中西药结合治疗变应性咳嗽临床效果观察
|
摘要
目的观察中西药结合治疗变应性咳嗽(凉燥犯肺证)的效果。方法将变应性咳嗽(凉燥犯肺证)患者62例随机分为研究组和对照组各31例,对照组采用罗红霉素、西替利嗪、泼尼松和孟鲁司特治疗,研究组在对照组的基础上加用杏苏散及中药穴位敷贴治疗。治疗后观察2组治疗前后咳嗽积分及不良反应。结果治疗后2组日间咳嗽积分、夜间咳嗽积分、咳嗽总积分均低于治疗前,且研究组低于对照组,差异均有统计学意义(P<0.05)。研究组患者出现疲倦3例,敷贴皮肤起泡1例。对照组患者出现疲倦2例,恶心2例,2组患者不良反应发生率比较差异无统计学意义(P>0.05)。结论采用罗红霉素、西替利嗪、泼尼松、孟鲁司特联合杏苏散及中药穴位敷贴治疗变异性咳嗽(凉燥犯肺证)疗效较好,值得临床推广。
Objective To investigate the effect of traditional Chinese medicine combined with western medicineon in treatment of allergic cough(cold dryness invading lung syndrome).Methods 62 patients with allergic cough(cold dryness invading lung syndrome) were randomly divided into study group and control group,each of 31 cases.Control group was treated with roxithromycin,cetirizine,prednisone and montelukast.On the basis of control group,study group added Xing Su San and Chinese medicine acupoint application.The cough scores and adverse reactions of two groups before and after treatment were observed.Results After treatment,the daily cough score,night cough score and total cough score of two groups were lower than before treatment,and study group was lower than control group,the difference was statistically significant(P<0.05).In study group,3 patients developed fatigue and 1 patient presented with foaming on the skin.In control group,there were 2 cases of fatigue and 2 cases of nausea.There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion The curative effect of roxithromycin,cetirizine,prednisone,montelukast combined with Xing Su San and acupoint application of Chinese traditional medicine is good,and it is worthy of clinical popularization.
Objective To investigate the effect of traditional Chinese medicine combined with western medicineon in treatment of allergic cough(cold dryness invading lung syndrome).Methods 62 patients with allergic cough(cold dryness invading lung syndrome) were randomly divided into study group and control group,each of 31 cases.Control group was treated with roxithromycin,cetirizine,prednisone and montelukast.On the basis of control group,study group added Xing Su San and Chinese medicine acupoint application.The cough scores and adverse reactions of two groups before and after treatment were observed.Results After treatment,the daily cough score,night cough score and total cough score of two groups were lower than before treatment,and study group was lower than control group,the difference was statistically significant(P<0.05).In study group,3 patients developed fatigue and 1 patient presented with foaming on the skin.In control group,there were 2 cases of fatigue and 2 cases of nausea.There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion The curative effect of roxithromycin,cetirizine,prednisone,montelukast combined with Xing Su San and acupoint application of Chinese traditional medicine is good,and it is worthy of clinical popularization.
引文
[1] 赖克方.慢性咳嗽[M].北京:人民卫生出版社,2008.
[2] 夏祥新.肺部曲菌感染61例的临床、X线与病理对照分析[J].中华结核和呼吸杂志,2005,15(1):16.
[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(2009版)[J].中华结核和呼吸杂志,2009,32(6):407-413.DOI:10.3760/cma.j.issn.1001-0939.2009.06.004.
[4] 田德禄.中医内科学[M].北京:人民卫生出版社,2002:60.
[5] 官福兰.枳壳及辛弗林对小鼠胃排空、小肠推进功能的影响[J].现代中西医结合杂志,2002,11(11):1001-1003.
[6] 肖锷,罗珍华,肖士熹.止嗽散与地红霉素联用对变态性咳嗽患者的临床疗效评价[J].抗感染药学,2017,14(7):1387-1388.
[7] 褚建.变应性咳嗽38例诊断及治疗体会[J].中国现代医药杂志,2008,10(8):78.DOI:10.3969/j.issn.1672-9463.2008.08.035.
