消風止咳湯治療風邪戀肺型感染后咳嗽臨床觀察
發(fā)布時間：2019-05-14 04:16
【摘要】：目的：通過對現(xiàn)代醫(yī)學中感染后咳嗽(post-infectious cough PIC)的發(fā)病機理、臨床特點.中西醫(yī)目前治療等方面的理論研究,運用肖波教授臨床經(jīng)驗方“消風止咳湯”對辯證為風邪戀肺型感染后咳嗽進行治療和觀察其治療效果,驗證中醫(yī)藥在治療感染后咳嗽方面有著較明顯的優(yōu)勢,可以為眾多感染后咳嗽患者帶來更為廉便的治療方案。方法：通過收錄80例符合納入標準且不符合排除標準的感染后咳嗽患者(失訪病例除外),所有患者均為在2014年3月至2015年10月期間至廣州中醫(yī)藥大學附屬湛江市第二中醫(yī)院接受門診或住院治療。把入組且符合納入標準的80例患者按照隨機數(shù)字表法隨機分成研究組和對照組兩組,其中研究組為40人,對照組為40人。兩組患者較在性別、年齡、咳嗽癥狀積分、咳嗽嚴重程度視覺評分及中醫(yī)癥狀積分等方面在治療前經(jīng)統(tǒng)計學比較,P0.05,無統(tǒng)計學差異,可以進行療效差異性研究。研究組給予口服(廣東一方制藥生產(chǎn))顆粒型中藥,中藥處方為肖波教授經(jīng)驗基本處方(消風止咳湯),根據(jù)臨床實際辯證可進行適當?shù)募訙p,于藥杯中先加150-200ml開水,然后加入中藥配方顆粒,攪拌至溶解充分后適溫口服。用量：1服/次,2次/日,于早餐及晚餐30分鐘后服用。對照組給予指南推薦西醫(yī)常規(guī)用藥治療,給予富馬酸酮替芬1粒(1.38mg)一日2次,右美沙芬15mg一日3次。兩組治療療程均為10天,在治療過程中4d,7d,10d及治療結束1周,進行隨訪并記錄相關觀察指標。分別按照要求在相應時間點記錄兩組患者相對應治療時間點的數(shù)據(jù)：咳嗽癥狀積分、咳嗽視覺評分、中醫(yī)癥狀積分。每個患者在治療開始前和治療終結的1周后都進行安全性項目監(jiān)測,以評估藥物安全性。在治療觀察期間所有患者禁止使用除了試驗藥物之外的藥物(外用或內(nèi)服)。對所取得的臨床資料數(shù)據(jù)運用SPSS18.0統(tǒng)計軟件進行統(tǒng)計分析。數(shù)據(jù)以均數(shù)土標準差用(x±s)表示,計量資料用t檢驗,計數(shù)資料用X。檢驗,等級資料用秩和檢驗,重復測量設計采用方差分析,當P0.05時認為兩組數(shù)據(jù)之間存在顯著性差異,當P0.05時兩組數(shù)據(jù)之間無顯著性差異。結果：(1)臨床結果分析顯示運用肖波教授消“消風止咳湯”治療的研究組中臨床療效、癥狀改善程度相對指南推薦的西藥治療對照組均有較明顯優(yōu)勢,且不良反應少,無明顯毒副作用。(2)臨床研究結果顯示,研究組治療40例患者中治愈17例,在觀察時間窗內(nèi)治愈率為42.5%,總有效率為92.5%；而對照組同樣治療40例患者,其中治愈9例,在觀察時間窗內(nèi)治愈率為22.5%,總有效率為72.5%。經(jīng)統(tǒng)計學分析兩組在療效方面比較存在顯著性差異(P0.05)。經(jīng)過治療后兩組患者在咳嗽癥狀積分、咳嗽視覺模擬評分、中醫(yī)癥狀積分與治療前比較都有積分有較明顯下降,患者自覺癥狀改善,并且兩組治療后各種指標積分下降差值經(jīng)過統(tǒng)計學比較存在顯著性差異(P0.05)顯示研究組比對照組效果更明顯,且具有統(tǒng)計學意義。(3)經(jīng)過不同治療的患者在治療后兩組不良反應發(fā)生率分別為：研究組：7.5%,對照組27.5%。研究組中藥在治療過程中未發(fā)現(xiàn)肝腎功能損害及其他不良反應,而對照組有11位患者出現(xiàn)嗜睡,頭暈、或胃腸道反應等不良反應,經(jīng)停藥后癥狀可消失。不良事件發(fā)生率兩組比較研究組的不良反應率低于對照組,經(jīng)X2檢驗有統(tǒng)計學意義。結論：肖波教授“消風止咳湯”在治療感染后咳嗽(風邪戀肺型)臨床試驗中能取得較好的臨床效果,并且安全有效,能有效地緩解患者臨床癥狀,值得在臨床中推廣。
[Abstract]:Objective: To study the pathogenesis and clinical characteristics of post-infectious cough (PPIC) in modern medicine. The theoretical study on the current treatment of traditional Chinese and western medicine, using the "Xiaofeng Zhike Decoction" of Professor Xiao-bo's clinical experience, to treat and observe the treatment effect of the cough after the infection of the lung-type infection, and to verify the obvious advantages of the traditional Chinese medicine in the treatment of post-infection cough, Can provide a more effective treatment scheme for a plurality of patients with post-infection cough. Method:80 patients with post-infection cough (with the exception of lost-to-follow-up) included in the standard and not meeting the exclusion criteria were collected, and all the patients were admitted to the second middle-level hospital in Zhanjiang, Guangzhou, from March 2014 to October 2015 for outpatient or hospitalization. 80 patients enrolled and met the criteria were randomly divided into two groups in the study group and the control group according to the random digital table method. The study group was 40, and the control group was 40. There was no statistical difference between the two groups in the treatment of sex, age, cough symptom, the severity of cough, and the integral of the symptoms of TCM. The study group is given the granule type traditional Chinese medicine for oral administration (one of Guangdong's pharmaceutical production), and the prescription of the traditional Chinese medicine is the basic prescription of Professor Xiao Bo's experience (Xiaofeng Zhike Tang). According to the clinical practice, the appropriate addition and subtraction can be carried out, and 150-200 ml of boiled water is added in the medicine cup, and then the traditional Chinese medicine formula particles are added, Stirring until the solution is fully dissolved, and is suitable