皮内针调理肝肺法治疗慢性难治性咳嗽的临床效果

Clinical effect of treating chronic refractory cough with intradermal needle regulating liver and lung

目的研究皮内针调理肝肺法治疗慢性难治性咳嗽的临床效果。方法根据Excel生成随机数字表,采用随机、对照、单盲的方法将2015年6月—2016年3月中国中医科学院广安门医院门诊诊断为肝火犯肺型慢性难治性咳嗽24例患者分为治疗组和对照组,每组各12例。两组均予以基础治疗,在此基础上,治疗组给予皮内针治疗,对照组给予真穴安慰针治疗。治疗4周及治疗结束4周随访1次。以咳嗽症状积分、莱切斯特咳嗽量表(LCQ)和咳嗽视觉模拟评分(VAS)得分作为主要评估指标。结果研究过程中对照组脱落3例,失访2例,出差1例,剩余9例。咳嗽症状积分:日间咳嗽时间点比较差异、交互作用差异均有统计学意义(均P<0.05),组间比较差异无统计学意义(P>0.05)。夜间咳嗽评分时间点比较差异有统计学意义(均P<0.05),组间比较及交互作用差异均无统计学意义(均P>0.05)。组内比较:治疗4周后、疗程结束后4周,治疗组日间咳嗽积分和夜间咳嗽积分均较治疗前降低,对照组夜间咳嗽积分较治疗前降低(均P<0.05)。VAS评分:咳嗽程度、咳嗽频率评分组间比较、时间点比较差异均有统计学意义(均P<0.05),交互作用差异无统计学意义(P>0.05)。夜间咳嗽评分时间点比较差异有统计学意义(均P<0.05),组间比较及交互作用差异均无统计学意义(均P>0.05)。组内比较:治疗4周后、疗程结束后4周,两组的咳嗽程度、咳嗽频率和夜间咳嗽评分均较治疗前降低(均P<0.05)。组间比较:治疗4周后、疗程结束后4周,治疗组的咳嗽程度、咳嗽频率评分均低于对照组(均P<0.05)。LCQ评分:生理部分、心理部分、社会部分评分时间点比较差异有统计学意义(均P<0.05),组间比较及交互作用差异均无统计学意义(均P>0.05)。总分的组间比较、时间点比较、交互作用差异均无统计学意义(均P>0.05)。组内比较:治疗4周后、疗程结束后4周,治疗组生理部分、心理部分、社会部分评分均高于治疗前,差异均有统计学意义(均P<0.05),疗程结束后4周,对照组心理部分、社会部分评分均高于治疗前,差异均有统计学意义(均P<0.05)。结论皮内针治疗慢性难治性咳嗽安全有效。治疗效果主要体现在减轻咳嗽的严重程度及减少咳嗽的频率方面。

Objective To study the clinical effect of treating chronic refractory cough with intradermal needle regulating liver and lung.Methods According to Excel,a random number table was generated,and the 24 patients diagnosed as liver fire invading lung type chronic refractory cough in the outpatient clinic of Guang′anmen Hospital,China Academy of Chinese Medical Sciences from June 2015 to March 2016 were divided into treatment group and control group by random,controlled and single blind method,with 12 cases in each group.Both groups were given basic treatment,on this basis,the treatment group was given intradermal needle treatment,and the control group was given true acupoint comfort needle treatment.Treatment was performed for four weeks,and one follow-up was performed after four weeks of treatment.Cough symptom score,Leicester cough questionnaire(LCQ)and cough visual analogue scale(VAS)scores were used as the main evaluation indicators.Results During the study,three cases of abscission,two cases of loss of follow-up,one case of business trip and the remaining nine cases were in the control group.Cough symptom scores:there were statistically significant differences in the time points and the interaction of daytime cough between the two groups(all P<0.05),but no statistically significant differences between the two groups(P>0.05).The differences of night cough score at time points were statistically significant(all P<0.05),while the differences between the two groups and interaction were not statistically significant(all P>0.05).Intra-group comparison:after four weeks of treatment and four weeks after the end of the treatment course,the scores of daytime cough and night cough in the treatment group were all lower than those before treatment,and the scores of night cough in the control group were lower than those before treatment(all P<0.05).VAS score:there were statistically significant differences in the scores of cough degree and cough frequency between groups and at time points(all P<0.05),but no statistically significant difference in the interaction(P>0.05).The differences of night cough score at time point were statistically significant(all P<0.05),while the differences between the two groups and interaction were not statistically significant(all P>0.05).Intra-group comparison:after four weeks of treatment and four weeks after the end of treatment course,cough degree,cough frequency and night cough score of the two groups were all lower than those before treatment(all P<0.05).Comparison between groups:after four weeks of treatment and four weeks after the end of treatment course,the scores of cough degree and cough frequency in the treatment group were lower than those in the control group(all P<0.05).LCQ scores:there were statistically significant differences in the time points of the physiological,psychological and social part scores(P<0.05),while the differences between the two groups and interaction were not statistically significant(all P>0.05).There were no statistically significant differences between the two groups,time points and interaction in the total score(all P>0.05).Intra-group comparison:after four weeks of treatment and four weeks after the end of treatment course,the treatment group physical parts,psychological part,social part scores were higher than those before treatment,the differences were statistically significant(all P<0.05),four weeks after the end of treatment course,the control group psychological part,social part scores were higher than those before treatment,the differences were statistically significant(all P<0.05).Conclusion Intradermal needle is safe and effective in treating chronic refractory cough.The therapeutic effect is mainly reflected in reducing the severity and frequency of cough.