中药离子导入佐治小儿慢性咳嗽鼻后滴漏综合征的临床疗效观察
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摘要
目的：通过对由鼻后滴漏所引起的慢性咳嗽患儿在中药汤剂口服的基础上，加用香丹注射液经皮穴位离子导入治疗，观察其治疗前后症状及体征的变化，并与对照组比较疗效，以探寻更有效的治疗途径，提高临床疗效。
方法：按中华医学会呼吸病学分会哮喘学组2005年制定的《咳嗽的诊断与治疗指南》(草案)中鼻后滴漏综合征的诊断标准，选择慢性咳嗽鼻后滴漏综合征患儿60例，采取简单随机方法，分治疗组A、对照组B、C三组，每组各20例。其中治疗组A及对照组B采用自拟方通窍止咳汤加减，A组配合香丹注射液经皮穴位离子导入，1日1次，每次20分钟；B组加氯雷他定口服；C组为西药激素鼻喷剂、氯雷他定口服并配合止咳对症治疗。三组治疗均为7天1个疗程，共观察2个疗程。治疗过程中因各种原因不能规律用药者5例，失访2例，疗程结束后，资料完整的仅53例，其中A组18例、B组20例、C组15例，比较三组临床疗效。
结果：1．总有效率，A组94.4％，B组85％，C组80％，A组疗效与C组比较有显著差异(P＜0.05)，A组与B组、B组与C组比较均无显著差异(P＞0.05)。
2．对症状、体征积分进行比较：三组治疗前后各自组内分值比较，均有非常显著差异(P＜0.01)，三组治疗后分差比较，A组与C组比较，差异非常显著(P＜0.01)，A组与B组比较，差异显著(P＜0.05)。
3．疗程结束后1个月随访情况：总有效率，A组88.9％，B组70％，C组60％，A组疗效与C组比较有非常显著的差异(P＜0.01)，A组与B组、B组与C组比较均无显著差异(P＞0.05)，说明A组疗效较确切、稳定。在鼻部症状上，三组疗程结束后1个月随访与疗程结束时比较，治疗组鼻塞疗效优于B、C组，差异非常显著(P＜0.01)，说明离子导入治疗对鼻塞疗效较突出；鼻痒方面，B组与A、C组比差异显著(P＜0.05)，说明中药加氯雷他定治疗对鼻痒改善疗效较稳定。
结论：中药配合经皮穴位离子导入治疗慢性咳嗽鼻后滴漏综合征疗效较好。由于香丹注射液经皮穴位离子导入，能迅速改善局部微循环状态，较快减轻鼻充血肿胀、有效缓解鼻塞，减少鼻咽部分泌物；同时中药宣肺通窍又调理善后，所以咳嗽症状得到较好控制，且停止治疗后病情稳定。经观察，治疗过程中无一例不良反应。经皮穴位离子导入操作简便，患儿无痛苦，依从性好，可作为治疗小儿鼻后滴漏所致慢性咳嗽的局部给药方法在临床应用。
Objectives:
By treating the children in chronic cough of postnasal drip syndrome (PNDs) with XiangDan injection by iontophoresis through acupuncture points on the basis of decoction herbalmedicine to observe the changes of signs and symptoms before and after treatment andcompare the clinical effect with control groups to search for a more efficient way to improveclinical effect.
Methods:
According to the standard of PNDs in the Guideline for Diagnosis of Cough andTreatment established by the asthma panel of the pneumologie branch of Chinese MedicalUnion in 2005, sixty children suffering from chronic cough of PNDs were randomly dividedinto the Treatment Group A and the Control Groups B and C in which there are 20 ratesrespectively. Both of the Treatment Group A and the Control Group B were andled withdecoction of my tutor who designs the prescription—Freeing opening and relieving coughprescription. Then Group A receives therapy of Xiang Dan injection by iontophoresis throughacupuncture points. Additionally, the patients in Group B were given Lorata-dine pills orally,and the Group C was treated with Budesonide aqueous nasal spray as well as Lorata-dine pillsorally combined with relieving cough. There is no significant deviation between the data ofthree groups with Homogeneity-of-variance Test (P＞0.05). Then the therapeutic groupreceived therapy of iontophoresis once a day, 20minutes each time and 7 times constituted acourse of treatment and 2 courses were given. There are 5 cases using medicine irregularlyand 2 cases failed to follow up during lamivudine therapy and there are 53 cases ofinformation completely with 18 cases in Group A, 20 in Group B, 15 in Group C after the endof treatment. Then the curative effects among three groups were compared.