[8] 余夏发,曾抱民,潘茂才,等.变应性咳嗽46例临床分析[J].河北医学,2011,5,17(5):636-637.DOI:10.3969/j.issn.1006-6233.2011.05.026.
[9] 王海翔,徐丽华.变应性咳嗽的研究进展[J].国际呼吸杂志,2009,29(15):945-955.
[10] Brightling CE,Bradding P,Symon FA,et al.Mast-cell jnfiltration of airway smooth muscle in asthma[J].N Engl J Med,2002(346):1699-1705.DOI:10.1056/NEJMoa012705.
[11] 中华医学会呼吸病学分会.社区获得性肺炎诊断和治疗指南(草案)[J].现代实用医学,2002,14(3):158-160.
[12] 甘露.大鼠pEGFP-N1-BKβ1真核表达载体的构建及苦杏仁苷对支气管平滑肌细胞增殖的研究[D].武汉:华中科技大学,2007.
[13] 孙也评.紫苏叶提取物及其有效成分的抗菌活性研究[D].延吉:延边大学药学院,2014:2-22.
[14] 魏雯,高婷婷,谭勇,等.紫苏不同部位的体外抑菌作用[J].医药导报,2014,33(2):149-151.
[15] 谌立巍,卢先明,陈思敏.不同产地半夏的初步药效学评价实验研究[J].成都中医药大学学报,2008,31(2):54-57.DOI:10.3969/j.issn.1004-0668.2008.02.020.
[16] 柯昌毅.半夏5种不同溶剂提取物对小鼠祛痰镇咳作用的研究[J].中国药房,2012,23(39):3652-3654.DOI:10.6039/j.issn.1001-0408.2012.39.02.
[17] 邓媛媛,邵贝贝,王光忠,等.茯苓调节免疫功能有效物质的比较研究[J].中国医药指南,2012,10(12):94-95.DOI:10.3969/j.issn.1671-8194.2012.12.057.
[18] 张村,殷小杰,李丽,等.白花前胡蜜炙前后的药效学比较研究[J].中国实验方剂学杂志,2010,16(15):146-148.
[19] 孙荏苒,张满云,陈勤.桔梗皂苷胶囊抗炎止咳平喘作用研究[J].中药药理与临床,2010,26(4):27-29.
[20] 郑繁慧.黑曲霉转化桔梗皂苷及其祛痰作用研究[D].吉林:吉林农业大学,2011.
[21] Shi Q,Liu Z,Yang Y,et al.Identification of anti-asthmatic compoundsin Pericarpium citrireticulatae and evaluation of their synergistic effects[J].Acta Pharmacol Sin,2009,30(5):567-575.DOI:10.1038/aps.2009.36.
[22] 史坤,张泽生,王玉本,等.甘草多糖的体外免疫调节作用[J].食品科技,2008(5):267-269.DOI:10.3969/j.issn.1005-9989.2008.05.079.
[23] 王小飞,吴国泰,牛亭惠,等.生姜的化学、药理及应用[J]中国果菜,2016,36(6):23-26.
[24] 高艳青.半夏,甘草,生姜三泻心汤药物配伍的实验研究[D].北京:北京中医药大学,2004:6.
[25] 刘小云,牛媛媛,张常然,等.中药六君子汤对慢性支气管炎大鼠气道炎症因子的影响[J].实用医学杂志,2009,25(22):3776-3778.DOI:10.3969/j.issn.1006-5725.2009.22.017.
[26] 陆忠凯,陈卫昌.血管活性肠肽在调节肠黏膜屏障功能中的作用[J].国际消化病杂志,2008,28(3):226-229.
[27] 林沁臻.浅谈肺系疾病从脾论治[J].湖北中医杂志,2004,26(2):21.DOI:10.3969/j.issn.1000-0704.2004.02.010.
[28] 王维有,曹晨晨,欧赟,等.大枣中环磷酸腺苷的提取及体外抗过敏活性研究[J].食品工业科技,2013,34(11):49-52,282.
