二陈消瘰汤治疗咽炎相关型颈椎病60例临床观察

Clinical observation of Erchen Xiaoluo Decoction in treating 60 cases of pharyngitis related cervical spondylosis

目的:观察二陈消瘰汤治疗咽炎相关型颈椎病的临床疗效.咽炎中医称之为喉痹,其是指因外邪壅遏肺胃或脏腑虚损、咽喉失养所致的以咽痛或咽部异物不适感,咽部红肿,或喉底有颗粒状突起为主要特征的咽部疾病,相当于现代医学中的咽炎范畴.喉痹在临床上可分为急喉痹和慢喉痹,其中急喉痹起病急,病程短暂易变,治疗时间短;而慢喉痹多由急喉痹失治转化而成,或因素体虚弱,阴阳失调而导致阴阳气血偏虚或偏亢所致.方法:选取2017年1月-2017年12月佛山市中医院符合咽炎型颈椎病的患者共60例,按照数字随机表法随机分为两组:治疗组及对照组各30例.对照组采用佛山市中医院常规疗法予筋络舒+咽立爽口服,治疗组在常规疗法基础上予佛山市中医院协定处方二陈消瘰汤内服.10天为1个疗程,3个疗程后评价其疗效,同时选用视觉模拟评分法(Visual Analogue Scale,VAS)评分、功能障碍问卷(Oswestry Disability Index,ODI)指数及改良Macnab标准(Modified MacNab Criteria,Macnab)评分去比较两组患者疼痛、功能及疗效变化以评价其临床疗效.结果:经治疗后两组患者在末次随访VAS评分、ODI指数方面均较治疗前有明显下降(P<0.05),治疗组在末次随访VAS评分、ODI指数方面较对照组有优势(P<0.05),而在颈椎病疗效比较方面,治疗组总有效率达93.33%(28/30),对照组为76.67%(23/30),两组比较有显著性差异(P<0.05),在慢喉痹疗效比较,治疗组总有效率达96.67%(29/30),对照组为76.67%(23/30),两组比较有显著性差异(P<0.05),在Macnab评分方面治疗组优良率为83.3%(25/30),对照组总有效率为60.00%(18/30),两组比较有显著性差异(P<0.05).结论:二陈消瘰汤治疗咽炎相关型颈椎病疗效显著,值得临床推广.

Objective:To observe the clinical effect of Erchen Xiaoluo Decoction(二陈消瘰汤)in treating pharyngitis related cervical spondylosis.Method:60 patients with pharyngitis cervical spondylosis in Foshan hospital of traditional Chinese medicine from January 2017 to December 2017 were selected and randomly divided into two groups according to the numerical random table method:30 patients in the treatment group and 30 patients in the control group.The control group was treated with Jingluo shu combined with Yanlishuang Decoction by conventional therapy,while the treatment group was treated with agreement prescription Erchen Xiaoluo Decoction combined with conventional therapy.Ten days was a course of treatment,and the efficacy was evaluated after three courses.Meanwhile,VAS score,ODI index and Macnab score were used to compare the changes in pain,function and efficacy of the two groups of patients to evaluate their clinical efficacy.Results:VAS score,ODI index of two groups of patients after treatment were significantly lower than those before treatment in the last follow-up(P<0.05),VAS score,ODI index of the treatment group at the last follow-up were better than those of the control group(P<0.05),while in terms of cervical spondylosis curative effect comparison,the efficiency of the treatment group was 93.33%(28/30),and that of the control group was 76.67%(23/30),the difference of two groups was of significant difference(P<0.05).As for the slow pharyngalgia comparative effectiveness,the effective rate of the treatment group was 96.67%(29/30),and that of the control group was 76.67%(23/30),the difference of two groups was of significant difference(P<0.05).In terms of Macnab score,the excellent and good rate of the treatment group was 83.3%(25/30),and the total effective rate of the control group was 60.00%(18/30).The difference of two groups was of significant difference(P<0.05).Conclusion:Erchen Xiaoluo Decoction is effective in treating pharyngitis-related cervical spondylosis and it is worthy of clinical promotion.