Result:
1. the side of total effective rate: The total of effective rate of Group A was 94.4% and that of Group B was 85% and C was 80%. There was significant difference between Group Aand Group C(P＜0.05) and no significant difference between Group A and B as well as GroupB and C(P＞0.05).
2. comparing the scores of symptomatic with those of physical sign: There wassignificant difference in comparison of scores of before and after therapy in each group(P＜0.01) and after the treatments the scores difference was Remarkable between Group A andC(P＜0.01) and there was significant difference between Group A and B(P＜0.05).
3. following up after one month of the end of treatment: There was no significantdifference in the total effective rate between the time of the following up after one month ofthe end of treatment and the very time of the therapy finished in Group A as well asB(P＞0.05). Otherwise, significant difference existed in Group C (P＜0.05), which indicatedthat the symptomatic in Group C often recurred when the treatment was stopped. It is relatedto the period of treatment that was short (only 2 weeks). As the number of cases is small, theconclusion can just be treated as reference. There was Remarkbale difference in the curativeeffect of symptomatic recovery of nasal obstruction between the treatment group and thecontrol groups B and C (P＜0.01), which indicated that the effect of iontophoresis waspredominant in the nasal obstruction. As regards the effect of rhinocnesmus, there wassignificant difference between Group B and A, as well as between Group B and C(P＜0.05),which improved that efficacy in rhinocnesmus symptomatic of Group B with therapeuticmethods of Lorata-dine pills on the basis of decoction herbal was more stable than the othertwo groups.
Conclusion:
The clinical effect is good to treat chronic cough of PNDs in children withiontophoresis through acupuncture points on the basis of decoction herbal medicine. Owing totherapy with compound injection of red sage root by iontophoresis, delivery can improvelocal microcirculation quickly and alleviate nasal mucosa's hyperemia more rapidly toreliving nasal obstruction effectively, reducing secretion of nasopharynx, meanwhile herbalmedicine percolating the lung to open the orifices as well as conditioning prognosis, whichcan control the symptomatic of cough better and by which the patients' conditions were stableafter treatment and recurred less. There was no adverse reactions during this therapy afterobserving. The therapy of being operated by iontophoresis through acupuncture points is easy; meanwhile, children don't sufer affliction and compliance of children is good, so it can beregarded as therapeutic methods of topical administration in chronic cough of PNDs inchildren in clinical applications.
