于阅尽+黄卫+张慧+黄秋燕+黄少鹰

【摘要】目的： 探讨中医定向透药疗法治疗主要表现为上气道咳嗽综合征（UACS）的慢性咳嗽的临床效果。方法： 将138例来我院耳鼻喉科就诊的UACS慢性咳嗽患者按随机数字表法分为治疗组和对照组各69例。2组均口服氯雷他定1周，鼻腔吸人糖皮质激素1月。治疗组在此基础上加用中医定向透药治疗仪辅助治疗，隔天1次，连续5次，对照组不予药物导入治疗。结果： 两组治疗前后，咳嗽程度、鼻部症状和体征、咽部症状方面均明显改善；组间比较，除鼻部症状外，咳嗽和咽部症状治疗组评分明显低于单纯药物治疗对照组，统计学分析呈显著性差异（P <0.05）。临床疗效治疗组总有效率（89.9%）明显高于单纯药物治疗对照组（76.8%），统计学分析呈显著性差异（P =0.033）。结论：在西医常规治疗基础上加用中医定向透药疗法治疗慢性咳嗽能显著改善患者症状，提高其生活质量，值得推广。

【关键词】 中医定向透药疗法；慢性咳嗽；上气道咳嗽综合征

[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

【中圖分类号】R445.62

【文献标识码】A

【文章编号】2095-6851（2017）08-074-01

慢性咳嗽也可称为慢性干咳。临床通常将以咳嗽为唯一症状或主要症状，时间超过8周， 胸部X线检查正常者称为不明原因慢性咳嗽， 简称慢性咳嗽。上气道咳嗽综合征（upper airway cough syndrome，UACS）是引起慢性咳嗽的常见症因之一^[1]，2006美国ACCP指南编撰委员会将由上呼吸道疾病如普通感冒等通过鼻分泌物后流和/或炎症刺激引起的咳嗽统称为UACS^[2]。由于本病疗程偏长、症状容易反复，影响患者的生活质量，故引起临床医生关注。近年来，中医药治疗慢性咳嗽取得了一定的进展，可能有助于解决慢性咳嗽治疗中的一些困境。我科自2014年开展了中医定向透药疗法配合药物治疗慢性咳嗽取得一定疗效，现报道如下。

1 资料与方法

1.1 病例选择及分组：收集的病例为我院耳鼻喉科门诊就诊的符合上气道咳嗽综合征诊断标准的慢性咳嗽患者，共138例。按1：1比例随机分为治疗组和对照组。排除有急性细菌性感染、胃食管反流、咳嗽变异性哮喘、支气管哮喘、异物吸入及先天性气道疾病等心肺部疾病、合并鼻息肉、严重鼻中隔偏曲、装有人工支架、人工瓣膜与人工起搏器的患者。endprint