【摘要】：目的:闡明喉源性咳嗽各證型的發(fā)病原因及證候形成的相關(guān)因素。方法:選取2013年1月至2016年1月來自廣西中醫(yī)藥大學(xué)第一附屬醫(yī)院及附屬瑞康醫(yī)院耳鼻喉科門診符合納入標(biāo)準(zhǔn)的喉源性咳嗽患者96例,對研究對象進(jìn)行臨床檢查及問卷調(diào)查,包括誘因、發(fā)病時(shí)間等,間接鼻咽鏡、間接喉鏡及電子鼻咽喉鏡檢查、胸部X線片檢查、外周血常規(guī)、C-反應(yīng)蛋白、吸入性變應(yīng)原篩查等實(shí)驗(yàn)指標(biāo)的觀察,對喉源性咳嗽的典型證候和一般證候進(jìn)行隨機(jī)對照研究以及處理,統(tǒng)計(jì)分析,提出喉源性咳嗽的基本證型。運(yùn)用廣義Logits模型(Generalized logits model)和判別分析(逐步判別、Fisher判別、Bayes判別)方法,對各證型喉源性咳嗽的相關(guān)因素和定量診斷進(jìn)行分析,為進(jìn)一步闡明喉源性咳嗽辨證標(biāo)準(zhǔn)及各證型證候演變規(guī)律提供依據(jù)。結(jié)果:1.本課題臨床流行病學(xué)調(diào)查發(fā)現(xiàn)喉源性咳嗽的證型以衛(wèi)表不固,稟質(zhì)過敏型為主,占64.58%,其次為脾虛痰濁型,占22.92%,第三為陰虛火旺型,占6.25%,第四為風(fēng)邪犯肺型,占6.25%。2.統(tǒng)計(jì)分析表明喉源性咳嗽各證型的發(fā)病與性別、年齡等人口學(xué)特征無關(guān)。3.喉源性咳嗽脾虛痰濁型的發(fā)病與煙酒嗜好、過敏史、感冒受涼等誘因有關(guān),衛(wèi)表不固、稟質(zhì)過敏型與煙酒嗜好、辛辣飲食、過敏史、感冒受涼等誘因有關(guān)系,而風(fēng)邪犯肺、陰虛火旺型因臨床病例較少,暫不能得出明確結(jié)論。4.而病程的長短、干咳、咽癢、清嗓、咽干、咽后壁淋巴濾泡增生等臨床特征在各證型見分布無明顯差異,脾虛痰濁型咽異物感、鼻癢打噴嚏、咽充血等特征較為明顯,衛(wèi)表不固,稟質(zhì)過敏型以鼻癢、打噴嚏、咽充血為主要特征。結(jié)論:1.統(tǒng)計(jì)分析表明喉源性咳嗽的發(fā)生與性別、年齡、職業(yè)、既往史、家族史、過敏史無關(guān),與煙酒嗜好、辛辣飲食、感冒、受涼等誘因有關(guān)系,而咽干、病程的長短、鼻癢、眼癢、痰多等伴隨癥狀在喉源性咳嗽各證型之間的分布情況有差異,但其具體聯(lián)系還有待更大樣本病例的采集及統(tǒng)計(jì)學(xué)的進(jìn)一步分析及探討。2.通過對喉源性咳嗽進(jìn)行臨床流行病學(xué)調(diào)查,獲得了喉源性咳嗽中醫(yī)證候的大樣本臨床流行病學(xué)資料以及對收集數(shù)據(jù)的整理和處理等具體經(jīng)驗(yàn),對喉源性咳嗽的臨床辯證分型及發(fā)病因素的研究進(jìn)行了有意義和成效的探索。
[Abstract]:Objective: to elucidate the pathogenesis of laryngeal cough and the related factors of syndrome formation. Methods: from January 2013 to January 2016, 96 patients with laryngogenic cough were selected from the first affiliated Hospital of Guangxi University of traditional Chinese Medicine and the Department of Otolaryngology of affiliated Ruikang Hospital. Including inducement, onset time, indirect nasopharyngoscope, indirect laryngoscope and electronic nasopharyngoscope, chest X-ray examination, peripheral blood routine C-reactive protein, screening of inhaled allergens, etc. The typical syndromes and general syndromes of laryngogenic cough were studied and treated randomly, and the basic syndromes of laryngogenic cough were put forward. Using the generalized Logits model (Generalized logits model) and discriminant analysis (stepwise discriminant Logits discriminant Bayes discriminant), the related factors and quantitative diagnosis of laryngogenic cough of various syndromes were analyzed. To further clarify the laryngogenic cough syndrome differentiation criteria and the evolution of syndrome patterns to provide the basis. The result is 1: 1. The clinical epidemiological investigation found that the syndrome type of laryngogenic cough was not solid, the type of intrinsic hypersensitivity was 64.58, followed by spleen deficiency and phlegm turbid type, accounting for 22.92um, the third type was Yin deficiency and fire flourishing type (6.2525), the fourth type was wind evil invading lung type (6.25g. 2). Statistical analysis showed that the onset of laryngeal cough was not related to the demographic characteristics of sex, age, etc. The onset of larynx cough, spleen deficiency and phlegm turbid type is related to smoking and wine addiction, allergic history, cold and other inducements. The health table is not strong. The intrinsic hypersensitivity type is related to smoking and alcohol addiction, spicy diet, allergic history, cold, etc., while wind evil invades the lung. Yin deficiency fire flourishing type because of the clinical cases are less, temporarily unable to reach a clear conclusion. 4. However, the clinical features of the disease course, dry cough, itchy pharynx, clear throat, dry pharynx, lymphoid follicular hyperplasia in the posterior pharynx wall were not significantly different in all syndromes. The characteristics of foreign body in pharynx with spleen deficiency and phlegm turbidity, nasal itching and sneezing, and hyperemia of pharynx were obvious. It is characterized by itching of nose, sneezing and hyperemia of pharynx. Conclusion 1. Statistical analysis showed that the occurrence of laryngeal cough was not related to sex, age, occupation, past history, family history, allergic history, but related to smoking and alcohol addiction, spicy diet, cold, and so on, while dry pharynx, duration of disease, nasal itch, eye itch, etc. There are differences in the distribution of sputum and other associated symptoms among the syndromes of laryngogenic cough, but the specific relationship needs to be collected from larger sample cases and further analyzed and discussed by statistics. 2. Through the clinical epidemiological investigation of laryngogenic cough, we obtained the large sample of clinical epidemiological data of laryngogenic cough syndrome, and the specific experience of collecting data and processing, etc. The clinical dialectical classification of laryngogenic cough and the study of its pathogenic factors were explored.
【學(xué)位授予單位】：廣西中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R276.1

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