方法：按中华医学会呼吸病学分会哮喘学组2005年制定的《咳嗽的诊断与治疗指南》(草案)中鼻后滴漏综合征的诊断标准，选择慢性咳嗽鼻后滴漏综合征患儿60例，采取简单随机方法，分治疗组A、对照组B、C三组，每组各20例。其中治疗组A及对照组B采用自拟方通窍止咳汤加减，A组配合香丹注射液经皮穴位离子导入，1日1次，每次20分钟；B组加氯雷他定口服；C组为西药激素鼻喷剂、氯雷他定口服并配合止咳对症治疗。三组治疗均为7天1个疗程，共观察2个疗程。治疗过程中因各种原因不能规律用药者5例，失访2例，疗程结束后，资料完整的仅53例，其中A组18例、B组20例、C组15例，比较三组临床疗效。
结果：1．总有效率，A组94.4％，B组85％，C组80％，A组疗效与C组比较有显著差异(P＜0.05)，A组与B组、B组与C组比较均无显著差异(P＞0.05)。
2．对症状、体征积分进行比较：三组治疗前后各自组内分值比较，均有非常显著差异(P＜0.01)，三组治疗后分差比较，A组与C组比较，差异非常显著(P＜0.01)，A组与B组比较，差异显著(P＜0.05)。
3．疗程结束后1个月随访情况：总有效率，A组88.9％，B组70％，C组60％，A组疗效与C组比较有非常显著的差异(P＜0.01)，A组与B组、B组与C组比较均无显著差异(P＞0.05)，说明A组疗效较确切、稳定。在鼻部症状上，三组疗程结束后1个月随访与疗程结束时比较，治疗组鼻塞疗效优于B、C组，差异非常显著(P＜0.01)，说明离子导入治疗对鼻塞疗效较突出；鼻痒方面，B组与A、C组比差异显著(P＜0.05)，说明中药加氯雷他定治疗对鼻痒改善疗效较稳定。
结论：中药配合经皮穴位离子导入治疗慢性咳嗽鼻后滴漏综合征疗效较好。由于香丹注射液经皮穴位离子导入，能迅速改善局部微循环状态，较快减轻鼻充血肿胀、有效缓解鼻塞，减少鼻咽部分泌物；同时中药宣肺通窍又调理善后，所以咳嗽症状得到较好控制，且停止治疗后病情稳定。经观察，治疗过程中无一例不良反应。经皮穴位离子导入操作简便，患儿无痛苦，依从性好，可作为治疗小儿鼻后滴漏所致慢性咳嗽的局部给药方法在临床应用。
Objectives:
By treating the children in chronic cough of postnasal drip syndrome (PNDs) with XiangDan injection by iontophoresis through acupuncture points on the basis of decoction herbalmedicine to observe the changes of signs and symptoms before and after treatment andcompare the clinical effect with control groups to search for a more efficient way to improveclinical effect.
Methods:
According to the standard of PNDs in the Guideline for Diagnosis of Cough andTreatment established by the asthma panel of the pneumologie branch of Chinese MedicalUnion in 2005, sixty children suffering from chronic cough of PNDs were randomly dividedinto the Treatment Group A and the Control Groups B and C in which there are 20 ratesrespectively. Both of the Treatment Group A and the Control Group B were andled withdecoction of my tutor who designs the prescription—Freeing opening and relieving coughprescription. Then Group A receives therapy of Xiang Dan injection by iontophoresis throughacupuncture points. Additionally, the patients in Group B were given Lorata-dine pills orally,and the Group C was treated with Budesonide aqueous nasal spray as well as Lorata-dine pillsorally combined with relieving cough. There is no significant deviation between the data ofthree groups with Homogeneity-of-variance Test (P＞0.05). Then the therapeutic groupreceived therapy of iontophoresis once a day, 20minutes each time and 7 times constituted acourse of treatment and 2 courses were given. There are 5 cases using medicine irregularlyand 2 cases failed to follow up during lamivudine therapy and there are 53 cases ofinformation completely with 18 cases in Group A, 20 in Group B, 15 in Group C after the endof treatment. Then the curative effects among three groups were compared.
Result:
1. the side of total effective rate: The total of effective rate of Group A was 94.4% and that of Group B was 85% and C was 80%. There was significant difference between Group Aand Group C(P＜0.05) and no significant difference between Group A and B as well as GroupB and C(P＞0.05).
2. comparing the scores of symptomatic with those of physical sign: There wassignificant difference in comparison of scores of before and after therapy in each group(P＜0.01) and after the treatments the scores difference was Remarkable between Group A andC(P＜0.01) and there was significant difference between Group A and B(P＜0.05).
3. following up after one month of the end of treatment: There was no significantdifference in the total effective rate between the time of the following up after one month ofthe end of treatment and the very time of the therapy finished in Group A as well asB(P＞0.05). Otherwise, significant difference existed in Group C (P＜0.05), which indicatedthat the symptomatic in Group C often recurred when the treatment was stopped. It is relatedto the period of treatment that was short (only 2 weeks). As the number of cases is small, theconclusion can just be treated as reference. There was Remarkbale difference in the curativeeffect of symptomatic recovery of nasal obstruction between the treatment group and thecontrol groups B and C (P＜0.01), which indicated that the effect of iontophoresis waspredominant in the nasal obstruction. As regards the effect of rhinocnesmus, there wassignificant difference between Group B and A, as well as between Group B and C(P＜0.05),which improved that efficacy in rhinocnesmus symptomatic of Group B with therapeuticmethods of Lorata-dine pills on the basis of decoction herbal was more stable than the othertwo groups.
