止嗽散可明显改善患者气道受累情况,但与对照组比较无统计学显著性差异(P0.05)。结论：(1)对于风邪犯肺型的喉源性咳嗽患者来说,采用止嗽散,化痰止咳,不仅能显著改善咽干、咽痒、咳嗽等临床症状,还能有效减轻患者局部体征、改善患者受累气道,其临床治疗效果确切,且无明显副作用,患者耐受性好,可推广至临床中使用。(2)IOS检查通过分析研究证实可以用作喉源性咳嗽治疗效果的客观量化指标,但不能作为诊断指标,其对于喉源性咳嗽的疗效判断有指导意义。
[Abstract]:Objective: the purpose of this study was to observe and compare the improvement of laryngogenic cough treated by traditional Chinese medicine and western medicine respectively, and to analyze the difference among them, so as to clarify the curative effect of traditional Chinese medicine on laryngogenic cough, and to seek the clinical basis of traditional Chinese medicine for the treatment of laryngogenic cough. By comparing the changes of the affected airway before and after treatment, the objective quantitative indexes for evaluating the therapeutic effect of laryngogenic cough were sought. Methods: prospective statistical analysis was carried out using the statistical principle of random control. Sixty patients (dated from September 2015 to March 2016) who were admitted to the Department of Respiratory Medicine, first affiliated Hospital of Guangzhou University of traditional Chinese Medicine, were randomly divided into two groups. Methods the patients were divided into treatment group and control group. There were 30 cases in each group. The treatment group was treated with oral Zhisou San (10 g of Platycodon grandiflorum, 10 g of Schizonepeta thaliana, 10 g of Aster 10g, 10 g of Baibei, 4 g of Glycyrrhiza uralensis, 5 g of Chen Pei), while the control group was treated with ketotifen 1mg bid cough butadiene 25mg tid, followed up for 5 days and recorded. The differences of syndrome score, local examination and IOS before and after treatment were compared between the two groups. Results: 1. Score of TCM syndromes: after 5 weeks treatment, both the treatment group and the control group could improve the clinical symptoms such as dry pharynx, itching and coughing. The treatment group could significantly improve the symptoms of dry pharynx, pharynx itch and cough, while the control group could improve the symptoms of dry pharynx, pharynx itch and cough. The treatment group was better than the control group in improving the clinical symptoms of the patients. Local examination: after 5 weeks of treatment, both the treatment group and the control group could improve the local signs of the patients (chronic congestion of the pharyngeal mucosa, light edema of the pharynx mucous membrane, local signs of the treatment group and the control group). Effect of lymphoid follicular hyperplasia on posterior pharynx. In the treatment group, the local physical signs of the patients were significantly improved (P 0.01), while the control group was able to improve the local signs of the patients (P 0.01). Compared with the control group, the therapeutic effect of the treatment group was better than that of the control group in improving the clinical symptoms of the patients. In the treatment group and control group, the respiratory impedance indexes were within the normal range, but they all decreased significantly. By chi-square test, there was a significant difference between the two groups (P 0.05). After treatment, the indexes of respiratory impedance in the treatment group and the control group were significantly decreased, but there was no significant difference between the treatment group and the control group, and there was no statistical difference between the two groups (P 0.05). The results showed that Zhisou San could obviously improve the airway involvement of the patients, but there was no significant difference compared with the control group (P 0.05). Conclusion (1) for the patients with laryngogenic cough caused by wind evil, the clinical symptoms, such as dry pharynx, itchy pharynx, cough and so on, can be significantly improved by using Zhisou San and resolving phlegm to stop coughing, and the local signs of the patients can also be effectively alleviated and the affected airway can be improved. Its clinical treatment effect is accurate, and there are no obvious side effects, the patient has good tolerance, and can be extended to clinical use. The analysis and research prove that it can be used as an objective quantitative index for the treatment effect of laryngogenic cough, but it can not be used as a diagnostic index. It is of guiding significance for the evaluation of the curative effect of laryngeal cough.
【学位授予单位】：广州中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R276.1

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