[29] 张学梅,刘凡亮,梁文波,等.白芥子提取物的镇咳、祛痰及平喘作用研究[J].中草药,2003,34(7):635-637.
[30] 宋晓平,姬晓兰.斑、蝥白芥子发泡规律的研究[J].中国针灸,2007,27(2):126-128.
[31] 刁义平.甘遂和醋甘遂提取物急性毒性和刺激性实验研究[J].药物不良反应杂志,2007,9(4):243-246.DOI:10.3969/j.issn.1008-5734.2007.04.004.
[32] 周桢祥,李军,陈泽斌,等.细辛散剂对家兔呼吸运动及膈神经电活动的影响[J].湖北中医,2005,27(4):3-5.DOI:10.3969/j.issn.1000-0704.2005.04.001.
[33] 胡洪波,钱长苏.丁香柿蒂在呃逆中的应用[J].实用中医内科杂志,2007,21(1):84.DOI:10.3969/j.issn.1671-7813.2007.01.073.
[34] 侯仙明,王文智,王亚利,等.肉桂对哮喘模型豚鼠血清中IL-2、5的影响[J].中国中医基础医学杂志,2009,15(7):543.
[35] 石萍,王玉珍,杨敏.穴位止咳贴辅助治疗喘息性支气管炎疗效观察[J].山东医药,2008,48(4):56.
[36] 王树凡.冬病夏治中药穴位贴敷法的临床运用[J].光明中医,2007,22(4):16-17.DOI:10.3969/j.issn.1003-8914.2007.04.011.
[2] 夏祥新.肺部曲菌感染61例的临床、X线与病理对照分析[J].中华结核和呼吸杂志,2005,15(1):16.
[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(2009版)[J].中华结核和呼吸杂志,2009,32(6):407-413.DOI:10.3760/cma.j.issn.1001-0939.2009.06.004.
[4] 田德禄.中医内科学[M].北京:人民卫生出版社,2002:60.
[5] 官福兰.枳壳及辛弗林对小鼠胃排空、小肠推进功能的影响[J].现代中西医结合杂志,2002,11(11):1001-1003.
[6] 肖锷,罗珍华,肖士熹.止嗽散与地红霉素联用对变态性咳嗽患者的临床疗效评价[J].抗感染药学,2017,14(7):1387-1388.
[7] 褚建.变应性咳嗽38例诊断及治疗体会[J].中国现代医药杂志,2008,10(8):78.DOI:10.3969/j.issn.1672-9463.2008.08.035.
[8] 余夏发,曾抱民,潘茂才,等.变应性咳嗽46例临床分析[J].河北医学,2011,5,17(5):636-637.DOI:10.3969/j.issn.1006-6233.2011.05.026.
[9] 王海翔,徐丽华.变应性咳嗽的研究进展[J].国际呼吸杂志,2009,29(15):945-955.
[10] Brightling CE,Bradding P,Symon FA,et al.Mast-cell jnfiltration of airway smooth muscle in asthma[J].N Engl J Med,2002(346):1699-1705.DOI:10.1056/NEJMoa012705.
[11] 中华医学会呼吸病学分会.社区获得性肺炎诊断和治疗指南(草案)[J].现代实用医学,2002,14(3):158-160.
[12] 甘露.大鼠pEGFP-N1-BKβ1真核表达载体的构建及苦杏仁苷对支气管平滑肌细胞增殖的研究[D].武汉:华中科技大学,2007.
[13] 孙也评.紫苏叶提取物及其有效成分的抗菌活性研究[D].延吉:延边大学药学院,2014:2-22.
[14] 魏雯,高婷婷,谭勇,等.紫苏不同部位的体外抑菌作用[J].医药导报,2014,33(2):149-151.
[15] 谌立巍,卢先明,陈思敏.不同产地半夏的初步药效学评价实验研究[J].成都中医药大学学报,2008,31(2):54-57.DOI:10.3969/j.issn.1004-0668.2008.02.020.