Conclusion:
The clinical effect is good to treat chronic cough of PNDs in children withiontophoresis through acupuncture points on the basis of decoction herbal medicine. Owing totherapy with compound injection of red sage root by iontophoresis, delivery can improvelocal microcirculation quickly and alleviate nasal mucosa's hyperemia more rapidly toreliving nasal obstruction effectively, reducing secretion of nasopharynx, meanwhile herbalmedicine percolating the lung to open the orifices as well as conditioning prognosis, whichcan control the symptomatic of cough better and by which the patients' conditions were stableafter treatment and recurred less. There was no adverse reactions during this therapy afterobserving. The therapy of being operated by iontophoresis through acupuncture points is easy; meanwhile, children don't sufer affliction and compliance of children is good, so it can beregarded as therapeutic methods of topical administration in chronic cough of PNDs inchildren in clinical applications.
引文
[1] Irwin Rs, Madison JM. AM J Med, 2000; 108 (4A): 126—130s.
[2] Irwin RS, Curley FJ, French CL. Chronic cough, the spectrum and frequency of causes, key components of the diagnostic evaluation, and outcome of specific therapy[J]. Am Rev Respir Dis, I990, 141(3): 640—647.
[3] 钟南山．中华医学会呼吸病学分会哮喘学组．咳嗽的诊断与治疗指南(草案)．中华 结核和呼吸杂志，2005，28(11)：738—744．
[4] 郑筱萸．中药新药临床研究指导原则(试行)．中国医药科技出版社．2002：54-56．
[5] 1997年中华医学会耳鼻喉科分会，中华耳鼻咽喉科杂志．变应性鼻炎的诊断标准及疗效评定标准．中华耳鼻咽喉科杂志，1998，33(3)：134—135．
[6] 张红霞、李元霞．鼻后滴注综合征与小儿慢性咳嗽的关系探讨(附60例报告)．陕西医学，2006，35(6)：711—712．
[7] 李丽、王宁宇、葛晓辉．鼻后滴漏综合征．国外医学耳鼻咽喉科学分册，2005，29(3)：164—166．
[8] 马玉起．麻黄素诱发药物性鼻炎30例．临床耳鼻咽喉科杂志，2003，17(11)：692．
[9] 孙晓萍、赵杰．雷诺考特在鼻腔疾病的临床应用．包头医学院学报，2006，22(2)：199—200．
[10] 王孙尧、杨世炳、王伟群．孟鲁司特治疗咳嗽变异性鼻炎31例疗效观察．浙江医学，2003，28(3)：235—236．
[11] 韩德民、王向东、周兵，等．鼻粘膜纤毛系统的研究进展．中华医学杂志，2003．83(2)：172—174
[12] Evansk L. Recognition and management of sinusitis[J].Drugs, 1998, 56 (1): 59—71.
