健脾舒咽汤联合揿针治疗脾气虚弱型慢喉痹的疗效观察  

Observation on the Therapeutic Effect of Jianpi Shuyan Decoction Combined with Thumbtack Needling Therapy for Chronic Sore Throat of Spleen-Qi Weakness Type

作　　者：何逊 谭华儒 HE Xun;TAN Hua-Ru(The Seventh Clinical Medical School,Guangzhou University of Chinese Medicine,Shenzhen 518000 Guangdong,China;Bao’an Traditional Chinese Medicine Hospital Affiliated to Guangzhou University of Chinese Medicine,Shenzhen 518000 Guangdong,China)

机构地区：[1]广州中医药大学第七临床医学院,广东深圳518000 [2]广州中医药大学附属宝安中医院,广东深圳518000

出　　处：《广州中医药大学学报》2024年第8期2054-2061,共8页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：深圳市宝安区中医药发展基金科研项目(编号:2020KJCX-KTYJ-60)。

摘　　要：【目的】探究健脾舒咽汤(由黄芪、党参、白术、当归、法半夏、厚朴、僵蚕、桔梗等中药组成)联合揿针治疗脾气虚弱型慢喉痹(慢性咽炎)的临床疗效。【方法】将68例脾气虚弱型慢喉痹患者随机分为对照组和试验组,每组各34例。对照组给予西地碘含片含服治疗,试验组在对照组的基础上加用健脾舒咽汤联合揿针浅刺“咽疾六穴”(扶突穴、哑门穴、廉泉穴、天突穴、列缺穴、照海穴)治疗,2组均以7 d为1个疗程,共治疗2个疗程,并于治疗结束后进行1个月和3个月的远期随访。观察2组患者治疗前后病情程度视觉模拟量表(VAS)评分分级、炎性指标[C反应蛋白(CRP)、白细胞介素2(IL-2)]以及中医证候积分的变化情况,并评价2组治疗方案的临床疗效、复发情况和安全性。【结果】(1)脱落情况方面,研究过程中,2组均有2例患者脱落,最终各有32例患者完成全部疗程的治疗。(2)疗效方面,治疗2周后,试验组的总有效率为90.63%(29/32),对照组为75.00%(24/32),组间比较,试验组的总有效率(χ^(2)检验)和总体疗效(秩和检验)均明显优于对照组(P<0.05)。(2)病情程度改善方面,治疗2周后,2组患者的病情程度VAS评分分级均较治疗前改善(P<0.05),且试验组对病情程度VAS评分分级的改善幅度明显优于对照组(P<0.05)。(3)炎性指标方面,治疗2周后,2组患者的血清CRP、IL-2水平均较治疗前降低(P<0.05),且试验组对血清CRP、IL-2水平的降低幅度均明显优于对照组(P<0.05)。(4)中医证候积分方面,治疗2周后及治疗结束后1个月、3个月,2组患者的中医证候积分均较治疗前降低(P<0.05),但治疗结束后3个月与治疗结束后1个月的中医证候积分比较,差异无统计学意义(P>0.05);组间比较,试验组在治疗2周后及治疗结束后1个月、3个月对中医证候积分的降低幅度均明显优于对照组(P<0.05)。(5)安全性方面,治疗过程中,2组患者均无明显�Objective To explore the clinical efficacy of Jianpi Shuyan Decoction(mainly composed of Astragali Radix,Codonopsis Radix,Atractylodis Macrocephalae Rhizoma,Angelicae Sinensis Radix,Pinelliae Rhizoma Praeparatum,Cortex Magnoliae Officinalis,Bombyx Batryticatus,and Platycodonis Radix)combined with thumbtack needling therapy(treated with thumbtack-type needle for subcutaneous embedding)in the treatment of chronic sore throat,i.e.,chronic pharyngitis,of spleen-qi weakness type.Methods Sixty-eight patients with chronic pharyngitis of spleen-qi weakness type were randomly divided into the control group and the trial group,with 34 patients in each group.The two groups were given buccal use of Cydiodine Buccal Tablets,and additionally,the trial group was treated with Jianpi Shuyan Decoction combined with thumbtack needling therapy at the six acupoints for pharyngeal disease,i.e.,Futu(LI18),Yamen(GV15),Lianquan(CV23),Tiantu(CV22),Lieque(LU7),and Zhaohai(KI6).Seven days constituted one course of treatment,and the two groups were treated for a total of two courses of treatment.One month and three months after the completion of treatment,the long-term follow-up of the patients was carried out.Before and after the treatment,the changes in visual analogue scale(VAS)score of the illness,inflammatory indicators of C-reactive protein(CRP)and interleukin 2(IL-2),and traditional Chinese medicine(TCM)syndrome scores in the two groups were observed.Moreover,the clinical efficacy,recurrence rate and clinical safety of the two groups were evaluated.Results(1)During the study,2 patients in each of the two groups fell off,and finally 32 patients in each group completed the whole course of treatment.(2)After 2 weeks of treatment,the total effective rate of the trial group was 90.63%(29/32),and that of the control group was 75.00%(24/32).The total effective rate(tested by chi-square test)and overall efficacy(tested by rank sum test)of the trial group were significantly superior to those of the control group(P<0.05).(2)After 2 weeks of tre

关 键 词：健脾舒咽汤 揿针 脾气虚弱型 慢喉痹 慢性咽炎 C反应蛋白 白细胞介素2 

分 类 号：R276.1[医药卫生—中医五官科学]