慢性咳嗽的中医体质评价及中药干预前后探讨
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摘要
目的：运用中医体质量表调查慢性咳嗽患者的体质,探讨慢性咳嗽患者体质类型的季节发病特点；拟通过中药对不同体质患者进行干预,从而分析干预前后的统计学意义,及体质分数与症状评分的相关性,评价中药干预有效率、治愈率；评价慢性咳嗽中医体质和探讨中药干预性治疗,为中医中药在慢性咳嗽的立方选药和预防中提供重要依据,并在临床上推广应用。
方法：在被调查者获得知情同意的基础上,发放中医体质量表问卷130份,由调查者自填问卷,调查者逐条检查,确认资料合格。中药干预性治疗后,随访,再调查问卷。记录患者一般情况(包括年龄、性别、病程等)及患者的现病史、既往史、诊断及用药情况。运用中医体质量表,收集所有临床资料,建立数据库,计算各体质分型的百分率,得出全部体质分型的构成比；并计算中药干预前后各体质类型体质分数,统计分析中药干预治疗自身前后的差异性,对体质分数与症状评分做相关性分析,评价有效率和治愈率。
结果：①中药干预前后均以平和质、气虚质、阳虚质所占比重大,其中平和质比重最大,中药干预后,平和质、气郁质中药干预后较治疗前人数有所增多,气虚质、阳虚质、阴虚质干预后人数较治疗前减少,痰湿质、湿热质、瘀血质、特禀质干预前后人数无明显变化。统计学表明中药干预前后比较以上九种中医体质分布无差异(P>0.05)。②130例患者,春、冬季节分布较多。③本研究中对平和质、气虚质、阳虚质三种体质患者分别行干预前后评分比较,中药干预1个月后,平和质患者前后差值有差异性(P<0.05),阳虚质患者前后差值有显著差异性(P<0.01),气虚质患者前后差值无差异性(P>0.05)；中药干预2个月后进行体质评分,研究显示三种体质患者体质分数前后比较均有统计学意义,平和质(P<0.05),气虚质、阳虚质(P<0.001)。④本研究中评价慢性咳嗽患者体质评分与症状评分中药干预前后相关性,结果显示,平和质干预前后体质分数与症状评分呈负相关,气虚质、阳虚质呈正相关。研究中观察三种体质患者有效率、治愈率,平和质、气虚质、阳虚质中药干预1个月与2个月比较有效率、治愈率,统计学有显著差异(P<0.001)
结论：①中药干预前后,患者以平和质、气虚质、阳虚质最为多见,且平和质为主要类型,中药干预后,平和质、气郁质较治疗前人数有所增多,气虚质、阳虚质、阴虚质干预后人数较治疗前减少,痰湿质、湿热质、瘀血质、特禀质干预前后人数无明显变化。②四季分布以春、冬季节分布较多,可能与岭南气候及岭南人饮食习惯有关,本研究收集样本量少,体质类型分布特点及季节发病特点只能是对病防治方面的初步探讨,还有待于今后大样本量的进一步研究。③研究中对平和质、气虚质、阳虚质三种体质患者中药干预1个月后,平和质、阳虚质患者前后差值有差异性,提示中药可改善两种体质患者体质分数,中药干预后有效；气虚质患者前后差值无差异性；对三种患者中药干预2个月后,显示三种体质患者体质分数前后比较均有差异性,可以认为延长中药干预时间,慢性咳嗽患者体质分数有明显的变化,中药可以提高平和质患者体质分数,降低阳虚质、气虚质患者体质分数,气虚质体质改善与干预时间长短有关。④本研究中评价体质评分与症状评分干预前后相关性,结果显示,慢性咳嗽患者平和质中药干预前后体质分数与症状评分呈负相关,提示干预前后平和质体质分数越低,症状评分越高,病情越重,反之,体质分数越高,症状评分越低,病情越轻；气虚质、阳虚质中药干预前后体质分数与症状评分呈正相关,提示干预前气虚质体质分数越高,症状评分越高,病情越重,干预后后体质分数和症状评分越低,病情越轻；因此从体质分数的升高和降低,可以反映有效率和治愈率。又对三种体质进行症状评分后,比较平和质、气虚质、阳虚质中药干预1个月与干预2个月的有效率、治愈率,显示三种体质中药干预1个月与干预2个月后有显著差异,表明延长中药干预时间还可增加有效率、治愈率,干预时间越长,有效率、治愈率越高。
Objective:Traditional physical scale investigation of patients with chronic cough, body, body types in patients with chronic cough, the season of disease characteristics; proposed by Chinese intervention in patients with different body mass, to analyze the statistical significance before and after intervention; And physical symptoms score and score in the evaluation of Chinese Herbal Medicine and efficient, the cure rate; evaluation of chronic cough medicine and traditional Chinese medicine physical therapy intervention for Chinese medicine in patients with chronic cough medicine and prevention of the cube selected to provide an important basis and clinical application.
Methods:The respondents were informed consent, based on questionnaires issued 130 Chinese constitution scale, self-administered questionnaire by the investigators, the investigators by one check to confirm eligibility information. Chinese intervention treatment, follow-up, and then the questionnaire. Records of patients with general conditions (including age, gender, disease duration, etc.) and in patients with history of present illness, past history, diagnosis, and drug use. The use of TCM constitution scale to collect all the clinical data, to establish a database, calculate the percentage of body type, come all physiques, composition ratio; and calculate the physical type of medicine before and after the physical intervention scores, statistical analysis before and after the Chinese intervention itself differences. Scores on physical symptom score, the correlative analysis, evaluation of efficiency and cure rate.