[13] 林蔚达．鼻源性咳嗽的诊治经验．四川中医，2001，19(5)：8．
[14] 喻清和，邱志楠。中西医结合治疗小儿鼻后滴漏致慢性咳嗽疗效观察．中医药学刊，2006，24(12)：2353—2354．
[15] 李欣、郑敏宇．邵长荣治疗鼻源性咳嗽的经验．浙江中医杂志，2002，37(8)：323—325．
[16] 干祖望原著，干千主编．干氏耳鼻咽喉口腔科学．南京：江苏科学技术出版社．1999：248．
[17] 王晓平．喉源性咳嗽的辨证论治．辽宁中医学院学报，2001，3(4)：287．
[18] 胡睿．“疏风清热汤”加减治疗喉源性咳嗽36例．江苏中医，2001，22(10)：32．
[19] 王春松、季静峰．含苏散治疗喉源性咳嗽．中国社区医师，2005，7(125)：78
[20] 叶云生．清宣郁热治疗喉源性咳嗽．浙江中医，2006，41(1)：6．
[21] 王业龙．皂荚在喉源性咳嗽中的应用．山西中医，2004，20(2)：8．
[22] 李来秀、卫元峡、周若梅．喉咳饮治疗喉源性咳嗽66例．新中医，2004，36(3)：57—58．
[23] 杜建华．补肺益肾法治疗阴虚肺燥型喉源性咳嗽42例．北京中医杂志，2003，22(1)：24—25
[24] 赵彼得．临床电疗与光疗．北京：人民军医出版社，1992：10．
[25] 晏泽、肖能坎、刘春利等．丹参注射液改善兔皮瓣组织微循环的实验研究．现代中西医结合杂志，1999，8(8)；1211—1213．
[26] 王晓蕾，何平，张黎蓉，等．复方丹参对窒息新生儿的心肌保护作用[J]．实用儿科临床杂志，1995，10(1)：22—24。
[27] 蒋盂良，黄政德，易延逵，等．酒制丹参、大黄对大鼠血液流变学影响的研究．中国中药杂志，2001，26(11)：783．
[28] 杨艺，邓长生．丹参酮药理作用近识．湖北中医杂志，1999．21(6)：284—286．
[29] 岳仁宋．丹参药理作用新进展[J]．新中医．1991，23(11)：54．
[30] 高式国：针灸穴名解．哈尔滨：黑龙江省科学技术出版社，1985：31．
[31] 王本显，国外对经络问题的研究．北京：人民卫生出版社，1984：317—318．
[32] 赵宁侠、李宝琴、史恒军等．针刺正常人肺俞穴后肺功能的变化．针刺研究，2000，25(4)：290—291．
[33] 张明发，沈雅琴．苍耳子药理与临床．中南药学，2006，4(3)：216—218．
[34] 龙艳华．地龙的化学及药理研究概况[J]．数理医药学杂志，2005，18(4)：379—380．
[35] 胡慧娟，祁公任，洪敏．皂角刺水煎剂的抗凝血作用[J]．中药药理与临床．1995(1)：30—32．
[1] Irwin Rs, Madison JM. AM J Med, 2000; 108 (4A): 126—130s.
[2] Irwin RS, Curley FJ, French CL. Chronic cough, the spectrum and frequency of causes, key components of the diagnostic evaluation, and outcome of specific therapy[J]. Am Rev Respir Dis, 1990, 141(3): 640—647.
[3] 李丽、王宁宇、葛晓辉．鼻后滴漏综合征．国外医学耳鼻咽喉科学分册，2005，29(3)：164—166．
[4] 钟南山．中华医学会呼吸病学分会哮喘学组．咳嗽的诊断与治疗指南(草案)．中华结核和呼吸杂志，2005，28(11)：738—744．
[5] 梁山．止嗽散加减治疗小儿喉源性咳嗽60例．梁山．江苏中医药，2005，26，(9)：25．
[6] 胡睿．“疏风清热汤”加减治疗喉源性咳嗽36例．江苏中医，2001，22(10)：32．
[7] 王春松、季静峰．杏苏散治疗喉源性咳嗽．中国社区医师，2005，7(125)：78．
[8] 姚黎、姚卫东．祛风止嗽散治疗喉源性咳嗽100例．辽宁中医学院学报，2005，7(5)：464．
[9] 任为．润燥祛风法治疗喉源性咳嗽48例．新中医，2004，36(1)：60—61．
[10] 叶云生．清宣郁热治疗喉源性咳嗽．浙江中医，2006，41(1)：6．
[11] 敖素华、彭素岚、王俊峰．银翘马勃散加味治疗喉源性咳嗽50例．陕西中医，2005，26(12)：1273—1274．
