鼻肺咳方治疗上气道咳嗽综合征湿热型的临床研究

发布时间：2018-04-22 05:05

本文选题：鼻肺咳方 + 上气道咳嗽综合征　；参考：《广州中医药大学》2016年硕士论文

【摘要】：目的：本研究通过“鼻肺咳方”治疗上气道咳嗽综合征湿热型临床研究,观察咳嗽、咯痰、鼻后倒流涕、咽痒等主要症状及咽部体征改善情况、咳嗽改善起始时间、21天整体疗效等指标,通过统计学分析和临床评价,为临床提供一个可以有效治疗上气道咳嗽综合征湿热型的中药复方制剂。方法：采用随机、阳性药物对照的临床试验设计,受试者为我院2015年2月至2016年2月呼吸科门诊、急诊、发热门诊患者中明确诊断为上气道咳嗽综合征湿热型患者共120例,随机分为治疗组(鼻肺咳方组)60例,对照组(阿奇霉素或头孢泊肟联合孟鲁司特)60例。治疗组予口服鼻肺咳方(由辛夷10g、白芷10g、蔓荆子10g、蜜麻黄10g、杏仁10g、紫苏叶10g、陈皮10g、荆芥10g、白前10g、桔梗10g、鱼腥草10g、黄芩10g、甘草10g组成),日一剂,一日两次；对照组予均予孟鲁司特钠咀嚼片10mg口服每晚1次。属慢性鼻窦炎患者予阿奇霉素干混悬剂0.5g,口服每日1次,服三天停四天,或头孢泊肟脂胶囊100mg口服每日2次。7天1个疗程,共观察3个疗程。结果：两组在性别、年龄、病程方面差异性不明显,经统计学处理具有可比性(P0.05)。治疗后咳嗽咯痰等积分改善情况：两组病例自身治疗前后的咳嗽、咯痰、鼻后倒流涕、咽痒、咽部体征积分比较,P0.05,有统计学意义。说明两组治疗对咳嗽、咯痰、鼻后倒流涕、咽痒均有效。而组间治疗后差值比较,咳嗽、咽痒症状治疗组与对照组比较,P0.01,有显著性差异。说明治疗组改善上气道咳嗽综合症湿热型的咳嗽、咽痒症状的疗效明显高于对照组。咯痰症状治疗组与对照组比较,P0.05,有差异。说明治疗组改善上气道咳嗽综合症湿热型的咯痰症状的疗效高于对照组。咳嗽改善起始时间结果显示：治疗组能够更快的改善咳嗽症状(P0.05),明显缩短疗程;治疗21天后两组整体疗效比较：治疗组临床控制14例,显效24例,有效17例,无效5例,总有效率91.67%；西药组临床控制4例,显效14例,有效28例,无效14例,总有效率76.67%。经秩和检验,中药组疗效优于西药组(P0.05)。结论：根据上述临床观察结果,经分析得出如下结论：鼻肺咳方治疗上气道咳嗽综合征湿热型,在整体疗效、主要症状(咳嗽、咯痰、咽痒)改善情况等方面均优于西药对照组。
[Abstract]:Objective: to observe the improvement of main symptoms and pharynx signs such as cough, sputum, runny after nose, pharynx and other main symptoms and signs of upper airway cough syndrome by "Bifei Ke Fang" in the treatment of damp and heat type of upper airway cough syndrome. By statistical analysis and clinical evaluation, a traditional Chinese medicine compound preparation which can effectively treat upper airway cough syndrome with damp and heat type is provided by statistical analysis and clinical evaluation. Methods: a randomized, positive drug controlled clinical trial was carried out in 120 patients with upper airway cough syndrome, including respiratory outpatient, emergency department and fever outpatient from February 2015 to February 2016. They were randomly divided into treatment group (n = 60) and control group (n = 60) with azithromycin or cefoxime combined with montelukast. The treatment group was treated with BFK (10g, 10g, 10g, 10g, 10g, 10g, 10g, 10g, 10g, 10g, 10g, 10g, 10g, 10g, 10g, 10g, 10g, 10g, 10g, 10g, 10g, 10g, 10g, 10g, twice a day, respectively). The control group was given montelukast sodium chewable tablet 10mg once a night. Patients with chronic sinusitis were treated with azithromycin dry suspension 0.5g once a day for three days for four days or cefoxime capsule 100mg twice a day for one course of treatment. Results: there was no significant difference in sex, age and course of disease between the two groups. The improvement of cough and sputum after treatment: the scores of cough, sputum, rhinorrhagia, itching and pharynx were significantly different between the two groups before and after treatment (P 0.05). The two groups were effective for cough, sputum, nasal runny and itching. There was a significant difference in the difference between the two groups in terms of cough and pharyngotic symptoms compared with the control group (P 0.01). The results showed that the curative effect of the treatment group was higher than that of the control group in improving the hygrothermal cough and pharyngotic symptoms of the upper airway cough syndrome. The symptoms of sputum in the treatment group were significantly different from those in the control group (P 0.05). It indicated that the curative effect of the treatment group was higher than that of the control group in improving the expectoration symptom of the upper airway cough syndrome damp-heat type. The results of the initial time of cough improvement showed that the treatment group could improve cough symptoms more quickly and shorten the course of treatment significantly, and after 21 days of treatment, the overall curative effect of the two groups was compared: 14 cases of clinical control, 24 cases of marked effect, 17 cases of effective and 5 cases of ineffectiveness in treatment group. The total effective rate was 91.67 and the total effective rate was 76.677.In the western medicine group, there were 4 cases of clinical control, 14 cases of marked effect, 28 cases of effective, 14 cases of ineffectiveness, and 76.67% of the total effective rate. By rank sum test, the curative effect of traditional Chinese medicine group was better than that of western medicine group (P 0.05). Conclusion: according to the above clinical observation results, the conclusion is as follows: the treatment of upper airway cough syndrome with Bifei Ke Fang is effective in the whole, the main symptoms (cough, sputum, phlegm, phlegm, etc.) The improvement of pharyngitis was better than that of western medicine control group.
【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】：R256.1

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