本文選題：喉源性咳嗽 + 風(fēng)邪犯肺型��； 參考：《廣州中醫(yī)藥大學(xué)》2016年碩士論文

【摘要】：目的：本研究主要通過觀察對比單純中西醫(yī)分別治療喉源性咳嗽的病情好轉(zhuǎn)情況,分析其中差異性,以明確中藥治療喉源性咳嗽的療效,尋求中醫(yī)藥治療該種疾病的臨床依據(jù),并通過對比治療前后受試者受累氣道的變化情況,尋求喉源性咳嗽治療效果評價的客觀量化指標(biāo)。方法：采用隨機(jī)對照的統(tǒng)計學(xué)原則,進(jìn)行前瞻性統(tǒng)計分析研究,將符合喉源性咳嗽(風(fēng)邪犯肺型)的并且就診于廣州中醫(yī)藥大學(xué)第一附屬醫(yī)院呼吸內(nèi)科門診的60例患者(就診日期為2015年9月至2016年3月之間)用簡單隨機(jī)分組方法將之分為治療組及對照組,每組各30例。治療組予口服止嗽散(桔梗l0g、荊芥10g、紫菀10g、百部10g、白前l(fā)0g、甘草4g、陳皮5g),對照組予酮替芬1mg bid+咳必清25mg tid治療,治療5天后隨診,記錄觀察。比較兩組患者治療前后的證候評分、局部檢查方面及IOS檢查前后差異性。成果：1、中醫(yī)證候評分方面：治療5周后治療組及對照組均能起到改善患者咽干、咽癢、咳嗽等臨床癥狀的效果。治療組能顯著改善患者咽干、咽癢、咳嗽等癥狀(P0.01)；對照組能改善患者咽干、咽癢、咳嗽等癥狀(P0.01)。治療組較對照組在改善患者臨床癥狀方面療效更佳(P0.05)。2、局部檢查方面：治療5周后治療組及對照組均能起到改善患者局部體征(咽部粘膜慢性充血、咽部粘膜色淡水腫、咽后壁淋巴濾泡增生)的效果。治療組能顯著改善患者局部體征(P0.01)；對照組能改善患者局部體征(P0.01)。治療組較對照組在改善患者臨床癥狀方面療效更佳(P0.05)。3、IOS檢查方面：治療組及對照組在治療前后測量呼吸阻抗指標(biāo)均在正常值范圍內(nèi),但皆有顯著下降。兩組經(jīng)卡方檢驗,有統(tǒng)計學(xué)顯著性差異(P0.05)。治療后,治療組與對照組各項呼吸阻抗指標(biāo)均顯著下降,治療組與對照組差異不明顯；兩組統(tǒng)計學(xué)上無顯著差異(P0.05)。說明止嗽散可明顯改善患者氣道受累情況,但與對照組比較無統(tǒng)計學(xué)顯著性差異(P0.05)。結(jié)論：(1)對于風(fēng)邪犯肺型的喉源性咳嗽患者來說,采用止嗽散,化痰止咳,不僅能顯著改善咽干、咽癢、咳嗽等臨床癥狀,還能有效減輕患者局部體征、改善患者受累氣道,其臨床治療效果確切,且無明顯副作用,患者耐受性好,可推廣至臨床中使用。(2)IOS檢查通過分析研究證實可以用作喉源性咳嗽治療效果的客觀量化指標(biāo),但不能作為診斷指標(biāo),其對于喉源性咳嗽的療效判斷有指導(dǎo)意義。
[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.
【學(xué)位授予單位】：廣州中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R276.1

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相關(guān)期刊論文 前1條

1 滕磊;忻耀杰;尋滿湘;;喉源性咳嗽年節(jié)律性及與中醫(yī)證型相關(guān)性臨床觀察[J];中國中醫(yī)藥信息雜志;2010年06期

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本文編號：1836237