[12] 濮欣、何健生．加味二陈汤治疗喉源性咳嗽206例．中医研究，2005，18(5)：33—34．
[13] 王业龙．皂荚在喉源性咳嗽中的应用．山西中医，2004，20(2)：8．
[14] 沈志勇．喉源性咳嗽从内热论治．河北中医，2000，22(6)：48。
[15] 邹萍．养阴清热活血化瘀治疗喉源性咳嗽46例．陕西中医，2003，24(4)：303—304．
[16] 李来秀、卫元峡、周若梅．喉咳饮治疗喉源性咳嗽66例．新中医，2004，36(3)：57—58．
[17] 林蔚达．鼻源性咳嗽的诊治经验．四川中医，2001，19(5)：8．
[18] 李欣、郑敏宇．邵长荣治疗鼻源性咳嗽的经验．浙江中医杂志，2002，37(8)：323—325．
[19] 杜建华．补肺益肾法治疗阴虚肺燥型喉源性咳嗽42例．北京中医杂志．2003，22(1)：24—25．
[20] 肖厥明．麻黄附子细辛汤新用．新中医，2002，34(1)：62—63．
[21] 万文蓉．干祖望辨治喉源性咳嗽经验探要．北京中医，2000，(5)：8．
[22] 干千．仲景方在耳鼻咽喉科的运用举隅．江苏中医，1996，17(12)：19．
[23] 刘茂辉．鼻渊舒治疗慢性鼻窦炎所致顽固性咳嗽64例临床观察．中国中西医结合耳鼻咽喉科杂志，2001，9(6)：297—298．
[24] 刘爱华．止咳鼻敏散治疗过敏性鼻窦炎性久咳36例．陕西中医，2003，24(10)：869—870．
[25] 马玉起．麻黄素诱发药物性鼻炎30例．临床耳鼻咽喉科杂志，2003，17(11)：692．
[26] 孙晓萍、赵杰。雷诺考特在鼻腔疾病的临床应用．包头医学院学报，2006，22(2)：199—200。
[27] 韦福依．色甘酸钠滴眼液治疗变应性鼻炎52例．新医学，2002，33(2)：68—68．
[28] 王孙尧、杨世炳、王伟群．孟鲁司特治疗咳嗽变异性鼻炎31例疗效观察。浙江医学，2003，28(3)：235—236．
[29] 韩德民、王向东、周兵，等．鼻粘膜纤毛系统的研究进展．中华医学杂志，2003．83(2)：172—174
[30] Evansk L. Recognition and management of sinusitis[J]. Drugs, 1998, 56 (1): 59—71.
[31] 李华．综合治疗变应性鼻炎致久咳不愈11例．新中医，2004，36(1)：59—60．
[32] 马华安、陈国丰、曹济航．中西医结合治疗鼻后滴漏综合征的临床观察．中国中西医结合耳鼻咽喉科杂志2006，14(4)：230—231．
[2] Irwin RS, Curley FJ, French CL. Chronic cough, the spectrum and frequency of causes, key components of the diagnostic evaluation, and outcome of specific therapy[J]. Am Rev Respir Dis, I990, 141(3): 640—647.
[3] 钟南山．中华医学会呼吸病学分会哮喘学组．咳嗽的诊断与治疗指南(草案)．中华 结核和呼吸杂志，2005，28(11)：738—744．
[4] 郑筱萸．中药新药临床研究指导原则(试行)．中国医药科技出版社．2002：54-56．
[5] 1997年中华医学会耳鼻喉科分会，中华耳鼻咽喉科杂志．变应性鼻炎的诊断标准及疗效评定标准．中华耳鼻咽喉科杂志，1998，33(3)：134—135．
[6] 张红霞、李元霞．鼻后滴注综合征与小儿慢性咳嗽的关系探讨(附60例报告)．陕西医学，2006，35(6)：711—712．
[7] 李丽、王宁宇、葛晓辉．鼻后滴漏综合征．国外医学耳鼻咽喉科学分册，2005，29(3)：164—166．
[8] 马玉起．麻黄素诱发药物性鼻炎30例．临床耳鼻咽喉科杂志，2003，17(11)：692．
[9] 孙晓萍、赵杰．雷诺考特在鼻腔疾病的临床应用．包头医学院学报，2006，22(2)：199—200．
[10] 王孙尧、杨世炳、王伟群．孟鲁司特治疗咳嗽变异性鼻炎31例疗效观察．浙江医学，2003，28(3)：235—236．
[11] 韩德民、王向东、周兵，等．鼻粘膜纤毛系统的研究进展．中华医学杂志，2003．83(2)：172—174
[12] Evansk L. Recognition and management of sinusitis[J].Drugs, 1998, 56 (1): 59—71.
