苓甘五味姜辛汤联合止嗽散加减治疗慢性咳嗽40例临床观察

Clinical observation of Linggan Wuwei Jiangxin decoction combined with modified Zhisu powder in treating 40 cases of chronic cough

目的:观察苓甘五味姜辛汤合止嗽散加减治疗慢性咳嗽的临床效果。方法:随机抽取常德市第一中医医院2017年10月-2019年12月收治的80例慢性咳嗽患者,以用药方法不同分为观察组与对照组,对照组以常规的西药疗法(复方甲氧那明胶囊每次2粒,每天3次,口服治疗;布地奈德粉吸入剂每次400~800μg,每天2次,吸入治疗)治疗,观察组在对照组的治疗基础上加用苓甘五味姜辛汤合止嗽散加减方治疗,2组患者均治疗1个月后比较疗效、中药证候评分、咳嗽症状改善与消失时间、肺功能及药物不良反应情况。结果:观察组总有效率为97.50%(39/40),高于对照组的87.50%(35/40),差异具有统计学意义(P<0.05);治疗后观察组的咳嗽、形寒肢冷、神疲乏力等中医证候评分均低于对照组,差异具有统计学意义(P<0.05);观察组的咳嗽症状改善、消失时间均短于对照组,差异具有统计学意义(P<0.05);治疗后观察组FEV_(1)、FVC、FEV_(1)/FVC均高于对照组,差异具有统计学意义(P<0.05);两组皮疹、胃肠道反应、头痛等不良反应发生率比较差异无统计学意义(P>0.05)。结论:苓甘五味姜辛汤合止嗽散加减治疗慢性咳嗽疗效确切,可有效改善症状,改善肺功能指标,值得临床推广。

Objective:To observe the clinical effect of Linggan Wuwei Jiangxin decoction(苓甘五味姜辛汤)combined with modified Zhike powder(止嗽散)in the treatment of chronic cough.Methods:80 cases of patients with chronic cough treated from The First Hospital of Traditional Chinese Medicine of Changde city from October 2017 to December 2019 were randomly selected,and divided into the observation group and the control group according to different treatment methods,the control group received conventional western medicine therapy(2 capsules once time,3 times every day,oral treatment;Budesonide powder inhalant 400-800μg once time,2 times every day,inhalation treatment).In addition to the treatment of the control group,the observation group was treated with Linggan Wuwei Jiangxin decoction combined with Modified Zhike powder.Patients in both groups were treated for 1 month,the curative effect and traditional Chinese medicine(TCM)syndrome score,cough symptoms disappearing time,pulmonary function and adverse drug reactions of two groups were compared.Results:The total effective rate was 97.50%(39/40)in the observation group,which was higher than 87.50%(35/40)in the control group,the difference was statistically significant(P<0.05).After treatment,the scores of TCM syndromes in the observation group were all lower than those in the control group,which was with statistically significant differences(P<0.05).The improvement and disappearance time of cough symptoms in the observation group were shorter than those in the control group,and the difference was statistically significant(P<0.05).After treatment,FEV_(1),FVC and FEV_(1)/FVC in the observation group were all higher than those in the control group,which was with statistically significant differences(P<0.05)There was no significant difference in the incidence of rash,gastrointestinal reactions,headache and other adverse reactions between the two groups(P<0.05).Conclusion:Linggan Wuwei Jiangxin decoction combined with Zhike powder has a definite therapeutic effect on chronic cough,it can effectively relieve symptoms and improve pulmonary function indexes,and is worthy of clinical promotion.