张亚平 冯茜 干洪洲

摘要 目的：探讨养阴利咽饮与玉液散吹喉对阴虚肺燥型慢性咽炎患者血清炎性因子的影响。方法：将2015年8月至2017年3月山东省淄博市第四人民医院收治的慢性咽炎患者118例作为研究对象，按治疗方法不同分为对照组和观察组，每组59例。对照组用常规西药治疗，观察组用养阴利咽饮与玉液散吹喉治疗，均连续治疗30 d。比较2组临床疗效，观察并比较治疗前后2组患者主要临床症状改善情况，唾液中分泌型免疫球蛋白A（SIgA）、血清炎性因子水平及生命质量变化。结果：治疗后观察组总有效率为91.53%，高于对照组的76.27%（P<0.05）。治疗后2组咽痛、干咳、咽黏膜充血水肿临床症状积分低于治疗前，且观察组低于对照组（P<0.01）。与治疗前比较，治疗后2组患者唾液中SIgA水平均明显升高，血清肿瘤坏死因子-α（TNF-α）及C-反应蛋白（CRP）水平均明显降低，且2组比较差异均有统计学意义（均P<0.01）。治疗后2组患者SF-36各项评分均明显高于治疗前，且觀察组高于对照组（P<0.05或P<0.01）。结论：养阴利咽饮与玉液散吹喉联用可降低阴虚肺燥型慢性咽炎患者血清TNF-α、CRP水平，升高唾液中SIgA含量，改善患者临床症状，提高患者生命质量。

关键词  慢性咽炎;阴虚肺燥型;养阴利咽饮;玉液散;分泌型免疫球蛋白A;肿瘤坏死因子-α;C-反应蛋白

Effects of Yangyin Liyan Decoction and Yuye Powder Blowing Throat on Serum Factors in Patients with Chronic Pharyngitis with Yin Deficiency and Pulmonary Dryness

ZHANG Yaping，FENG Xi，GAN Hongzhou

（Department of Traditional Chinese Medicine，the Fourth People′s Hospital of Zibo，Zibo 255000，China）

Abstract Objective：To explore the effects of Yangyin Liyan Decoction and Yuye Powder blowing throat on serum factors in patients with chronic pharyngitis with yin deficiency and pulmonary dryness.Methods：A retrospective analysis was conducted on 118 cases of chronic pharyngitis patients in the Fourth People′s Hospital of Zibo and were divided into an experiment group and a control group according to different treatment methods，with 59 cases in each groups.The control group was treated with conventional Western medicine，the experiment group was treated with Yangyin Liyan Decoction and yuye Powder blowing throat.All were treated for 30 days continuously.The clinical efficacy of 2 groups after treatment were compared.The improvement of main clinical symptoms，the levels of SIgA in saliva，inflammatory factors in serum and the changes of quality of life in the 2 groups before and after treatment were compared.Results：The total effective rate was 91.53% in the experiment group，which was higher than 76.27% in the control group（P<0.05）.After treatment，the scores of clinical symptoms of pharyngeal pain，dry cough and pharyngeal mucosal congestion and edema in the 2 groups was lower than before treatment，and those in the experimental group was lower than that in the control group（P<0.01）.Compared with those before treatment，the SIgA level in the 2 groups after treatment significantly increased，the levels of serum TNF-α and CRP significantly decreased，and there was significant difference between the 2 groups（P<0.01）.The SF-36 scores of 2 groups after treatment were significantly higher than those before treatment，and the experiment group was significantly higher than the control group（P<0.05 or P<0.01）.Conclusion：Yangyin Liyan Decoction and Yuye Powder blowing throat can reduce the levels of serum TNF-α，CRP in patients with yin deficiency and lung dryness chronic pharyngitis，increase the content of SIgA in saliva，improve the clinical symptoms and the quality of life of patients.

2 结果

2.1 2组患者临床疗效比较 治疗后观察组总有效率（91.53%），高于对照组（76.27%），2组比较差异有统计学意义（P<0.05）。见表1。

2.2 2组患者治疗前后主要临床症状积分改善情况比较 治疗后2组咽痛、干咳、咽黏膜充血水肿等症状积分低于治疗前，且观察组低于对照组（P<0.01）。见表2。

2.3 2组患者治疗前后唾液中SIgA及血清炎性因子水平比较 与治疗前比较，治疗后2组唾液中]SIgA水平均明显升高，且观察组明显高于对照组（]P<0.01）;2组血清TNF-α及CRP水平均下降，且观察组低于对照组（P<0.01）。见表3。

2.4 2组患者治疗前后SF-36评分变化 与治疗前比较，治疗后2组患者躯体功能、社会功能、生理职、疼痛、一般健康、精神健康、活力、情绪角色等SF-36评分均上升，且观察组高于对照组（P<0.05或P<0.01）。见表4。

3 讨论

现代医学认为慢性咽炎多由急性咽炎治疗不彻底，反复发作而致，咽喉局部神经长期处于慢性炎性反应刺激状态，导致疾病反复发作、迁延难愈。……