疏肝健脾利咽汤治疗反流性咽喉炎临床研究

目的:观察疏肝健脾利咽汤治疗反流性咽喉炎的临床疗效。方法:将80例反流性咽喉炎患者采用随机数字法分为观察组和对照组,每组40例。观察组采用疏肝健脾利咽汤(甘草6 g,柴胡、桔梗各9 g,白术、党参、山药、玄参各15 g,白芍、茯苓、陈皮、郁金、生地黄各12 g)治疗,对照组采用金嗓利咽丸治疗。两组患者均治疗4周后进行临床疗效比较,并记录两组患者治疗前后症状积分、体征积分情况。两组患者治疗前后中医证侯积分,采用酶联免疫吸附试验检测胃蛋白酶浓度。结果:观察组有效率为95.00%,对照组有效率为80.00%,两组比较,差异有统计学意义(P0.05)。两组患者治疗后症状评分均显著降低,治疗后两组患者刺激性咳嗽、呼吸困难、仰卧咳嗽、吞咽困难比较,差异无统计学意义(P0.05);治疗后观察组声嘶、咽喉黏液增多、清喉、喉中有黏滞、烧心及反酸显著低于对照组,差异有统计学意义(P0.05)。两组患者治疗前后临床体征积分比较,治疗后内芽肿、弥漫性喉水肿、喉室消失比较,差异无统计学意义(P0.05),声带水肿、息肉样变、喉黏液蓄积、声门下水肿比较,差异有统计学意义(P0.05)。两组患者治疗前后中医证候积分均显著降低,治疗后观察组倦怠懒言、腹胀便溏、嗳气反酸、胸肋胀痛、舌质舌苔、脉象均显著低于对照组,差异均有统计学意义(P0.05)。两组患者治疗前后胃蛋白酶水平均显著降低,且治疗后观察组显著低于对照组,差异有统计学意义(P0.05)。结论:疏肝健脾利咽汤紧扣反流性咽喉炎肝郁脾虚病机,在症状、体征以及胃蛋白酶水平的改善方面均优于金嗓利咽丸,临床疗效显著。

Clinical Study of Shugan Jianpi Liyan Decoction in Treatment of Reflux Pharyngolaryngitis

Objective:To observe the clinical effect of Shugan Jianpi Liyan Decoction in treatment of reflux laryngitis.Methods:80 patients with reflux laryngitis were randomly divided into observation group and control group,with 40 cases in each group.The observation group was treated with Shugan Jianpi Liyan Decoction (licorice 6 g,Bupleurum 9 g,Campanulaceae 9 g,Atractylodes macrocephala 15 g,Codonopsis 15 g,Chinese yam 15 g,Scrophulariaceae 15 g,Papaya 12 g,Citrus 12 g,Turmeric12 g,Rehmannia 12 g.The control group was treated with Jinsang Liyan Pills.Two groups of patients were treated for 4 weeks.Before and after treatment of two groups of patients,the clinical efficacy comparison was made,and the symptoms and signs were recorded.The enzymelinked immunosorbent assay was used to detect the pepsin concentration.Results:The effective rate in the observation group was 95.00％ and that in the control group was 80.00％.The difference was statistically significant (P ＜ 0.05).The Symptom score of the two groups were significantly lowered and there was no significant difference between the two groups in patients' irritation cough,dyspnea,supine cough and dysphagia (P ＞ 0.05).Patients' symptoms such as hoarseness,throat mucus,clear throat,throat sticky,heartburn and acid reflux in the observation group was significantly better than that of the control group,the difference was statistically significant (P ＜0.05).There were no significant differences in granulomatous,diffuse laryngeal edema and laryngeal disappearance between the two groups before and after treatment (P ＞ 0.05).The scores of TCM syndromes were significantly lowered in the two groups before and after treatment.After treatment,the scores of burnout,bloating and shortness of the observation group were significantly lower than those of the control group,and the differences were statistically significant (P ＜ 0.05).The levels of pepsin in the two groups before and after treatment were significantly decreased,and that of the observation group was statistically better (P ＜ 0.05).Conclusion:The clinical curative effect of Shugan Jianpi Liyan Decoction is better than that of Jinsang Liyan Pills and it can significantly bring about the improvement of symptoms,signs and pepsin levels in treatment of reflux laryngitis with Liver and Spleen deficiency Syndrome.