桂枝麻黄各半汤对呼吸道感染后咳嗽气道炎症介质的影响
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摘要
目的:观察桂枝麻黄各半汤对呼吸道感染后咳嗽患者的临床疗效,并研究其对气道炎性介质的调节作用。方法:选取80例呼吸道感染后咳嗽患者,随机分为两组,每组各40例。对照组患者给予复方甲氧那敏胶囊治疗,观察组患者采用桂枝麻黄各半汤治疗。比较治疗前后两组患者咳嗽评分、咳嗽程度、临床症状消失时间、气道炎性介质(SP、NKA、NKB及CGRP)水平、生活质量评价、临床疗效及不良反应。结果:观察组治疗的总有效率为92.5%,对照组的临床总有效率为82.5%,两组比较差异有统计学意义(P<0.05)。治疗后两组SP、NKA、NKB及CGRP的水平较治疗前显著降低(P<0.05),并且治疗后观察组降低幅度明显较对照组大(P<0.05);治疗后两组的日间咳嗽、夜间咳嗽、咳嗽总评分及VAS评分均明显降低(P<0.05),并且观察组的各项评分明显低于对照组(P<0.05)。治疗后两组生理状况、心理健康、社会功能及总分均较治疗前显著升高(P<0.05),并且观察组各项评分较对照组升高幅度大(P<0.05)。对照组不良反应发生率为37.5%,观察组未发现不良反应。结论:桂枝麻黄各半汤可以明显改善感染后咳嗽患者的临床症状,显著降低气道炎症性介质水平,改善气道炎症,具有较好的临床疗效,安全性高。
Objective: To observe the clinical curative effect of Guizhi Mahuang Geban Decoction on patients with cough after respiratory infectionand study its regulating effect on airway inflammatory mediators. Methods: Eighty patients with cough after respiratory tract infection were selected and randomly divided into two groups, 40 cases in each group. Patients in the control group were treated with compound methoxamine. The observation group was treated with Guizhi Mahuang Geban Decoction. The score of cough, the degree of cough, the time of disappearance of clinical symptoms, the level of airway inflammatory mediators(SP, NKA, NKB and CGRP), the evaluation of quality of life, clinical efficacy and adverse reactions were compared between the two groups before and after treatment. Results: The total effective rate of the patients in the observation group was 92.5% and that of the control group was 82.5%and the difference between the two groups was statistically significant(P<0.05). After treatment, the levels of two groups' SP, NKA, NKB and CGRP were significantly lower than those before treatment(P<0.05), and the decrease of the observation group was significantly higher than that of the control group(P<0.05) after treatment. The total day cough, coughing and cough score and VAS score in the two groups were significantly reduced(P<0.05) after treatment and the scores of the observation group were scored. It was significantly lower than that of the control group(P<0.05). After treatment, the physiological status, mental health, social function and total score of the two groups were significantly higher than those before treatment(P<0.05), and the scores of the observation group were higher than those in the control group(P<0.05). The incidence of adverse reactions in the control group was 37.5%and no adverse reactions were observed in the observation group. Conclusion:Guizhi Mahuang Geban Decoction can obviously improve the clinical symptoms of the patients with coughing after infection, reduce the level of airway inflammatory mediators and improve the airway inflammation, which has good clinical effect and high safety.
Objective: To observe the clinical curative effect of Guizhi Mahuang Geban Decoction on patients with cough after respiratory infectionand study its regulating effect on airway inflammatory mediators. Methods: Eighty patients with cough after respiratory tract infection were selected and randomly divided into two groups, 40 cases in each group. Patients in the control group were treated with compound methoxamine. The observation group was treated with Guizhi Mahuang Geban Decoction. The score of cough, the degree of cough, the time of disappearance of clinical symptoms, the level of airway inflammatory mediators(SP, NKA, NKB and CGRP), the evaluation of quality of life, clinical efficacy and adverse reactions were compared between the two groups before and after treatment. Results: The total effective rate of the patients in the observation group was 92.5% and that of the control group was 82.5%and the difference between the two groups was statistically significant(P<0.05). After treatment, the levels of two groups' SP, NKA, NKB and CGRP were significantly lower than those before treatment(P<0.05), and the decrease of the observation group was significantly higher than that of the control group(P<0.05) after treatment. The total day cough, coughing and cough score and VAS score in the two groups were significantly reduced(P<0.05) after treatment and the scores of the observation group were scored. It was significantly lower than that of the control group(P<0.05). After treatment, the physiological status, mental health, social function and total score of the two groups were significantly higher than those before treatment(P<0.05), and the scores of the observation group were higher than those in the control group(P<0.05). The incidence of adverse reactions in the control group was 37.5%and no adverse reactions were observed in the observation group. Conclusion:Guizhi Mahuang Geban Decoction can obviously improve the clinical symptoms of the patients with coughing after infection, reduce the level of airway inflammatory mediators and improve the airway inflammation, which has good clinical effect and high safety.
