从秋燥辨证论治感冒后咳嗽临床观察

摘要

目的 观察从秋燥辨证论治感冒后咳嗽的临床疗效.方法 将80例感冒后咳嗽患者随机分为2组,对照组40例予常规西药复方氢溴酸右美沙芬糖浆、富马酸酮替芬片治疗,治疗组40例从秋燥辨证论治,温燥型予桑杏汤,凉燥型予杏苏散.2组均治疗l周.观察2组治疗前后脉冲振荡法测定肺功能指标[呼吸总阻抗(Zrs)、总气道阻力(R5)、中心气道阻力(R20)、周边弹性阻力(X5)]、咳嗽症状积分、呼出气体一氧化氮(NO)变化,比较2组疗效.结果 治疗组总有效率97.5％,对照组总有效率62.5％,2组总有效率比较差异有统计学意义(P＜0.05),治疗组疗效优于对照组.治疗组咳嗽总有效率97.5％,对照组咳嗽总有效率72.5％,2组咳嗽总有效率比较差异有统计学意义(P＜0.05),治疗组咳嗽疗效优于对照组.治疗组咯痰总有效率95.0％,对照组咯痰总有效率67.5％,2组咯痰总有效率比较差异有统计学意义(P＜0.05),治疗组咯痰疗效优于对照组.2组治疗后Zrs、R5、R20均较本组治疗前降低(P＜0.05),X5升高(P＜0.05);治疗组治疗后Zrs、R5、R20低于对照组治疗后(P＜0.05),X5高于对照组治疗后(P＜0.05).2组治疗后咳嗽症状积分均较本组治疗前降低(P＜0.05),且治疗组治疗后降低更明显(P＜0.05).治疗组治疗后呼出气体NO较本组治疗前下降(P＜0.05),且低于对照组治疗后(P＜0.05).结论 从秋燥辨证论治感冒后咳嗽具有更好的临床疗效.%Objective To observe the clinical effects of syndrome differentiation based on the theory of autumn dryness on the treatment of post-infectious cough.Methods 80 patients with post-infectious cough were randomly divided into 2 groups.40 cases in the control group were treated by compound dextromethorphan hydrobromide syrup and ketotifen fumarate tablets,and 41 cases in the treatment group syndrome differentiation based on the theory of autumn dryness,that is the warm dryness type was treated by modified Sangxing decoction and the cool dryness type was treated by modified Xingsu powder.The two groups were treated for one week.The lung function indicators including total respiratory impedance (Zrs),airway total viscosity resistance (R5),proximal airway total viscosity resistance (R20),and peripheral elastic resistance (X5) by impulse oscillation system (IOS),the cough symptom score and exhaled gas nitric oxide (NO) before and after treatment were observed in two groups,and the curative effects were compared between the two groups.Results There were statistical differences on the total effective rate between the treatment group (97.5％) and the control group (62.5％,P ＜0.05),and the curative effects in the treatment group was superior that in the control group (P ＜ 0.05).The total effective rate of cough in the treatment group (97.5％) was superior to that in the control group (72.5％,P ＜0.05).The total effective rate of cough up phlegm in the treatment group (95.0％) was superior to that in the control group (67.5％,P ＜0.05).The Zrs,R5 and R20 after treatment reduced in the two.groups (P ＜ 0.05),X5 increased (P ＜ 0.05).The Zrs,R5 and R20 after treatment in the treatment group were lower than that in the control group (P ＜ 0.05),and X5 higher (P ＜ 0.05).The cough symptom score after treatment reduced in two groups (P ＜ 0.05),and the reduction in the treatment group more obvious (P ＜ 0.05).The exhaled gas NO after treatment reduced in the treatment group(P ＜ 0.05),and which lower than that in the control group (P ＜ 0.05).Conclusion Syndrome differentiation based on the theory of autumn dryness on the treatment of post-infectious cough has better clinical effects.