会厌逐瘀汤加减治疗痰瘀互结型慢性扁桃体炎疗效观察  

Therapeutic efficacy of modified decoction for dissipating stasis in the epiglottis in the treatment of phlegm-stasis intermingling type chronic tonsillitis

作　　者：戈智花 李斐 边芳子 Ge Zhihua;Li Fei;Bian Fangzi(Department of Otolaryngology,Xi'an Hospital of Traditional Chinese Medicine,Xi'an 710000,Shaanxi Province,China)

机构地区：[1]西安市中医医院耳鼻喉科,西安710000

出　　处：《中国基层医药》2024年第11期1655-1660,共6页Chinese Journal of Primary Medicine and Pharmacy

基　　金：陕西省西安市中医医院院级科研项目(2024YJ16)。

摘　　要：目的观察会厌逐瘀汤加减治疗痰瘀互结型慢性扁桃体炎的疗效及其对患者中医症状体征积分、白细胞计数(WBC)、血清白细胞介素3(IL-3)水平的影响。方法选取西安市中医医院2022年1月至2023年10月诊治的痰瘀互结型慢性扁桃体炎患者120例进行随机对照研究,根据随机数字表法分为对照组、观察组各60例。对照组予阿莫西林胶囊联合开喉剑喷雾剂治疗,观察组给予会厌逐瘀汤加减治疗,两组疗程14 d。观察两组疗效,比较两组治疗前后中医症状体征积分及血清T淋巴细胞亚群、WBC、高敏C反应蛋白(hs-CRP)、IL-3水平的变化。结果观察组总有效率为93.33%(56/60),高于对照组的80.00%(48/60),差异有统计学意义(χ^(2)=4.62,P<0.05)。治疗后,两组咽干涩痛、迁延不愈、咽部发痒、咳嗽痰白、胸脘痞闷及纳差评分均较治疗前降低(均P<0.001),且观察组均低于对照组(t=8.08、18.01、13.36、8.75、8.57、9.17,均P<0.001);观察组WBC、hs-CRP、IL-3分别为(8.23±1.44)×10^(9)/L、(5.62±1.27)mg/L、(81.36±8.87)ng/L,均低于对照组的(10.05±1.91)×10^(9)/L、(8.23±1.78)mg/L、(97.43±10.22)ng/L(t=5.89、0.95、9.20,均P<0.001);两组CD4^(+)/CD8^(+)、NK淋巴细胞、CD4^(+)均较治疗前升高(均P<0.001),且观察组均高于对照组(t=2.30、6.31、5.97、6.60,均P<0.05)。两组不良事件发生率差异无统计学意义(P>0.05)。结论会厌逐瘀汤加减治疗痰瘀互结型慢性扁桃体炎可降低WBC、hs-CRP、IL-3的表达,改善T淋巴细胞亚群,减轻症状,提高疗效。Objective To investigate the therapeutic efficacy of modified decoction for dissipating stasis in the epiglottis in the treatment of phlegm-stasis intermingling type chronic tonsillitis and its effects on patients'traditional Chinese medicine(TCM)symptom scores,white blood cell count(WBC),and serum interleukin-3(IL-3)levels.Methods A total of 120 patients with phlegm-stasis intermingling type chronic tonsillitis who received treatment at Xi'an Hospital of Traditional Chinese Medicine from January 2022 to October 2023 were selected for this randomized controlled study.The patients were randomly divided into two groups of 60 each using a random number table method.The control group received amoxicillin capsules combined with open-throat sword spray,while the observation group was treated with modified decoction for dissipating stasis in the epiglottis.All patients were treated for 14 days.Clinical efficacy was evaluated in each group.TCM symptom and sign scores,serum T-lymphocyte subgroups,WBC,high-sensitivity C-reactive protein(hs-CRP),and IL-3 levels were compared between the two groups before and after treatment.Results The total response rate in the observation group was 93.33%(56/60),which was significantly higher than that in the control group[80.00%(48/60),χ^(2)=4.62,P<0.05].After treatment,the scores for symptoms including dry and astringent pharynx,prolonged soreness,itchy pharynx,cough with white sputum,chest and epigastric congestion,and poor appetite were significantly lower in both groups compared with their baseline scores(all P<0.001).After treatment,all symptom scores in the observation group were significantly lower than those in the control group(t=8.08,18.01,13.36,8.75,8.57,9.17,all P<0.001).The WBC,hs-CRP,and IL-3 levels in the observation group were(8.23±1.44)×10^(9)/L,(5.62±1.27)mg/L,and(81.36±8.87)ng/L,respectively.These values were significantly lower than those in the control group[(10.05±1.91)×10^(9)/L,(8.23±1.78)mg/L,(97.43±10.22)ng/L,t=5.89,0.95,9.20,all P<0.001].After treatment

关 键 词：扁桃体炎 医学 中国传统 体征和症状 白细胞计数 T淋巴细胞亚群 C反应蛋白质 白细胞介素3 阿莫西林 

分 类 号：R276.1[医药卫生—中医五官科学]