引文
[1] 胡诣璋,赵俊,崔瑷. 感染后咳嗽发病机制及治疗进展[J]. 临床药物治疗杂志,2016,14(1):11-16.
[2] 王晶. 中医药治疗呼吸道病毒感染后咳嗽的疗效观察[J]. 临床医药文献电子杂志,2017,4(77):15093-15094.
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[5] 诸葛建成,王春林,余优琴,等. 桂枝麻黄各半汤治疗风寒恋肺型感染后咳嗽临床观察[J]. 新中医,2017,49(5):32-34.
[6] 中华医学会呼吸病学分会哮喘学组. 咳嗽的诊断与治疗指南[S].中华结核和呼吸杂志,2016,39(5):323-338.
[7] 李璟,吴春红,刘丽.过敏煎联合孟鲁司特钠对咳嗽变异性哮喘患儿肺功能影响的研究[J].中华中医药学刊,2018,36(2):499-501.
[8] 王志刚,朱阿瑾,方霞,等.热毒宁联合头孢哌酮舒巴坦钠对多重耐药菌呼吸道感染患儿临床疗效及安全性研究[J].中华中医药学刊,2017,35(3):677-679.
[9] 姜燕,刘昊,毛兵. 中医药治疗感染后咳嗽系统评价[J]. 辽宁中医药大学学报,2017,19(2):149-152.
[10] 魏宗明,洪敏俐. 洪敏俐治疗感染后咳嗽的临床经验[J]. 中医药通报,2018,17(1):22-23.
[11] 张英兰,唐斌擎,方泓,等. 咳喘六味合剂治疗风寒犯肺感染后咳嗽与小青龙合剂等效性随机平行对照研究[J]. 实用中医内科杂志,2017,31(12):1-3.
[12] 蔡林,雷长国.健脾宣肺法论治小儿慢性咳嗽[J].川北医学院学报,2016,31(5):635-636.
[13] 井梦昕,周贤梅.周贤梅教授治疗感染后咳嗽经验浅析[J].四川中医,2018,36(1):6-8.
[14] 卢峰,王世聪,陈志斌. 麻荆止咳颗粒治疗咳嗽变异性哮喘风盛挛急证37例[J]. 福建中医药,2017,48(6):1-3.
[15] 贾维刚,曲颖,周泉宇,等. 芩百清肺浓缩丸对感染后咳嗽大鼠SP、CGRP、NEP的影响[J]. 中国中医药科技,2018,25(3):334-338.
[16] 李才元. 自拟加味二陈汤调控咳嗽变异性哮喘患者气道神经源性炎症的作用机制研究[J]. 现代中西医结合杂志,2018,27(8):837-840.
[17] 石晓岚.TRPV1及TGF-β2的ELISA及免疫组化方法检测对上气道咳嗽综合征的诊断价值[J].川北医学院学报,2016,31(5):637-640.
[18] 杨洋,方丽萍,卞清明.羟考酮复合右美托咪定抑制芬太尼诱发的咳嗽反射[J].江苏大学学报(医学版),2018,28(1):82-85.
[19] 李飞侠,王文,朱佳,等. 宣肺止嗽方对感染后咳嗽大鼠气道神经源性炎症的影响及其机理研究[J]. 江苏中医药,2013,45(6):66-68.
[20] 沈若冰,余小萍,何铭晟. 蝉芩颗粒对大鼠气道神经源性炎症的作用机制研究[J]. 四川中医,2016,34(1):51-56.