[13] 林蔚达．鼻源性咳嗽的诊治经验．四川中医，2001，19(5)：8．
[14] 喻清和，邱志楠。中西医结合治疗小儿鼻后滴漏致慢性咳嗽疗效观察．中医药学刊，2006，24(12)：2353—2354．
[15] 李欣、郑敏宇．邵长荣治疗鼻源性咳嗽的经验．浙江中医杂志，2002，37(8)：323—325．
[16] 干祖望原著，干千主编．干氏耳鼻咽喉口腔科学．南京：江苏科学技术出版社．1999：248．
[17] 王晓平．喉源性咳嗽的辨证论治．辽宁中医学院学报，2001，3(4)：287．
[18] 胡睿．“疏风清热汤”加减治疗喉源性咳嗽36例．江苏中医，2001，22(10)：32．
[19] 王春松、季静峰．含苏散治疗喉源性咳嗽．中国社区医师，2005，7(125)：78
[20] 叶云生．清宣郁热治疗喉源性咳嗽．浙江中医，2006，41(1)：6．
[21] 王业龙．皂荚在喉源性咳嗽中的应用．山西中医，2004，20(2)：8．
[22] 李来秀、卫元峡、周若梅．喉咳饮治疗喉源性咳嗽66例．新中医，2004，36(3)：57—58．
[23] 杜建华．补肺益肾法治疗阴虚肺燥型喉源性咳嗽42例．北京中医杂志，2003，22(1)：24—25
[24] 赵彼得．临床电疗与光疗．北京：人民军医出版社，1992：10．
[25] 晏泽、肖能坎、刘春利等．丹参注射液改善兔皮瓣组织微循环的实验研究．现代中西医结合杂志，1999，8(8)；1211—1213．
[26] 王晓蕾，何平，张黎蓉，等．复方丹参对窒息新生儿的心肌保护作用[J]．实用儿科临床杂志，1995，10(1)：22—24。
[27] 蒋盂良，黄政德，易延逵，等．酒制丹参、大黄对大鼠血液流变学影响的研究．中国中药杂志，2001，26(11)：783．
[28] 杨艺，邓长生．丹参酮药理作用近识．湖北中医杂志，1999．21(6)：284—286．
[29] 岳仁宋．丹参药理作用新进展[J]．新中医．1991，23(11)：54．
[30] 高式国：针灸穴名解．哈尔滨：黑龙江省科学技术出版社，1985：31．
[31] 王本显，国外对经络问题的研究．北京：人民卫生出版社，1984：317—318．
[32] 赵宁侠、李宝琴、史恒军等．针刺正常人肺俞穴后肺功能的变化．针刺研究，2000，25(4)：290—291．
[33] 张明发，沈雅琴．苍耳子药理与临床．中南药学，2006，4(3)：216—218．
[34] 龙艳华．地龙的化学及药理研究概况[J]．数理医药学杂志，2005，18(4)：379—380．
[35] 胡慧娟，祁公任，洪敏．皂角刺水煎剂的抗凝血作用[J]．中药药理与临床．1995(1)：30—32．
[1] Irwin Rs, Madison JM. AM J Med, 2000; 108 (4A): 126—130s.
[2] Irwin RS, Curley FJ, French CL. Chronic cough, the spectrum and frequency of causes, key components of the diagnostic evaluation, and outcome of specific therapy[J]. Am Rev Respir Dis, 1990, 141(3): 640—647.
