摘要
目的基于真实世界临床研究数据, 评价定咳汤加减治疗感染后咳嗽(PIC)的临床疗效。方法回顾性队列研究。将2021年7月-2022年7月上海市静安区中医医院肺病科及中医内科245例PIC患者作为观察对象, 以是否服用定咳汤加减分为对照组90例(未服用)和治疗组155例(服用)。采用倾向性评分匹配(PSM)法按1∶1比例匹配均衡治疗前易混杂因素, 最终2组各有56例配对成功。对照组按临床实际情况予以对症处理, 治疗组在对照组基础上服用定咳汤加减治疗。2组均治疗2周。分别于治疗前后进行中医症状评分、咳嗽严重程度评分, 并采用莱切斯特咳嗽生命质量问卷(LCQ)评估患者的咳嗽及生活质量;采用ELISA法检测血清TNF-α、IL-6水平;记录治疗期间的不良反应, 评价临床疗效。结果治疗组总有效率为91.07%(51/56)、对照组为76.79%(43/56), 2组比较差异有统计学意义(χ^(2)=4.24, P=0.040)。治疗组治疗后日间咳嗽症状评分[(1.03±0.67)分比(1.20±0.66)分, t=7.40]、夜间咳嗽症状评分[(0.74±0.62)分比(1.26±0.54)分, t=6.27]低于对照组(P<0.001);LCQ生理[(5.30±0.79)分比(4.78±1.09)分, t=-2.44]、心理[(5.33±0.92)分比(4.70±1.12)分, t=-2.39]、社会[(5.23±0.94)分比(4.60±0.81)分, t=-2.86]评分高于对照组(P<0.05)。治疗组治疗后血清IL-6[(14.29±3.94)ng/L比(19.99±5.17)ng/L, t=4.80]、TNF-α[(36.23±7.83)ng/L比(42.44±7.63)ng/L, t=3.11]水平低于对照组(P<0.01)。治疗期间, 对照组不良反应发生率为8.92%(5/56)、治疗组为5.36%(3/56), 2组比较差异无统计学意义(χ^(2)=0.54, P=0.716)。结论基于真实世界研究方法的定咳汤加减可明显改善PIC患者的生活质量, 提高临床疗效, 其机制可能与减轻气道炎症反应有关。
Objective:To explore the curative efficacy of Dingke Decoction in the treatment of post infectious cough based on the the real-world clinical data.Methods:Retrospective cohort study was conducted.245 patients with cough after infection in the hospital of Jingan Chinese Medical Hospital from July 2021 to July 2022 were set as study objects.The fact that whether the patients with Dingke Decoction or not were divided into control group(90 cases,without Dingke Decoction)and treatment group(155 cases,with Dingke Decoction).By using propensity nearest neighbor 1:1 matching to balance the confounding factors before treatment,56 cases were successfully matched in both groups.The control group was treated symptomatically according to the actual clinical situation,while the treatment group was treated with modified Dingke Decoction on the basis of symptomatic treatment in the control group.The treatment for both groups lasted for 2 weeks.TCM symptom scores and cough severity score were evaluated using the Leicester Cough Quality of Life Questionnaire(LCQ)before and after treatment.Levels of tumor necrosis factor-alpha(TNF-α)and interleukin-6(IL-6)were detected through ELISA;adverse reactions during the treatment were recorded,and the clinical efficacy was evaluated.Results:The total effective rate of the treatment group was 91.07%(51/56),while that of the control group was 76.79%(43/56),with a statistically significant difference between the two groups(χ^(2)=4.24,P=0.040).The daytime cough symptom score(1.03±0.67 vs.1.20±0.66,t=7.40)and nighttime cough symptom score(0.74±0.62 vs.1.26±0.54,t=6.27)in the treatment group were lower than those in the control group after treatment(P<0.001).After treatment,the LCQ physiological(5.30±0.79 vs.4.78±1.09,t=-2.44),psychological(5.33±0.92 vs.4.70±1.12,t=-2.39),and social(5.23±0.94 vs.4.60±0.81,t=-2.86)scores in the treatment group were higher than those in the control group(P<0.05).After treatment,he treatment group serum IL-6[(14.29±3.94)ng/L vs.(19.99±5.17)ng/L,t=4.80]and TNF-α[(36.23±7.83)ng/L vs.(42.44±7.63)ng/L,t=3.11]were lower than those in the control group(P<0.01).The incidence of adverse reactions in the control group was 8.92%(5/56)and 5.36%(3/56),respectively,without statistical significance(χ^(2)=0.54,P=0.716).Conclusion:Based on the real-world research method,medicine Dingke Decoction can improve the clinical efficacy and the quality life of post infectious cough patients,and the mechanism may be related to reducing airway inflammation response.
作者
王安安
李燕兰
马成勇
孙靖
潘纬榕
王哲睿
张天嵩
Wang An'an;Li Yanlan;Ma Chengyong;Sun Jing;Pan Weirong;Wang Zherui;Zhang Tiansong(Depatment of Respiratory,Jing'an Chinese Medical Hospital,Shanghai 200072,China;Depatment of Internal Medicine,Jing'an Chinese Medical Hospital,Shanghai 200072,China)
出处
《国际中医中药杂志》
2024年第8期980-985,共6页
International Journal of Traditional Chinese Medicine
基金
上海市静安区名老中医专家传承创新工作室建设项目(JA2021-MLZZ05)
上海市静安区卫生科研课题(2023ZY05)。
关键词
咳嗽
感染后咳嗽
定咳汤加减
真实世界研究
倾向性评分匹配
临床疗效
Cough
Post infectious cough
Modified Dingke Decoction
Real-world study
Propensity score matching(PSM)
Clinicalefficacy
