理肺止咳汤辅助治疗儿童慢性鼻-鼻窦炎引发的上气道咳嗽综合征外寒内饮证38例临床观察

Clinical observation on 38 cases of upper airway cough syndrome symptom induced by chronic rhinosinusitis with exogenous cold in children treated by Lifei Zhike Tang(理肺止咳汤)as adjuvant therapy

目的观察理肺止咳汤辅助治疗儿童慢性鼻-鼻窦炎(CRS)引发的上气道咳嗽综合征(UACS)外寒内饮证的临床疗效。方法选取2018年1月至2019年5月广东省中西医结合医院儿科门诊收治的CRS引发的UACS外寒内饮证患儿80例,采用随机数字表法分为治疗组和对照组,各40例。治疗组最终脱落2例,实际完成38例;对照组脱落1例,实际完成39例。对照组予孟鲁司特钠咀嚼片,每日1次,睡前口服;生理盐水儿童鼻腔喷雾器喷鼻,每侧鼻孔4喷,每日3次。治疗组在对照组治疗方法的基础上加用中药理肺止咳汤。2组均治疗7 d后统计疗效。结果治疗前,2组咳嗽症状积分、视觉模拟(VSA)评分和血清IgE水平比较,差异无统计学意义(P>0.05),具有可比性。治疗后,2组上述指标值均明显下降,与同组治疗前比较,差异有统计学意义(P<0.01),且治疗组下降更显著,与对照组治疗后比较,差异有统计学意义(P<0.01)。治疗组CRS病情控制率为89.47%(34/38),高于对照组的71.79%(28/39),2组比较,差异有统计学意义(P<0.05)。本研究试验过程中,2组患儿均未发生精神神经系统症状、胃肠道反应、抑郁和睡眠不安等不适症状;试验结束后,2组患儿肝肾功能均未见异常。结论理肺止咳汤辅助治疗儿童CRS引发的UACS外寒内饮证,能明显缓解患儿的临床症状,降低血清IgE,疗效显著,安全可靠,值得临床推广应用。

Objective To observe the clinical efficacy of Lifei Zhike Tang(理肺止咳汤) in adjuvant treatment of upper airway cough syndrome(UACS) induced by chronic rhinosinusitis(CRS) with exogenous cold and internal retention symptom in children.Methods From January 2018 to May 2019,80 cases of UACS induced by CRS with exogenous cold and internal retention symptom admitted into outpatient service of pediatrics department of Guangdong Integrated Chinese and Western Medicine Hospital were chosen and divided into treatment group and control group by random number table method, with 40 cases in each group.There were 2 drop-out cases and 38 cases of actual completion in the treatment group;There were 1 drop-out case and 39 cases of actual completion in the control group.The control group was given montelukast sodium chewable tablets, once a day, oral administration at bedtime;saline nasal spray for children, 4 sprays for each nostril, 3 times a day.The treatment group was added with Lifei Zhike Tang on the basis of the control group.After 7 days of treatment for both groups, the curative effects of the 2 groups were statistically analyzed.Results Before treatment, there was no significant difference in cough symptom score, visual analogue scale(VAS) score and serum level of IgE between the 2 groups(P>0.05),and they were comparable.After treatment, the above indicators values of the 2 groups significantly decreased, and the difference was statistically significant compared with the same group before treatment(P<0.01), moreover, the treatment group decreased more significantly, and the difference was statistically significant compared with the control group after treatment(P<0.01).The control rate of CRS in the treatment group was 89.47%(34/38),which was higher than 71.79%(28/39) in the control group, and the difference was statistically significant between the 2 groups(P<0.05).In the course of this study, there were no uncomfortable symptoms of nervous system, gastrointestinal reaction, depression and sleep disturbance in the 2 groups.At the end of the trial, there was no abnormal liver and kidney function in the 2 groups.Conclusion It can significantly relieve the clinical symptoms of children, reduce serum level of IgE to use Lifei Zhike Tang in adjuvant treatment of UACS induced by CRS with exogenous cold and internal retention symptom in children, with significant curative effect and reliable safety, which is worthy of clinical promotion and application.