[3] 李丽、王宁宇、葛晓辉．鼻后滴漏综合征．国外医学耳鼻咽喉科学分册，2005，29(3)：164—166．
[4] 钟南山．中华医学会呼吸病学分会哮喘学组．咳嗽的诊断与治疗指南(草案)．中华结核和呼吸杂志，2005，28(11)：738—744．
[5] 梁山．止嗽散加减治疗小儿喉源性咳嗽60例．梁山．江苏中医药，2005，26，(9)：25．
[6] 胡睿．“疏风清热汤”加减治疗喉源性咳嗽36例．江苏中医，2001，22(10)：32．
[7] 王春松、季静峰．杏苏散治疗喉源性咳嗽．中国社区医师，2005，7(125)：78．
[8] 姚黎、姚卫东．祛风止嗽散治疗喉源性咳嗽100例．辽宁中医学院学报，2005，7(5)：464．
[9] 任为．润燥祛风法治疗喉源性咳嗽48例．新中医，2004，36(1)：60—61．
[10] 叶云生．清宣郁热治疗喉源性咳嗽．浙江中医，2006，41(1)：6．
[11] 敖素华、彭素岚、王俊峰．银翘马勃散加味治疗喉源性咳嗽50例．陕西中医，2005，26(12)：1273—1274．
[12] 濮欣、何健生．加味二陈汤治疗喉源性咳嗽206例．中医研究，2005，18(5)：33—34．
[13] 王业龙．皂荚在喉源性咳嗽中的应用．山西中医，2004，20(2)：8．
[14] 沈志勇．喉源性咳嗽从内热论治．河北中医，2000，22(6)：48。
[15] 邹萍．养阴清热活血化瘀治疗喉源性咳嗽46例．陕西中医，2003，24(4)：303—304．
[16] 李来秀、卫元峡、周若梅．喉咳饮治疗喉源性咳嗽66例．新中医，2004，36(3)：57—58．
[17] 林蔚达．鼻源性咳嗽的诊治经验．四川中医，2001，19(5)：8．
[18] 李欣、郑敏宇．邵长荣治疗鼻源性咳嗽的经验．浙江中医杂志，2002，37(8)：323—325．
[19] 杜建华．补肺益肾法治疗阴虚肺燥型喉源性咳嗽42例．北京中医杂志．2003，22(1)：24—25．
[20] 肖厥明．麻黄附子细辛汤新用．新中医，2002，34(1)：62—63．
[21] 万文蓉．干祖望辨治喉源性咳嗽经验探要．北京中医，2000，(5)：8．
[22] 干千．仲景方在耳鼻咽喉科的运用举隅．江苏中医，1996，17(12)：19．
[23] 刘茂辉．鼻渊舒治疗慢性鼻窦炎所致顽固性咳嗽64例临床观察．中国中西医结合耳鼻咽喉科杂志，2001，9(6)：297—298．
[24] 刘爱华．止咳鼻敏散治疗过敏性鼻窦炎性久咳36例．陕西中医，2003，24(10)：869—870．
[25] 马玉起．麻黄素诱发药物性鼻炎30例．临床耳鼻咽喉科杂志，2003，17(11)：692．
[26] 孙晓萍、赵杰。雷诺考特在鼻腔疾病的临床应用．包头医学院学报，2006，22(2)：199—200。
[27] 韦福依．色甘酸钠滴眼液治疗变应性鼻炎52例．新医学，2002，33(2)：68—68．
[28] 王孙尧、杨世炳、王伟群．孟鲁司特治疗咳嗽变异性鼻炎31例疗效观察。浙江医学，2003，28(3)：235—236．
[29] 韩德民、王向东、周兵，等．鼻粘膜纤毛系统的研究进展．中华医学杂志，2003．83(2)：172—174
[30] Evansk L. Recognition and management of sinusitis[J]. Drugs, 1998, 56 (1): 59—71.
[31] 李华．综合治疗变应性鼻炎致久咳不愈11例．新中医，2004，36(1)：59—60．
[32] 马华安、陈国丰、曹济航．中西医结合治疗鼻后滴漏综合征的临床观察．中国中西医结合耳鼻咽喉科杂志2006，14(4)：230—231．