[21] 马文建,鲁玉芬,刘永新,等. 小儿肺咳颗粒治疗儿童感染后咳嗽的疗效与作用机制[J]. 中国实验方剂学杂志,2017,23(14):204-209.
[22] 王静. 止咳汤治疗老年人感染后咳嗽临床研究[J]. 中医学报,2017,32(12):2336-2339.
[2] 王晶. 中医药治疗呼吸道病毒感染后咳嗽的疗效观察[J]. 临床医药文献电子杂志,2017,4(77):15093-15094.
[3] 中华医学会呼吸病学分会哮喘学组.咳嗽的诊断与治疗指南[S].中华结核和呼吸杂志,2009,32(6):407- 413.
[4] 谢先余.韩明向教授从风痰阳虚论治慢性咳嗽经验[J].河北中医,2018,40(2):173-176.
[5] 诸葛建成,王春林,余优琴,等. 桂枝麻黄各半汤治疗风寒恋肺型感染后咳嗽临床观察[J]. 新中医,2017,49(5):32-34.
[6] 中华医学会呼吸病学分会哮喘学组. 咳嗽的诊断与治疗指南[S].中华结核和呼吸杂志,2016,39(5):323-338.
[7] 李璟,吴春红,刘丽.过敏煎联合孟鲁司特钠对咳嗽变异性哮喘患儿肺功能影响的研究[J].中华中医药学刊,2018,36(2):499-501.
[8] 王志刚,朱阿瑾,方霞,等.热毒宁联合头孢哌酮舒巴坦钠对多重耐药菌呼吸道感染患儿临床疗效及安全性研究[J].中华中医药学刊,2017,35(3):677-679.
[9] 姜燕,刘昊,毛兵. 中医药治疗感染后咳嗽系统评价[J]. 辽宁中医药大学学报,2017,19(2):149-152.
[10] 魏宗明,洪敏俐. 洪敏俐治疗感染后咳嗽的临床经验[J]. 中医药通报,2018,17(1):22-23.
[11] 张英兰,唐斌擎,方泓,等. 咳喘六味合剂治疗风寒犯肺感染后咳嗽与小青龙合剂等效性随机平行对照研究[J]. 实用中医内科杂志,2017,31(12):1-3.
[12] 蔡林,雷长国.健脾宣肺法论治小儿慢性咳嗽[J].川北医学院学报,2016,31(5):635-636.
[13] 井梦昕,周贤梅.周贤梅教授治疗感染后咳嗽经验浅析[J].四川中医,2018,36(1):6-8.
[14] 卢峰,王世聪,陈志斌. 麻荆止咳颗粒治疗咳嗽变异性哮喘风盛挛急证37例[J]. 福建中医药,2017,48(6):1-3.
[15] 贾维刚,曲颖,周泉宇,等. 芩百清肺浓缩丸对感染后咳嗽大鼠SP、CGRP、NEP的影响[J]. 中国中医药科技,2018,25(3):334-338.
[16] 李才元. 自拟加味二陈汤调控咳嗽变异性哮喘患者气道神经源性炎症的作用机制研究[J]. 现代中西医结合杂志,2018,27(8):837-840.
[17] 石晓岚.TRPV1及TGF-β2的ELISA及免疫组化方法检测对上气道咳嗽综合征的诊断价值[J].川北医学院学报,2016,31(5):637-640.
[18] 杨洋,方丽萍,卞清明.羟考酮复合右美托咪定抑制芬太尼诱发的咳嗽反射[J].江苏大学学报(医学版),2018,28(1):82-85.
[19] 李飞侠,王文,朱佳,等. 宣肺止嗽方对感染后咳嗽大鼠气道神经源性炎症的影响及其机理研究[J]. 江苏中医药,2013,45(6):66-68.
[20] 沈若冰,余小萍,何铭晟. 蝉芩颗粒对大鼠气道神经源性炎症的作用机制研究[J]. 四川中医,2016,34(1):51-56.
[21] 马文建,鲁玉芬,刘永新,等. 小儿肺咳颗粒治疗儿童感染后咳嗽的疗效与作用机制[J]. 中国实验方剂学杂志,2017,23(14):204-209.
[22] 王静. 止咳汤治疗老年人感染后咳嗽临床研究[J]. 中医学报,2017,32(12):2336-2339.