岗梅清咽合剂对甲状腺术后咽痛的临床疗效观察  

Clinical Effect of Gangmei Qingyan Mixture for Treatment of Pharyngeal Pain After Thyroidectomy

作　　者：吴剑纯 林宗粤 吴漪彤 程宇星[2] WU Jian-Chun;LIN Zong-Yue;WU Yi-Tong;CHENG Yu-Xing(The First Clinical Medical School of Guangzhou University of Chinese Medicine,Guangzhou 510405 Guangdong,China;The First Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510405 Guangdong,China)

机构地区：[1]广州中医药大学第一临床医学院,广东广州510405 [2]广州中医药大学第一附属医院,广东广州510405

出　　处：《广州中医药大学学报》2020年第10期1881-1887,共7页Journal of Guangzhou University of Traditional Chinese Medicine

摘　　要：【目的】客观评价岗梅清咽合剂治疗甲状腺术后咽痛的临床疗效,发挥口服中药简便价廉优势,以期减少甚至代替术后应用氧气雾化治疗甲状腺术后咽痛的临床方案。【方法】将64例甲状腺术后出现以咽痛为主要并发症的患者随机分为岗梅组和雾化组,每组各32例。在术后常规治疗和护理基础上,岗梅组给予岗梅清咽合剂口服治疗,雾化组给予吸入用布地奈德混悬液为主氧气雾化治疗,疗程为3 d。观察2组患者治疗前后咽痛视觉模拟量表(VAS)评分、布氏舒适状态量表(BCS)评分、咽痛症状及综合症状(包括咽痛、咽干、咽痒、异物感及吞咽困难)评分的变化情况,评价2组患者的临床疗效及安全性。【结果】(1)治疗期间,岗梅组有1例患者因同步使用其他有相似功效的中草药而脱落,实际纳入31例;雾化组有2例患者因不能配合雾化治疗,后改用中草药治疗而脱落,实际纳入30例。(2)治疗1 d、2 d和3 d后,岗梅组的愈显率分别为16.13%(5/31)、48.39%(15/31)和87.10%(27/31),雾化组分别为10.00%(3/30)、26.67%(8/30)和86.67%(26/30),组间比较(非参数秩和检验),岗梅组在治疗2 d后的疗效优于雾化组,差异有统计学意义(P<0.05)。(3)治疗1 d、2 d和3 d后,2组患者的VAS评分、咽痛症状评分及综合症状评分均较治疗前明显降低(P<0.05),且在治疗2 d后,岗梅组对VAS评分、咽痛症状评分及综合症状评分的降低作用均明显优于雾化组(P<0.05)。(4)治疗后,2组患者的BCS评分均较治疗前明显提高(P<0.05),且岗梅组对BCS评分的提高作用明显优于雾化组,差异有统计学意义(P<0.05)。(5)在治疗过程中,2组患者均未出现明显不良反应,具有较高的安全性。【结论】岗梅清咽合剂治疗甲状腺术后咽痛疗效显著,能有效缓解患者咽痛症状,改善患者围术期舒适状态,与氧气雾化吸入相比,其疗效更好,起效更快。Objective To evaluate the clinical efficacy of Gangmei Qingyan Mixture(GQM)for the treatment of pharyngeal pain after thyroidectomy,so as to develop a practical,convenient,economic and effective Chinese medicine therapy to reduce or even replace the application of clinical scheme of oxygen atomization therapy in the treatment of pharyngeal pain after thyroidectomy. Methods Sixty-four patients with pharyngeal pain as the main complication after thyroidectomy were randomly divided into GQM group and atomization group,32 cases in each group. Based on routine postoperative care and treatment,GQM group was given oral administration of GQM,and atomization group was given the oxygen atomization therapy mainly by the medication of Budesonide Mixture Suspension for Inhalation for 3 days. Before and after treatment,we examined the scores of the pharyngeal pain evaluated with the visual analogue scale(VAS), Bruggrmann Comfort Scale(BCS)scores, and the scores of pharyngeal pain symptoms and comprehensive symptoms such as sore throat,dry throat,throat itching,foreign body sensation in the throat,and difficulty in swallowing in the two groups. After treatment,the clinical efficacy and safety in the two groups were evaluated. Results(1)During the treatment period,one patient in GQM group fell off due to the simultaneous medication of Chinese herbal medicine with similar effect, and two patients in atomization group fell off due to the medication of Chinese herbal medicine because of the failure in cooperating with atomization. Therefore,a total of 31 cases in GQM group and 30 cases in atomization group finished the trial.(2)After treatment for one,2,3 day(s),the markedly effective rate in GQM group was 16.13%(5/31),48.39%(15/31),and 87.10%(27/31)respectively,and that in the atomization group was 10.00%(3/30),26.67%(8/30),and 86.67%(26/30)respectively. The results of intergroup comparison by nonparametric rank sum test showed that after 2 days of treatment the clinical efficacy in GQM group was stronger than that in the atomizat

关 键 词：甲状腺手术 术后咽痛 岗梅清咽合剂 吸入用布地奈德混悬液 氧气雾化治疗 

分 类 号：R653[医药卫生—外科学]