加味桑杏汤治疗风燥犯肺型感染后咳嗽临床观察

发布时间：2017-12-31 15:14

本文关键词：加味桑杏汤治疗风燥犯肺型感染后咳嗽临床观察　出处：《广州中医药大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:通过比较加味桑杏汤治疗风燥犯肺型感染后咳嗽患者用药前后症状积分的变化,评价其疗效,探讨精简加味桑杏汤药味后对感染后咳嗽风燥犯肺型患者治疗效果的差异,以达到简化处方,提高临床疗效的目的。方法:本研究采用随机对照方法,把符合纳入标准的患者分至中西药A组、中西药B组、西药C组。中西药A组予加味桑杏汤A号方(桑叶10g、沙参15g、栀子10g、淡豆豉10g、麦冬15g、知母10g、杏仁15g、浙贝母15g、枇杷叶15g、川芎10g)联合西药复方甲氧那明胶囊及孟鲁司特钠治疗,中西药B组予加味桑杏汤B号方(加味桑杏汤A号方+黄芩10g、桑白皮15g、海蛤壳30g)及西药复方甲氧那明胶囊、孟鲁司特钠治疗,西药C组予复方甲氧那明胶囊及孟鲁司特钠治疗,治疗用药共1周。观察各组第4天、第8天咳嗽视觉模拟评分、咳嗽症状积分、中医症候积分的变化,并评价其疗效及安全性。成果:1.临床疗效:治疗第4天,中西药A组总有效率85%,B组总有效率71.43%,西药C组总有效率61.54%,三组总有效率差异无统计学意义(P0.05)。治疗第8天,中西药A组总有效率95%,中西药B组总有效率90.48%,西药C组总有效率61.54%,三组差异有统计学意义(P0.05),中西药A组总有效率与中西药B组差异无统计学意义(P0.05),中西药组总有效率与西药组总有效率差异有统计学意义(P0.05),表明中西药A组与中西药B组疗效相当,中西药组疗效比西药组疗效佳。2.加味桑杏汤B号方与加味桑杏汤A号方疗效相当(P0.05),增加清热化痰药后并未进一步提高临床疗效,表明可精简处方,减少加味桑杏汤不必要的药味,表明痰可能不是感染后咳嗽的主要病理因素。3.咳嗽症状积分:三组均能缓解日间咳嗽程度,但中西药治疗A组及中西药治疗B组能同等程度缓解日间咳嗽程度,比西药C组缓解程度大(P05)。中西药A组、B组均能缓解夜间咳嗽程度(P0.05),但西药组缓解夜间咳嗽症状不明显(P0.05)。4.中医症候积分:中西药A组、B组能同等程度地缓解咽痒、咽部异物感,缓解程度比西药C组佳(P0.05)。结论:1.加味桑杏汤A号方、B号方均能缓解风燥犯肺型感染后咳嗽的症状,尤其能缓解咽痒、咽部异物感症状,中西药联合治疗疗效佳于单纯西药疗效,可使有效率提高30%,达到90%以上。2.加味桑杏汤A号方、B号方治疗风燥犯肺型感染后咳嗽疗效相当,对风燥犯肺型感染后咳嗽患者的治疗可减少清热化痰药物使用,加味桑杏汤A号方较B号方在提高疗效基础上减少了不必要的药味。
[Abstract]:Objective: to compare the changes of symptom scores before and after the treatment of cough patients with wind dryness and lung type infection with Jiawei Sangxing decoction, and to evaluate its curative effect. To explore the difference of therapeutic effect of modified Sangxing decoction on patients with lung type of cough and wind dryness after infection, in order to simplify the prescription and improve the clinical curative effect. Methods: this study adopted a randomized controlled method. Patients who met the inclusion criteria were divided into Chinese and western medicine group A, Chinese and western medicine group B, western medicine group C. the Chinese and western medicine group A was treated with modified Sangxing decoction (10 g mulberry leaf, 15 g Sushen, 10 g gardenia, 10 g light soybean). Ophiopogon japonicus 15g, Amygdala 15g, Fritillaria thunbergii 15g, loquat leaf 15g, Chuanxiong 10g) combined with western medicine compound methoxifen capsule and montelukast sodium. Group B was treated with modified Sangxing decoction B (10 g of Scutellaria, 15 g of mulberry skin and 30 g of sea clam shell) and western medicine compound methoxifen capsule, montelukast sodium. Group C was treated with compound methoxysmin capsule and montelukast sodium for one week. The changes of cough visual analogue score, cough symptom score and TCM symptom score were observed on day 4 and day 8. Clinical efficacy: on the 4th day of treatment, the total effective rate of group A of traditional Chinese medicine and western medicine was 71.43 in group A and 61.54% in group C of western medicine. There was no significant difference in the total effective rate among the three groups (P 0.05). On the 8th day of treatment, the total effective rate of group A was 95, and that of group B was 90.48%. The total effective rate of western medicine group C was 61.54, the difference of three groups was statistically significant (P 0.05), the total effective rate of Chinese and western medicine group A was not significantly different from that of Chinese and western medicine group B (P 0.05). The total effective rate of Chinese and western medicine group was significantly different from that of western medicine group (P 0.05), which indicated that the curative effect of Chinese and western medicine group A and Chinese and western medicine group B was equal to that of western medicine group. The curative effect of traditional Chinese and western medicine group is better than that of western medicine group. 2. The curative effect of modified Sangxing decoction B is equivalent to that of modified Sangxing decoction A, but the clinical curative effect has not been further improved after adding heat-clearing and resolving phlegm medicine. The results showed that the prescription could be simplified, the unnecessary medicinal taste of modified mulberry Xing decoction could be reduced, and the phlegm might not be the main pathological factor of post-infection cough .3.The score of cough symptom: all the three groups could alleviate the degree of daytime cough. However, group A and group B were able to relieve the degree of daytime cough in the same degree, which was greater than that in group C (P05). Group A was treated with traditional Chinese medicine and western medicine (group A). Group B was able to alleviate the degree of nocturnal cough P0.05, but the western medicine group did not relieve the symptoms of nocturnal cough. 4. TCM symptom integral: group A of Chinese and western medicine. Group B could relieve pharynx itch and foreign body sensation in pharynx to the same extent, and the degree of relief was better than that of group C (western medicine C). Conclusion: 1. B prescription can alleviate the symptoms of cough after wind dryness invading lung type infection, especially can alleviate pharynx itch, pharynx foreign body feeling symptom, the curative effect of combination of Chinese and western medicine is better than that of pure western medicine, can make the effective rate increase 30%. The curative effect of modified Sangxing decoction A and B on cough after wind dryness and lung type infection is similar, and the treatment of cough after wind dryness infects lung type infection can reduce the use of antipyretic and phlegm medicine. Compared with B prescription, Jiawei Sangxing decoction A reduced unnecessary medicinal flavor on the basis of improving curative effect.
【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】：2017
【分类号】：R256.11

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