经方射干麻黄汤配合氨溴特罗治疗感染后咳嗽(风寒恋肺证)疗效及对中医证候积分和神经源性气道炎症介质的影响
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摘要
目的观察经方射干麻黄汤配合氨溴特罗治疗感染后咳嗽(风寒恋肺证)疗效及对其中医证候积分和神经源性气道炎症介质的影响并探讨其作用机制。方法患者126例随机分为两组,对照组应用氨溴特罗治疗,研究组应用经方射干麻黄汤配合氨溴特罗治疗。两组均治疗7 d。比较临床疗效,统计两组治疗前后中医症候积分和咳嗽症状积分,检测两组治疗前后神经源性气道炎症介质水平,记录两组治疗前后莱赛斯特咳嗽生命质量问卷(LCQ)评分。结果研究组治疗后临床治疗总有效率为95.24%,高于对照组之77.78%(P <0.05);两组治疗后中医证候积分、日间咳嗽积分、夜间咳嗽积分以及P物质(SP)、神经激肽A(NKA)、白细胞介素-8(IL-8)水平均低于治疗前(均P <0.05),且研究组均低于对照组(均P <0.05);与治疗前比较,两组患者治疗后分泌型免疫球蛋白A(sIgA)水平、LCQ评分均升高(均P <0.05),且研究组均高于对照组(均P <0.05)。结论经方射干麻黄汤配合氨溴特罗治疗感染后咳嗽(风寒恋肺证),疗效满意,同时能明显降低中医证候积分,改善神经源性气道炎症介质水平。
Objective: To observe the curative effect of Shegan Mahuang Decoction combined with Ambrocol on cough after wind-cold retention in lung type infection and its influences on the TCM symptoms and neurogenic airway inflammatory mediators. Methods: 126 patient were randomly divided into two groups,63 cases in each.The control group was treated with Ambrocol,and the study group was treated with Shegan Mahuang Decoction combined with Ambrocol. Both were treated for 7 d and the clinical efficacy was compared;the scores of TCM syndrome and cough symptom were counted;the levels of neurogenic airway inflammatory mediators were detected;the Leicester cough questionnaire(LCQ) scores was recorded in the two groups before and after treatment.Results: The total effective rate in the study group was 95.24%,significantly higher than that in the control group77.78%(P < 0.05);after treatment,TCM syndrome scores,diurnal cough symptoms scores,nocturnal cough symptom scores and substance P(SP),NKA,IL-8 levels were significantly lower than those before treatment(P <0.05),and the study group was significantly lower than the control group(P < 0.05);sIgA levels and LCQ scores increased significantly after treatment in the two groups(P < 0.05),and the study group was significantly higher than the control group(P < 0.05). Conclusion: Shegan Mahuang Decoction combined with Ambrocol on cough after wind-cold retention in lung type infection has a satisfying curative effect. Meanwhile,it can significantly reduced TCM syndrome scores,and improve the levels of neurogenic airway inflammatory mediators.
Objective: To observe the curative effect of Shegan Mahuang Decoction combined with Ambrocol on cough after wind-cold retention in lung type infection and its influences on the TCM symptoms and neurogenic airway inflammatory mediators. Methods: 126 patient were randomly divided into two groups,63 cases in each.The control group was treated with Ambrocol,and the study group was treated with Shegan Mahuang Decoction combined with Ambrocol. Both were treated for 7 d and the clinical efficacy was compared;the scores of TCM syndrome and cough symptom were counted;the levels of neurogenic airway inflammatory mediators were detected;the Leicester cough questionnaire(LCQ) scores was recorded in the two groups before and after treatment.Results: The total effective rate in the study group was 95.24%,significantly higher than that in the control group77.78%(P < 0.05);after treatment,TCM syndrome scores,diurnal cough symptoms scores,nocturnal cough symptom scores and substance P(SP),NKA,IL-8 levels were significantly lower than those before treatment(P <0.05),and the study group was significantly lower than the control group(P < 0.05);sIgA levels and LCQ scores increased significantly after treatment in the two groups(P < 0.05),and the study group was significantly higher than the control group(P < 0.05). Conclusion: Shegan Mahuang Decoction combined with Ambrocol on cough after wind-cold retention in lung type infection has a satisfying curative effect. Meanwhile,it can significantly reduced TCM syndrome scores,and improve the levels of neurogenic airway inflammatory mediators.
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]孟丹,徐传藩,陈培生,等.右美沙芬缓释混悬液联合孟鲁司特钠治疗感染后咳嗽的炎性因子水平和疗效分析[J].河北医药,2015,37(14):2151-2153.
[3]范海媚,林宁,张彦卿,等.感染后咳嗽中医辨证用药分析[J].辽宁中医药大学学报,2015,17(9):148-150.
[4]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.
[5]中华中医药学会内科分会肺系病专业委员会.咳嗽中医诊疗专家共识意见(2011版)[J].中医杂志,2011,52(10):896-899.
[6]中华人民共和国卫生部.中药新药临床研究指导原则(试行)[M].北京:中国医药科技出版社,2002:58-60.
