本文關(guān)鍵詞：加味桑杏湯治療風(fēng)燥犯肺型感染后咳嗽臨床觀察　出處：《廣州中醫(yī)藥大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

  更多相關(guān)文章： 感染后咳嗽 風(fēng)燥犯肺 加味桑杏湯 療效 臨床觀察

【摘要】：目的:通過比較加味桑杏湯治療風(fēng)燥犯肺型感染后咳嗽患者用藥前后癥狀積分的變化,評價其療效,探討精簡加味桑杏湯藥味后對感染后咳嗽風(fēng)燥犯肺型患者治療效果的差異,以達到簡化處方,提高臨床療效的目的。方法:本研究采用隨機對照方法,把符合納入標準的患者分至中西藥A組、中西藥B組、西藥C組。中西藥A組予加味桑杏湯A號方(桑葉10g、沙參15g、梔子10g、淡豆豉10g、麥冬15g、知母10g、杏仁15g、浙貝母15g、枇杷葉15g、川芎10g)聯(lián)合西藥復(fù)方甲氧那明膠囊及孟魯司特鈉治療,中西藥B組予加味桑杏湯B號方(加味桑杏湯A號方+黃芩10g、桑白皮15g、海蛤殼30g)及西藥復(fù)方甲氧那明膠囊、孟魯司特鈉治療,西藥C組予復(fù)方甲氧那明膠囊及孟魯司特鈉治療,治療用藥共1周。觀察各組第4天、第8天咳嗽視覺模擬評分、咳嗽癥狀積分、中醫(yī)癥候積分的變化,并評價其療效及安全性。成果:1.臨床療效:治療第4天,中西藥A組總有效率85%,B組總有效率71.43%,西藥C組總有效率61.54%,三組總有效率差異無統(tǒng)計學(xué)意義(P0.05)。治療第8天,中西藥A組總有效率95%,中西藥B組總有效率90.48%,西藥C組總有效率61.54%,三組差異有統(tǒng)計學(xué)意義(P0.05),中西藥A組總有效率與中西藥B組差異無統(tǒng)計學(xué)意義(P0.05),中西藥組總有效率與西藥組總有效率差異有統(tǒng)計學(xué)意義(P0.05),表明中西藥A組與中西藥B組療效相當,中西藥組療效比西藥組療效佳。2.加味桑杏湯B號方與加味桑杏湯A號方療效相當(P0.05),增加清熱化痰藥后并未進一步提高臨床療效,表明可精簡處方,減少加味桑杏湯不必要的藥味,表明痰可能不是感染后咳嗽的主要病理因素。3.咳嗽癥狀積分:三組均能緩解日間咳嗽程度,但中西藥治療A組及中西藥治療B組能同等程度緩解日間咳嗽程度,比西藥C組緩解程度大(P05)。中西藥A組、B組均能緩解夜間咳嗽程度(P0.05),但西藥組緩解夜間咳嗽癥狀不明顯(P0.05)。4.中醫(yī)癥候積分:中西藥A組、B組能同等程度地緩解咽癢、咽部異物感,緩解程度比西藥C組佳(P0.05)。結(jié)論:1.加味桑杏湯A號方、B號方均能緩解風(fēng)燥犯肺型感染后咳嗽的癥狀,尤其能緩解咽癢、咽部異物感癥狀,中西藥聯(lián)合治療療效佳于單純西藥療效,可使有效率提高30%,達到90%以上。2.加味桑杏湯A號方、B號方治療風(fēng)燥犯肺型感染后咳嗽療效相當,對風(fēng)燥犯肺型感染后咳嗽患者的治療可減少清熱化痰藥物使用,加味桑杏湯A號方較B號方在提高療效基礎(chǔ)上減少了不必要的藥味。
[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.
【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】：2017
【分類號】：R256.11

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