[16] 柯昌毅.半夏5种不同溶剂提取物对小鼠祛痰镇咳作用的研究[J].中国药房,2012,23(39):3652-3654.DOI:10.6039/j.issn.1001-0408.2012.39.02.
[17] 邓媛媛,邵贝贝,王光忠,等.茯苓调节免疫功能有效物质的比较研究[J].中国医药指南,2012,10(12):94-95.DOI:10.3969/j.issn.1671-8194.2012.12.057.
[18] 张村,殷小杰,李丽,等.白花前胡蜜炙前后的药效学比较研究[J].中国实验方剂学杂志,2010,16(15):146-148.
[19] 孙荏苒,张满云,陈勤.桔梗皂苷胶囊抗炎止咳平喘作用研究[J].中药药理与临床,2010,26(4):27-29.
[20] 郑繁慧.黑曲霉转化桔梗皂苷及其祛痰作用研究[D].吉林:吉林农业大学,2011.
[21] Shi Q,Liu Z,Yang Y,et al.Identification of anti-asthmatic compoundsin Pericarpium citrireticulatae and evaluation of their synergistic effects[J].Acta Pharmacol Sin,2009,30(5):567-575.DOI:10.1038/aps.2009.36.
[22] 史坤,张泽生,王玉本,等.甘草多糖的体外免疫调节作用[J].食品科技,2008(5):267-269.DOI:10.3969/j.issn.1005-9989.2008.05.079.
[23] 王小飞,吴国泰,牛亭惠,等.生姜的化学、药理及应用[J]中国果菜,2016,36(6):23-26.
[24] 高艳青.半夏,甘草,生姜三泻心汤药物配伍的实验研究[D].北京:北京中医药大学,2004:6.
[25] 刘小云,牛媛媛,张常然,等.中药六君子汤对慢性支气管炎大鼠气道炎症因子的影响[J].实用医学杂志,2009,25(22):3776-3778.DOI:10.3969/j.issn.1006-5725.2009.22.017.
[26] 陆忠凯,陈卫昌.血管活性肠肽在调节肠黏膜屏障功能中的作用[J].国际消化病杂志,2008,28(3):226-229.
[27] 林沁臻.浅谈肺系疾病从脾论治[J].湖北中医杂志,2004,26(2):21.DOI:10.3969/j.issn.1000-0704.2004.02.010.
[28] 王维有,曹晨晨,欧赟,等.大枣中环磷酸腺苷的提取及体外抗过敏活性研究[J].食品工业科技,2013,34(11):49-52,282.
[29] 张学梅,刘凡亮,梁文波,等.白芥子提取物的镇咳、祛痰及平喘作用研究[J].中草药,2003,34(7):635-637.
[30] 宋晓平,姬晓兰.斑、蝥白芥子发泡规律的研究[J].中国针灸,2007,27(2):126-128.
[31] 刁义平.甘遂和醋甘遂提取物急性毒性和刺激性实验研究[J].药物不良反应杂志,2007,9(4):243-246.DOI:10.3969/j.issn.1008-5734.2007.04.004.
[32] 周桢祥,李军,陈泽斌,等.细辛散剂对家兔呼吸运动及膈神经电活动的影响[J].湖北中医,2005,27(4):3-5.DOI:10.3969/j.issn.1000-0704.2005.04.001.
[33] 胡洪波,钱长苏.丁香柿蒂在呃逆中的应用[J].实用中医内科杂志,2007,21(1):84.DOI:10.3969/j.issn.1671-7813.2007.01.073.
[34] 侯仙明,王文智,王亚利,等.肉桂对哮喘模型豚鼠血清中IL-2、5的影响[J].中国中医基础医学杂志,2009,15(7):543.
[35] 石萍,王玉珍,杨敏.穴位止咳贴辅助治疗喘息性支气管炎疗效观察[J].山东医药,2008,48(4):56.
[36] 王树凡.冬病夏治中药穴位贴敷法的临床运用[J].光明中医,2007,22(4):16-17.DOI:10.3969/j.issn.1003-8914.2007.04.011.