摘要
目的探讨喉源性咳嗽相关病理改变与中医辨证分型的相关性。方法随机抽取2015年1月～2017年1月期间我科门诊喉源性咳嗽患者600例作为研究对象并进行中医辨证分型,统计证型分布情况;同时行血常规、C反应蛋白、间接鼻咽镜、间接喉镜、纤维鼻咽喉镜、胸部X线片、吸入性变应原筛查等相关检查,分析比较不同中医证型患者的各项检查结果差异,探索各项病理改变与喉源性咳嗽中医辨证分型之间的相关性。结果喉源性咳嗽的中医证型主要为风邪犯肺型、卫表不固型、脾虚痰浊型、阴虚火旺型,分别占38.17%、31.67%、17.50%、12.67%。不同证型患者的嗜酸性粒细胞数、中性粒细胞数、血清C反应蛋白水平差异均有统计学意义(P<0.05),局部病理改变以鼻中隔偏曲、鼻炎、咽喉炎、咽喉滤泡增生为主。所有证型患者胸部X线片中未见肺部异常改变征象。卫表不固型患者的吸入性变应原检测多为阳性。皮尔逊相关系数分析结果显示,喉源性咳嗽的局部病理改变与其中医辨证分型显著相关。结论喉源性咳嗽患者的相关病理改变与中医辨证分型有关,仔细辨析这些局部病理改变,可以为喉源性咳嗽的中医辨证施治提供客观指标。
Objective To investigate the relationship between the associated pathological changes of patients with laryngeal cough and the patterns of TCM syndrome differentiation based on a clinical trial.Methods Included in this study were 600 cases with laryngeal cough treated in our Hospital from Jan,2015 to Jan.,2017,randomly selected from the patients of our outpatient department.TCM syndrome differentiation was carried out among them to explore the distributing patterns of TCM syndrome by a statistic analysis procedure.At the same time,all these cases were assayed on the changes in blood routine test,the level of C reactive protein,local pathological features determined by indirect nasopharyngoscopy,indirect laryngoscopy and fiberoptic nasopharyngolaryngoscopy,chest X-ray,and skin prick test with inhalant allergens.Then,a comparative analysis was carried out to explore the possible relationships between the patterns of TCM syndrome and the associated pathological changes though analyzing the differences of associated pathological changes in different patterns of TCM syndrome among patients with laryngeal cough.Results The commonly seen patterns of TCM syndrome in this group of cases with laryngeal cough were the pattern of wind evil invading the lung,the pattern of insecurity of the defensive exterior,the one of spleen deficiency engendering phlegm turbidity,and effulgent yin deficient fire,accounted for 38.17%,31.67%,17.50% and 12.67% for each pattern respectively.There were significantly statistical significance in the differences in the numbers of eosinophils and neutrophils,and the levels of serum C reaction protein among different TCM Syndromes(P<0.05)as well,with the most frequently seen local pathology changes being deviated nasal septum,rhinitis,sphagitis and tumors in throat.Furthermore,the cases with the patterns of wind evil invading the lung,insecurity of the defensive exterior and spleen deficiency engendering phlegm turbidity usually showed abnormal changes in the lungs as shown by chest X-ray,with those of patients with the pattern of insecurity of the defensive exterior being in a positive reacting status more frequently to inhalant allergens as indicated by skin prick test.As the result of Pearson correlation coefficient analysis,there was a significant correlation of the associated pathological changes among cases with laryngeal cough with the patterns of TCM syndrome.Conclusion The associated pathological changes among patients with laryngeal cough are closely correlated with the patterns of TCM syndrome.It holds significantly clinical reference implications to improve the therapeutic effects on cases with laryngeal cough to carry out TCM syndrome differentiation and treatment accurately through identifying these kinds of pathological change.
作者
黄卓燕
张勉
高阳
陈潇
张钢军
杨培培
HUANGZhuoyan;ZHANGMian;GAOYang;CHENXiao;ZHANGGangjun;ZHANGPeipei(The First Affiliated Hospital of Guangxi TCM University, Guangxi, 530023, China)
出处
《中国中西医结合耳鼻咽喉科杂志》
2018年第6期448-450,471,共4页
Chinese Journal of Otorhinolaryngology in Integrative Medicine
基金
国家自然科学基金委员会地区科学基金课题(8126055)
关键词
喉源性咳嗽
病理改变
辨证分型
相关性
Laryngeal cough
Pathological changes
TCM syndrome differentiation
Correlation
