经方射干麻黄汤治疗感染后咳嗽风寒恋肺证临床疗效观察

目的 探讨经方射干麻黄汤治疗风寒恋肺型感染后咳嗽的临床疗效。 方法 将浙江中医药大学附属第三医院2014年11月-2015年8月间60例感染后咳嗽风寒恋肺型患者按随机数字法分为2组,每组30例。对照组给予复方甲氧那明胶囊,治疗组给予射干麻黄汤。分析2组中医证候积分和莱塞斯特咳嗽生命质量问卷(LCQ)变化、症状改善时间、临床疗效来评估射干麻黄汤的临床效果。通过分析2组痰液炎症因子(TNF-α、IL-4)、炎症介质[物质P(SP)、神经激肽A(NKA)]水平变化。 结果 治疗后,2组中医证候积分明显降低(P<0.05),且治疗组中医证候积分明显低于对照组(P<0.05)。治疗后,2组LCQ各指标显著升高(P<0.05),且治疗组LCQ各指标明显高于对照组(P<0.05)。治疗后治疗组症状起效时间和症状消失时间均显著低于对照组(P<0.05)。治疗组总有效率为93.3%,显著高于对照组的76.7%(P<0.05)。治疗后2组TNF-α、IL-4水平显著降低(P<0.05),且治疗组TNF-α、IL-4显著低于对照组(P<0.05)。治疗后2组SP、NKA水平明显降低(P<0.05),且治疗组SP、NKA明显低于对照组(P<0.05)。 结论 经方射干麻黄汤可有效改善感染后咳嗽风寒恋肺型患者临床症状与生活质量,其机制与改善患者气道神经源性炎症相关。 

Clinical observation of classic prescriptions Shegan Mahuang decoction on cough after infection patients with wind-cold stay in the lung

Objective To investigate the clinical effect of classic prescriptions Shegan Mahuang decoction on cough after infection patients with wind-cold stay in the lung. Methods Sixty cases of cough after infection patients with wind-cold stay in the lung in our hospital from November,2014 to August,2015 were randomly divided into 2 groups,each 30 cases.The control group was given Fufang Methamidophos Capsule,while the treatment group was given Shegan Mahuang decoction.The clinical TCM syndrome score,Leslie cough quality of life questionnaire (LCQ),symptom improvement time and clinical effect of both groups were analyzed to evaluate the efficacy of Shegan Mahuang decoction.The inflammatory factors (TNF-α,IL-4),inflammatory mediators[substance P (SP) and neurokinin A (NKA)]in sputum of both groups were analyzed. Results After the treatment,the TCM syndrome score of the two groups were significantly reduced (P<0.05),and the TCM syndrome score of the treatment group was significantly lower than that in the control group (P<0.05).After the treatment,the LCQ indicators of the two groups were significantly increased (P<0.05),and the LCQ indicators of the treatment group was significantly higher than that in the control group (P<0.05).After the treatment,symptom onset time and symptom disappearance time of the treatment group were significantly lower than that in the control group (P<0.05).The total effective rate of the treatment group was 93.3%,which was significantly higher than 76.7% in the control group (P<0.05).After the treatment,the TNF-α and IL-4 levels of the two groups were significantly reduced (P<0.05),and the TNF-α and IL-4 levels of the treatment group was significantly lower than those in the control group (P<0.05).After the treatment,the SP and NKA levels of the two groups were significantly reduced (P<0.05),and the SP and NKA levels of the treatment group was significantly lower than those in the control group (P<0.05). Conclusion Shegan Mahuang decoction could effectively improve the clinical symptoms and life quality of cough after infection patients with wind-cold stay in the lung,and its treatment mechanism might be related to the improvement of airway neurogenic inflammation.