中醫定向透藥療法治療慢性咳嗽的臨床觀察

于閱盡+黃衛+張慧+黃秋燕+黃少鷹

【摘要】目的： 探討中醫定向透藥療法治療主要表現為上氣道咳嗽綜合征（UACS）的慢性咳嗽的臨床效果。方法： 將138例來我院耳鼻喉科就診的UACS慢性咳嗽患者按隨機數字表法分為治療組和對照組各69例。2組均口服氯雷他定1周，鼻腔吸人糖皮質激素1月。治療組在此基礎上加用中醫定向透藥治療儀輔助治療，隔天1次，連續5次，對照組不予藥物導入治療。結果： 兩組治療前后，咳嗽程度、鼻部癥狀和體征、咽部癥狀方面均明顯改善；組間比較，除鼻部癥狀外，咳嗽和咽部癥狀治療組評分明顯低于單純藥物治療對照組，統計學分析呈顯著性差異（P <0.05）。臨床療效治療組總有效率（89.9%）明顯高于單純藥物治療對照組（76.8%），統計學分析呈顯著性差異（P =0.033）。結論：在西醫常規治療基礎上加用中醫定向透藥療法治療慢性咳嗽能顯著改善患者癥狀，提高其生活質量，值得推廣。

【關鍵詞】 中醫定向透藥療法；慢性咳嗽；上氣道咳嗽綜合征

[Abstract] Objective： To evaluate the clinical efficacy of Chinese medicine targeted transdermal therapy for treating upper airway cough syndrome （UACS）， a main manifestation of chronic cough. Methods： A total of 138 patients who were diagnosed with UACS at the Department of Ear Nose and Throat （ENT） were randomly divided into the treatment group and the control group （69 patients per group）. Both groups received oral loratadine for 1 week， and nasal inhalation of glucocorticoid for 1 month. In addition to these， the treatment group also received Chinese medicine targeted transdermal therapy as an adjuvant therapy once every 2 days， for a total of 5 times. The control group was not treated with any additional drugs. Results：The severity of coughing， nasal symptoms， pharyngeal symptoms and physical signs were significant improved in both groups following treatment. Besides nasal symptoms， coughing and pharyngeal symptoms were significantly lower in the treatment group compared to the drug therapy control group （P <0.05）. In addition， the total clinical efficacy was significantly higher in the treatment group （89.9%） than the drug therapy control group （76.8%） （P=0.033）. Conclusions： The addition of Chinese medicine targeted transdermal therapy on the basis of conventional treatment can significantly improve the symptoms of chronic coughing and enhance patients quality of life， and therefore should be widely promoted as an adjuvant treatment for chronic coughing.

[Key words] Chinese medicine targeted transdermal therapy； chronic coughing； upper airway cough syndrome

【中圖分類號】R445.62

【文獻標識碼】A

【文章編號】2095-6851（2017）08-074-01

慢性咳嗽也可稱為慢性干咳。臨床通常將以咳嗽為唯一癥狀或主要癥狀，時間超過8周， 胸部X線檢查正常者稱為不明原因慢性咳嗽， 簡稱慢性咳嗽。上氣道咳嗽綜合征（upper airway cough syndrome，UACS）是引起慢性咳嗽的常見癥因之一^[1]，2006美國ACCP指南編撰委員會將由上呼吸道疾病如普通感冒等通過鼻分泌物后流和/或炎癥刺激引起的咳嗽統稱為UACS^[2]。由于本病療程偏長、癥狀容易反復，影響患者的生活質量，故引起臨床醫生關注。近年來，中醫藥治療慢性咳嗽取得了一定的進展，可能有助于解決慢性咳嗽治療中的一些困境。我科自2014年開展了中醫定向透藥療法配合藥物治療慢性咳嗽取得一定療效，現報道如下。

1 資料與方法

1.1 病例選擇及分組：收集的病例為我院耳鼻喉科門診就診的符合上氣道咳嗽綜合征診斷標準的慢性咳嗽患者，共138例。按1：1比例隨機分為治療組和對照組。排除有急性細菌性感染、胃食管反流、咳嗽變異性哮喘、支氣管哮喘、異物吸入及先天性氣道疾病等心肺部疾病、合并鼻息肉、嚴重鼻中隔偏曲、裝有人工支架、人工瓣膜與人工起搏器的患者。endprint