“雾化-揿针-穴位注射”三联疗法治疗禀质特异型喉咳临床观察  

Clinical Observation of External Triple Therapy Based on Atomization-Pyonex-Acupoint Injection in Treatment of Endowment-Specific Laryngeal Cough

作　　者：黄卓燕[1] 张勉[1] 杨培培[1] 高阳[1] 陈潇[1] 李艺[1] 郑琴媛 HUANG Zhuoyan;ZHANG Mian;YANG Peipei;GAO Yang;CHEN Xiao;LI Yi;ZHENG Qinyuan(Department of Otolaryngology,The First Affiliated Hospital of Guangxi University of Traditional Chinese Medicine,Nanning 530023,China)

机构地区：[1]广西中医药大学第一附属医院耳鼻喉科

出　　处：《山东中医杂志》2019年第12期1131-1136,共6页Shandong Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金面上项目(编号:81260551);国家自然科学基金地区项目(编号:81660810)

摘　　要：目的:观察"雾化-揿针-穴位注射"外治三联疗法治疗禀质特异型喉咳的临床疗效与机制。方法:采用随机单盲单中心的研究方法,从广西中医药大学第一附属医院耳鼻喉科选取150例禀质特异型喉源性咳嗽患者,采用随机数字表法分为三联组、对照组、假揿针组各50例,治疗组采用中药内服配合"雾化-揿针-穴位注射"外治三联疗法,对照组采用中药内服配合常规西药治疗,假揿针组采用剥离SUS304不锈钢针体的假揿针进行安慰治疗,其余措施与三联组相同。3组均治疗10 d,观察治疗前后的各症状量化评分、疗效、不良反应、实验室检查[血清IgE、痰嗜酸性粒细胞(EOS)]、气道阻力测定(Zrs、R5、R35)以及生活质量(圣乔治呼吸问卷SGRQ)的变化。结果:症状量化评分方面,3组治疗后各症状均优于治疗前,而治疗后三联组咳嗽、咽干、口咽充血及淋巴滤泡增生等症状改善均优于其余两组,差异有统计学意义(P<0.05);咽痒、咽喉异物感改善三联组优于对照组,与假揿针组比较差异无统计学意义。疗效方面,三联组优于其余两组,差异有统计学意义(P<0.05)。实验室检查(IgE、EOS),3组IgE和EOS治疗后均较治疗前改善,差异有统计学意义(P<0.05);组间比较,IgE变化三联组与假揿针组差异有统计学意义(P<0.05),与对照组差异无统计学意义;EOS变化三联组优于对照组和假揿针组,差异有统计学意义(P<0.05)。气道阻力测定方面,3组呼吸道总阻抗(Zrs)、总气道黏性阻力(R5)以及近咽部黏性阻力(R35)的测定治疗后均优于治疗前,差异有统计学意义(P<0.05);组间比较,Zrs测定,三联组优于对照组,差异有统计学意义(P<0.05),与假揿针组比较,差异无统计学意义;R5测定,3组之间差异无统计学意义;R35测定,三联组优于其余两组,差异有统计学意义(P<0.05)。圣乔治呼吸问卷(SGRQ),3组治疗后与治疗前比较差异均有统计学意义(P<0.05),而治疗�Objective:To observe the effect of "atomization-pyonex-acupoint injection" external triple therapy in the treatment of endowment-specific laryngeal cough and to study the mechanism. Methods:A randomized,single-blind and single-center study was conducted. In the Department of Otolaryngology,The First Affiliated Hospital of Guangxi University of Traditional Chinese Medicine,150 patients with endogenous laryngeal cough were selected. They were divided into three groups using random number tables:the triple group,the control group and the sham pyonex group,50 cases in each group. The triple group was treated with oral administration of Chinese medicinals plus external therapy of "atomization-pyonex-acupoint injection". The control group was treated with oral administration of Chinese medicinals combined with conventional chemical drugs. The sham pyonex group was treated with the sham pyonex which was the SUS304 stainless steel pyonex without pyonex body as placebo treatment,and other measures were the same as the triple groups. After 10 days of treatment,the symptoms,efficacy,adverse reactions,laboratory tests for serum IgE and eosinophils(EOS),airway resistance total airway resistance(Zrs),total airway viscous resistance(R5) and near pharynx viscous resistance(R35) and quality of life(St. George’s Respiratory Questionnaire,SGRQ) of the three groups were observed. Results:Quantitative scores of symptoms after the treatment in three groups were better than those before treatment. After the treatment,the symptoms of cough,dry pharynx,oropharyngeal congestion and lymphatic follicular hyperplasia in the triple group were better than those in the other two groups(P< 0.05). On the symptoms of pharynx itching and pharynx and larynx foreign body sensation,the triple group was better than the control group(P< 0.05),but there was no difference between the triple group and the sham pyonex group. In terms of curative effect,the triple group was better than the other two groups,with statistical difference(P< 0.05). The results

关 键 词：雾化 揿针 穴位注射 禀质特异型喉咳 症状量化评分 IgE 痰嗜酸性粒细胞 气道阻力测定 圣乔治呼吸问卷 

分 类 号：R245[医药卫生—针灸推拿学]