for oral administration. Dosage:1 service/ time,2 times/ day, and taken after 30 minutes of breakfast and dinner. The control group recommended that western medicine should be treated with conventional medicine, and the ketotifen fumarate 1 particle (1.38 mg) was given 2 times a day, and the dextromethorphan was 15 mg daily for 3 times. The treatment course of the two groups was 10 days, and the follow-up was carried out for 4 days,7 days,10 days and 1 week after the treatment, and the relevant observation indexes were recorded. The data of the corresponding treatment time points of the two groups were recorded at the corresponding time points according to the requirements: the symptoms of cough, the visual score of the cough, and the integral of the symptoms of the Chinese medicine. Safety project monitoring was performed for each patient after 1 week of treatment initiation and end of treatment to assess drug safety. All patients were prohibited from using a drug (external or oral) other than the investigational drug during the treatment observation. The statistical analysis of the obtained clinical data was carried out using the SPSS18.0 statistical software. The data is represented by the standard deviation of the mean soil standard deviation (x% s). The measurement data is used for t-test, and the count data is used for X-ray. The rank and the test of the grade data are used for the measurement data. The analysis of variance is used for the repeated measurement design. When the difference between the two groups of data is considered as the difference between the two groups of data at the time of P0.05, There was no significant difference between the two groups when P0.05. Results: (1) The clinical result analysis showed that the clinical curative effect and the improvement degree of the clinical effect and the degree of improvement of the symptom in the study group treated by Xiao Bo's anti-"Xiaofeng Zhike Decoction" therapy had obvious advantages, with few adverse reactions and no obvious toxic and side effects. (2) The results showed that in the study group,17 cases were cured in 40 patients, the cure rate was 42.5% in the observation time window, the total effective rate was 92.5%, and the control group treated 40 patients, among which 9 cases were cured, and the cure rate in the observation time window was 22.5%. The total effective rate was 72.5%. There was a significant difference in the efficacy of the two groups (P0.05). After the treatment, the symptoms of the cough, the visual analogue of the cough and the integral of the symptoms of the traditional Chinese medicine and the pre-treatment of the symptoms of the cough were significantly reduced, and the patient's self-conscious symptoms were improved. There was a significant difference in the difference between the two groups after the treatment (P0.05). (3) The incidence of adverse reactions in the two groups after treatment was as follows: study group: 7.5%, control group 27.5%. In the study group, the function of the liver and the kidney and other adverse reactions were not found in the course of the treatment, while 11 patients in the control group had the adverse reactions such as somnolence, dizziness, or gastrointestinal reaction, and the symptoms may disappear after the drug withdrawal. The incidence of adverse events in the two groups was lower than that of the control group. Conclusion: Professor Xiao-bo's "Xiaofeng Zhike Decoction" has a good clinical effect in the clinical trial of treating cough after infection, and is safe and effective, and can effectively relieve the clinical symptoms of the patient and is worthy of being popularized in the clinic.
