摘要
目的 观察风咳浓煎剂治疗呼吸道感染后咳嗽(Postinfectious cough,PIC)患者的疗效及对其气道炎症的影响.方法 选取2021年1月-2023年6月期间南京中医药大学附属南京市中西医结合医院收治的呼吸道PIC患者122例,按随机数字表法分为观察组与对照组,每组各61例.对照组接受常规西药治疗,观察组在对照组基础上加用风咳浓煎剂治疗.治疗10 d后,观察比较两组患者临床疗效、临床症状缓解及不良反应情况,治疗前后中医证候评分、视觉模拟量表(Visual analogue scale,VAS)、简易咳嗽程度评分表(Cough evaluation test,CET)、莱切斯特咳嗽问卷(Leicester cough questionnaire,LCQ)、炎症相关指标[血清白介素-6(Interleukin-6,IL-6)、白介素-8(Interleukin-8,IL-8)、肿瘤坏死因子 α(Tumor necrosis factor-α,TNF-α)、P 物质(Substance P,SP)].结果 治疗后观察组患者咳嗽、咳痰、咽痒、气喘消失时间明显优于对照组,差异有统计学意义(P＜0.05).治疗后两组患者咳嗽、咽干咽痒、咳痰、气急及总评分均较治疗前降低,差异有统计学意义(P＜0.05);且观察组咳嗽、咽干咽痒、咳痰、气急及总评分均较对照组明显降低,差异有统计学意义(P＜0.05).治疗后两组患者咳嗽VAS和CET评分均较治疗前降低,差异有统计学意义(P＜0.05);且观察组咳嗽VAS和CET评分均较对照组明显降低,差异有统计学意义(P＜0.05).治疗后两组患者LCQ评分均较治疗前升高,差异有统计学意义(P＜0.05);且观察组LCQ评分较对照组明显升高,差异有统计学意义(P＜0.05).治疗后两组患者SP、IL-6、IL-8及TNF-α水平均较治疗前降低,差异有统计学意义(P＜0.05);且观察组SP、IL-6、IL-8及TNF-α水平均较对照组明显降低,差异有统计学意义(P＜0.05).治疗后观察组总有效率98.28％(57/58)、愈显率86.21％(50/58)明显优于对照组总有效率86.67％(52/60)、愈显率63.33％(38/60),差异有统计学意义(x2=4.114、8.138,P＜0.05).治疗期间,两组患者不良反应率比较,差异无统计学意义(x2=3.282,P=0.070).结论 风咳浓煎剂治疗PIC可有效改善患者的临床症状并缩短病程,提高临床疗效,其机制可能与减轻气道炎症有关.
Abstract
Objective To observe the clinical efficacy of Fengke Nongjian Decoction in the treatment of postin-fectious cough(PIC)after respiratory tract infection and its impact on airway inflammation.Methods A total of 122 patients with respiratory PIC,treated at the Nanjing Integrated Traditional Chinese and Western Medicine Hospital Affiliated to Nan-jing University of Chinese Medicine from January 2021 to June 2023,were selected and randomly divided into two groups:an observation group and a control group according to a random number table,with 61 patients in each group.The control group received conventional Western medication,while the observation group was treated with Fengke Nongjian Decoction in addi-tion to the conventional treatment.After 10 days of treatment,clinical efficacy,symptom relief,adverse reactions,traditional Chinese medicine(TCM)syndrome scores,Visual Analogue Scale(VAS)scores,Cough Evaluation Test(CET)scores,Leices-ter Cough Questionnaire(LCQ)scores,and inflammatory markers[serum interleukin-6(IL-6),interleukin-8(IL-8),tumor necrosis factor-α(TNF-α),substance P(SP)]before and after treatment were compared between the two groups.Results After treatment,the observation group showed significantly faster disappearance of symptoms such as cough,ex-pectoration,throat itching,and wheezing than the control group(P＜0.05).Both groups had significant reductions in symp-toms such as cough,throat dryness and itching,expectoration,and shortness of breath,as well as total scores,after treatment(P＜0.05).The observation group showed lower scores of cough,throat dryness and itching,expectoration,and shortness of breath,as well as total score,than the control group(P＜0.05).Both groups also exhibited a significant reduction in cough VAS and CET scores after treatment(P＜0.05),with the observation group showing greater reductions than the con-trol group(P＜0.05).LCQ scores increased significantly in both groups after treatment(P＜0.05),with the observation group showing a more substantial increase than the control group(P＜0.05).Inflammatory markers(SP,IL-6,IL-8,and TNF-α)were significantly reduced in both groups after treatment(P＜0.05),with the observation group showing more pronounced reductions than the control group(P＜0.05).The total effective rate in the observation group was 98.28％(57/58)with a recovery rate of 86.21％(50/58),significantly higher than the control group's total effective rate of 86.67％(52/60)and recovery rate of 63.33％(38/60)(x2=4.114,8.138,P＜0.05).There was no significant differ-ence in the incidence of adverse reactions between the two groups(x2=3.282,P=0.070).Conclusion Fengke Non-gjian Decoction is effective in improving clinical symptoms,shortening the course of illness,and enhancing clinical efficacy in the treatment of PIC.Its mechanism may be related to the reduction of airway inflammation.
维普
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