[7] Capristo C,Rossi GA. Post-infectious persistent cough:pathogenesis and therapeutic options[J]. Minerva Pediatr,2017,69(5):444-452.
[8]陈爱娥,蔡晓平,熊军芳.苏黄止咳胶囊治疗感染后咳嗽的疗效及神经源性气道炎症介质的动态变化[J].实用药物与临床,2016,19(8):981-984.
[9] Otsuka K,Niimi A,Matsumoto H,et al. Plasma substance P levels in patients with persistent cough[J]. Respiration,2011,82(5):431-438.
[10]江鹏,龚湛潮,杜雄章,等.气道神经源性炎症介质在儿童感染后咳嗽的变化及临床意义[J].中国小儿急救医学,2014,21(2):97-100.
[11] Baranwal AK,Murthy AS,Singhi SC. High-dose oral ambroxol for early treatment of pulmonary acute respiratory distress syndrome:an exploratory,randomized,controlled pilot trial[J]. J Trop Pediatr,2015,61(5):339-350.
[12]张妍.氨溴特罗联合孟鲁司特治疗儿童咳嗽变异性哮喘的疗效观察[J].实用临床医药杂志,2015,19(3):122-123.
[13]史利卿,林彬,马建岭,等.感染后咳嗽的中医证因特点初探[J].中华中医药杂志,2016,31(2):595-597.
[14]胡倩,王秋琴,段培蓓,等.刮痧联合宣肺止嗽汤治疗感染后咳嗽风寒恋肺证临床观察[J].中国针灸,2016, 36(12):1257-1262.
[15]王世强,楼黎明,张弘,等.经方射干麻黄汤治疗感染后咳嗽风寒恋肺证临床疗效观察[J].中华全科医学,2017,15(6):1044-1046.
[16]李静,秦雪梅,李震宇.款冬花中倍半萜类成分的研究进展[J].中草药,2017,48(14):2964-2971.
[17]张琳,张妮.川射干的化学及药理研究进展[J].陕西中医学院学报,2014,37(5):91-93.
[18]杨昕宇,肖长芳,张凯熠,等.麻黄临床应用与药理作用研究进展[J].中华中医药学刊,2015,33(12):2874-2877.
[2]孟丹,徐传藩,陈培生,等.右美沙芬缓释混悬液联合孟鲁司特钠治疗感染后咳嗽的炎性因子水平和疗效分析[J].河北医药,2015,37(14):2151-2153.
[3]范海媚,林宁,张彦卿,等.感染后咳嗽中医辨证用药分析[J].辽宁中医药大学学报,2015,17(9):148-150.
[4]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.
[5]中华中医药学会内科分会肺系病专业委员会.咳嗽中医诊疗专家共识意见(2011版)[J].中医杂志,2011,52(10):896-899.
[6]中华人民共和国卫生部.中药新药临床研究指导原则(试行)[M].北京:中国医药科技出版社,2002:58-60.
[7] Capristo C,Rossi GA. Post-infectious persistent cough:pathogenesis and therapeutic options[J]. Minerva Pediatr,2017,69(5):444-452.
[8]陈爱娥,蔡晓平,熊军芳.苏黄止咳胶囊治疗感染后咳嗽的疗效及神经源性气道炎症介质的动态变化[J].实用药物与临床,2016,19(8):981-984.
[9] Otsuka K,Niimi A,Matsumoto H,et al. Plasma substance P levels in patients with persistent cough[J]. Respiration,2011,82(5):431-438.
[10]江鹏,龚湛潮,杜雄章,等.气道神经源性炎症介质在儿童感染后咳嗽的变化及临床意义[J].中国小儿急救医学,2014,21(2):97-100.
[11] Baranwal AK,Murthy AS,Singhi SC. High-dose oral ambroxol for early treatment of pulmonary acute respiratory distress syndrome:an exploratory,randomized,controlled pilot trial[J]. J Trop Pediatr,2015,61(5):339-350.
[12]张妍.氨溴特罗联合孟鲁司特治疗儿童咳嗽变异性哮喘的疗效观察[J].实用临床医药杂志,2015,19(3):122-123.
[13]史利卿,林彬,马建岭,等.感染后咳嗽的中医证因特点初探[J].中华中医药杂志,2016,31(2):595-597.
[14]胡倩,王秋琴,段培蓓,等.刮痧联合宣肺止嗽汤治疗感染后咳嗽风寒恋肺证临床观察[J].中国针灸,2016, 36(12):1257-1262.
[15]王世强,楼黎明,张弘,等.经方射干麻黄汤治疗感染后咳嗽风寒恋肺证临床疗效观察[J].中华全科医学,2017,15(6):1044-1046.
[16]李静,秦雪梅,李震宇.款冬花中倍半萜类成分的研究进展[J].中草药,2017,48(14):2964-2971.
[17]张琳,张妮.川射干的化学及药理研究进展[J].陕西中医学院学报,2014,37(5):91-93.
[18]杨昕宇,肖长芳,张凯熠,等.麻黄临床应用与药理作用研究进展[J].中华中医药学刊,2015,33(12):2874-2877.