【學位授予單位】：廣州中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2016
【分類號】：R256.1
本文編號：2476428
[Abstract]:Objective: To study the pathogenesis and clinical characteristics of post-infectious cough (PPIC) in modern medicine. The theoretical study on the current treatment of traditional Chinese and western medicine, using the "Xiaofeng Zhike Decoction" of Professor Xiao-bo's clinical experience, to treat and observe the treatment effect of the cough after the infection of the lung-type infection, and to verify the obvious advantages of the traditional Chinese medicine in the treatment of post-infection cough, Can provide a more effective treatment scheme for a plurality of patients with post-infection cough. Method:80 patients with post-infection cough (with the exception of lost-to-follow-up) included in the standard and not meeting the exclusion criteria were collected, and all the patients were admitted to the second middle-level hospital in Zhanjiang, Guangzhou, from March 2014 to October 2015 for outpatient or hospitalization. 80 patients enrolled and met the criteria were randomly divided into two groups in the study group and the control group according to the random digital table method. The study group was 40, and the control group was 40. There was no statistical difference between the two groups in the treatment of sex, age, cough symptom, the severity of cough, and the integral of the symptoms of TCM. The study group is given the granule type traditional Chinese medicine for oral administration (one of Guangdong's pharmaceutical production), and the prescription of the traditional Chinese medicine is the basic prescription of Professor Xiao Bo's experience (Xiaofeng Zhike Tang). According to the clinical practice, the appropriate addition and subtraction can be carried out, and 150-200 ml of boiled water is added in the medicine cup, and then the traditional Chinese medicine formula particles are added, Stirring until the solution is fully dissolved, and is suitable for oral administration. Dosage:1 service/ time,2 times/ day, and taken after 30 minutes of breakfast and dinner. The control group recommended that western medicine should be treated with conventional medicine, and the ketotifen fumarate 1 particle (1.38 mg) was given 2 times a day, and the dextromethorphan was 15 mg daily for 3 times. The treatment course of the two groups was 10 days, and the follow-up was carried out for 4 days,7 days,10 days and 1 week after the treatment, and the relevant observation indexes were recorded. The data of the corresponding treatment time points of the two groups were recorded at the corresponding time points according to the requirements: the symptoms of cough, the visual score of the cough, and the integral of the symptoms of the Chinese medicine. Safety project monitoring was performed for each patient after 1 week of treatment initiation and end of treatment to assess drug safety. All patients were prohibited from using a drug (external or oral) other than the investigational drug during the treatment observation. The statistical analysis of the obtained clinical data was carried out using the SPSS18.0 statistical software. The data is represented by the standard deviation of the mean soil standard deviation (x% s). The measurement data is used for t-test, and the count data is used for X-ray. The rank and the test of the grade data are used for the measurement data. The analysis of variance is used for the repeated measurement design. When the difference between the two groups of data is considered as the difference between the two groups of data at the time of P0.05, There was no significant difference between the two groups when P0.05. Results: (1) The clinical result analysis showed that the clinical curative effect and the improvement degree of the clinical effect and the degree of improvement of the symptom in the study group treated by Xiao Bo's anti-"Xiaofeng Zhike Decoction" therapy had obvious advantages, with few adverse reactions and no obvious toxic and side effects. (2) The results showed that in the study group,17 cases were cured in 40 patients, the cure rate was 42.5% in the observation time window, the total effective rate was 92.5%, and the control group treated 40 patients, among which 9 cases were cured, and the cure rate in the observation time window was 22.5%. The total effective rate was 72.5%. There was a significant difference in the efficacy of the two groups (P0.05). After the treatment, the symptoms of the cough, the visual analogue of the cough and the integral of the symptoms of the traditional Chinese medicine and the pre-treatment of the symptoms of the cough were significantly reduced, and the patient's self-conscious symptoms were improved. There was a significant difference in the difference between the two groups after the treatment (P0.05). (3) The incidence of adverse reactions in the two groups after treatment was as follows: study group: 7.5%, control group 27.5%. In the study group, the function of the liver and the kidney and other adverse reactions were not found in the course of the treatment, while 11 patients in the control group had the adverse reactions such as somnolence, dizziness, or gastrointestinal reaction, and the symptoms may disappear after the drug withdrawal. The incidence of adverse events in the two groups was lower than that of the control group. Conclusion: Professor Xiao-bo's "Xiaofeng Zhike Decoction" has a good clinical effect in the clinical trial of treating cough after infection, and is safe and effective, and can effectively relieve the clinical symptoms of the patient and is worthy of being popularized in the clinic.
【學位授予單位】：廣州中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2016
【分類號】：R256.1
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