【作者】 杨玉华；

【导师】 朱佳；

【作者基本信息】 南京中医药大学 ， 中医内科呼吸病学， 2011， 硕士

【摘要】 目的：本论文以中医学关于外感咳嗽的理论为指导,论述了中医疏风宣肺法在治疗感冒后咳嗽(外感咳嗽)中可能具有的优势。本论文的主要目的如下：感冒后咳嗽在临床中越来越多见,但目前尚缺乏有效的治疗方法,本文目的在于探求一种较好的治疗感冒后咳嗽的方法,同时感冒后咳嗽也缺乏特异性的诊断方法,所以另一个目的为寻找一种检测的有效手段。方法：即本论文的实际操作过程,主要内容如下：病例收集主要在门诊,拟收集病例45例,将病例随机分为中药组及对照组,分别采用中药疏风宣肺法及西医对症止咳法治疗感冒后咳嗽。治疗前进行相关检查,如血常规、胸片、肺功能、气道阻力、呼出气一氧化氮检测,治疗第一天随访一次,了解症状、询问病情变化及用药情况,治疗第十天检查相关症状、询问病情、用药情况、气道阻力检测、呼出气NO检测,并建立数据库,对数据进行录入,并进行相关统计分析。结果：经研究后,中药组及对照组总有效率经统计学分析,P<0.05,说明中药组总体疗效优于对照组,中医药在治疗感冒后咳嗽总体疗效方面优于对照组。主要症状(咳嗽)临床疗效方面,两组在治愈率、显效率、有效率、无效率方面经统计学分析,P<0.05,具有统计学意义,中医药在治疗咳嗽疗效方面优于对照组。主要症状(咳痰)临床疗效方面,两者总有效率与无效率经相关统计学分析,P<0.05,可以认为中药组在治疗咳痰总体疗效方面仍优于对照组。两组Zrs方面,中药组治疗前后经检验得P<0.05,治疗前后有差异,对照组治疗前后P<0.05,治疗前后有差异,均具有统计学意义。两组治疗后检验得P>0.05,治疗后两组未见明显差异。两组R5方面,中药组治疗前后经检验得P<0.05,治疗前后有差异,具有统计学意义,对照组治疗前后经统计学分析P>0.05,治疗前后无差异,不具有统计学意义。R20中药组治疗前后P<0.05,治疗前后有差异,具有统计学意义,对照组治疗前后P>0.05,治疗前后无差异,不具有统计学意义。两组NO呼气测定方面,治疗前后所得P值分别为中药组P<0.05,对照组P>0.05,中药组疗效优于对照组。结论：中药组在治疗咳嗽、咳痰方面优于对照组；气道阻力方面,治疗前后中药组在呼吸总阻抗、总气道阻力、外周气道阻力方面均有明显改善；对照组呼吸总阻抗有改善两组外周气道弹性阻力方面改善均不明显；呼出气NO方面,中药组疗效优于对照组。更多还原

【Abstract】 Objective:The thesis is based on the traditional Chinese medical (TCM) about the the theory of post infectious cough (PIC),and it discusses the method of Dredging-Wind-and-Dispersing-Lung that may have more advantages than the other methods. The main purpose of this paper are as follows:PIC has become more common in the clinical, but there are no effective methods. The purpose of this text lies in seeking a more useful method of PIC. The specificity diagnostic method about PIC is still lack,so the other purpose is to find a testing effective means.Methods:This thesis actual operation processes are as follows:the case is collected in the outpatient,and will collect about 45cases. The cases will be divided into Chinese medicine group and control group.we will adopt the methods of Dredging-Wind-and-Dispersing-Lung and the modern medicine of cough treatment.We should do some related inspection before treatment,such as Routine blood,X-ray, pulmonary function test and airway resistance,FENO and so on.At the first day, we should know about the patient’s symptoms, ask their condition changes and the resoures.At the end of the treatment,we should inspect the related symptoms, ask their condition changes, the resoures,airway resistance,FENO.The databases should be established, and we should analysis the databases.Results:We found that the traditional Chinese medicine group and the control group total effectiveness by statistical analysis P<0.05, and in the asfect of overall efficacy Traditional Chinese medicine group is better than control group.Traditional Chinese medicine in treating PIC is better than control group.In the aspects of cough, two groups in cure rate, significant efficiency, efficient, inefficiency of statistical analysis P<0.05, there is a statistically significant,so in traditional Chinese medicine in treating cough curative is more effective than control group. Both total effectiveness and inefficient by related statistical analysis about sputum P<0.05, we can think that Chinese medicine in treatment of sputum is still better than control.In the aspect of Zrs, traditional Chinese medicine group before and after the treatment is P<0.05, there is difference before and after treatment. The control group before and after treatment is P<0.05,there is still different before and after the treatment. But the two groups after treating is P>0.05, so after treatment, the two groups did not see obvious difference. In the aspect of R5,traditional Chinese medicine group before and after the treatment is P<0.05,it is different before and after treatment, there is a statistically significant.The control group by statistical analysis before and after treatment is P>0.05, there is no differences before and after treatment. In the aspect of R20,traditional Chinese medicine group before and after treatment is P<0.05, there is a statistically significant difference. The control group before and after treatment is P>0.05, there is no difference,so there is no statistical significance. In the aspect of FENO,Before and after treatment Chinese medicine group is P<0.05, control group P>0.05, so the curative effect of Chinese medicine is better than control group.Conclusion:The traditional Chinese medicine in treating cough and sputum is better than the control group. In the aspect of the airway resistance, before and after the treatment of Chinese medicine,Zrs,R5,R20 be improved obviously,and the control group’s Zrs has improved.Both groups in X5 changs are not obvious.At the aspect of the FENO curative effect of Chinese medicine is more obvious than control group.更多还原