Results:①medicine before and after intervention are peaceful nature, Qi deficiency, yang quality major share of which the largest proportion of moderate quality, traditional Chinese medicine after the intervention, peaceful nature, Qi Yu quality than before treatment after the intervention of Chinese medicine have increased the number, Qi deficiency, of yang, yin deficiency before treatment after the intervention than the number of reduced phlegm, heat transfer, stasis, the number of special intrinsic quality no significant changes before and after intervention. Statistics show that more than nine kinds of Chinese medicine before and after intervention was no difference in body mass distribution (P> 0.05).②130 patients, spring and winter distribution of higher.③on the peaceful nature of this study, Qi deficiency, yang deficiency were treated by physical quality of three score before and after intervention,1 month after the Chinese intervention, peaceful quality difference before and after patients have differences (P <0.05), yang quality difference before and after patients had significantly different (P<0.01), quality deficiency in patients with no difference before and after difference (P> 0.05); Chinese intervention 2 months after the physical.score, studies have shown that three types of physical constitution of patients before and after scores were statistically significant, moderate quality (P<0.05), Qi deficiency, yang quality (P<0.001).④In this study, evaluation of patients with chronic cough medicine physical score and symptom score before and after intervention, the results show that moderate physical quality scores before and after the intervention was a negative correlation with symptom score, Qi deficiency, a positive correlation of yang. Observed three types of patients and efficient body, the cure rate, gentleness, Qi deficiency, yang quality of Chinese intervention in 1 month and 2 months, more efficient, the cure rate was statistically significant (P<0.001).
Conclusions:①Chinese medicine before and after intervention, patients in a calm nature, Qi deficiency, the most common of yang and peace as the main type of quality, traditional Chinese medicine after the intervention, Qi Yu quality than before treatment had increased the number, peaceful nature, Qi deficiency, yang deficiency, yin deficiency of quality than the number of treatment after the intervention reduced phlegm quality, heat transfer, stasis, the number of special intrinsic quality no significant changes before and after intervention.①seasonal distribution in spring and winter distribution and the possibility of climate and Lingnan Lingnan people with eating habits, less sample in this study, physical type of distribution and the characteristics of seasonal incidence of disease prevention and control is only a preliminary study, a large sample size has yet to be in the future further research.③ Study on the peaceful nature, Qi deficiency, yang nature of Chinese medicine in patients with three types of physical intervention 1 month after the peaceful nature, the difference before and after patients of yang are different, suggesting that patients with traditional Chinese medicine can improve the physical constitution of two scores, traditional Chinese medicine After the intervention force; deficiency of quality difference between patients with no difference before and after; on three kinds of Chinese medicine treatment of patients after 2 months, showed three types of physical constitution of patients before and after scores were different, and it can interfere with the time that the extension of traditional Chinese medicine, body.mass in patients with chronic cough significant changes in traditional Chinese medicine can improve the quality of patients with moderate physical scores, lower quality yang, qi quality physical scores of patients, deficiency of quality and organizational improvement and the duration of the intervention.④In this study, physical score and symptom score evaluation before and after intervention relevance, results showed that patients with mild chronic cough medicine before and after intervention of quality physical scores and symptom scores were negatively correlated, suggesting that intervention before and after the moderate physical scores, the lower the quality, the higher the symptom score, disease The more severe the contrary, the constitution the higher the score, symptom score, the lower, the more light condition; Qi deficiency, yang deficiency before and after the physical quality of Chinese intervention scores and symptom scores were positively correlated, suggesting that intervention before the deficiency of quality higher physical scores, higher symptom score, The degree of post-intervention scores and physical symptom score, the lower, the more light condition; therefore increased from the scores and lower body, can reflect the efficiency and the cure rate. Also for the three physical symptom score, the relatively mild nature, Qi deficiency, yang quality of Chinese intervention in 1 month and 2 months of intervention efficiency, the cure rate, show three kinds of physical medicine intervention in a month and Intervention 2 months were significantly different, that Chinese intervention to extend the time also increase efficiency, the cure rate, the longer the intervention, efficiency, the higher the cure rate.
方法：在被调查者获得知情同意的基础上,发放中医体质量表问卷130份,由调查者自填问卷,调查者逐条检查,确认资料合格。中药干预性治疗后,随访,再调查问卷。记录患者一般情况(包括年龄、性别、病程等)及患者的现病史、既往史、诊断及用药情况。运用中医体质量表,收集所有临床资料,建立数据库,计算各体质分型的百分率,得出全部体质分型的构成比；并计算中药干预前后各体质类型体质分数,统计分析中药干预治疗自身前后的差异性,对体质分数与症状评分做相关性分析,评价有效率和治愈率。
结果：①中药干预前后均以平和质、气虚质、阳虚质所占比重大,其中平和质比重最大,中药干预后,平和质、气郁质中药干预后较治疗前人数有所增多,气虚质、阳虚质、阴虚质干预后人数较治疗前减少,痰湿质、湿热质、瘀血质、特禀质干预前后人数无明显变化。统计学表明中药干预前后比较以上九种中医体质分布无差异(P>0.05)。②130例患者,春、冬季节分布较多。③本研究中对平和质、气虚质、阳虚质三种体质患者分别行干预前后评分比较,中药干预1个月后,平和质患者前后差值有差异性(P<0.05),阳虚质患者前后差值有显著差异性(P<0.01),气虚质患者前后差值无差异性(P>0.05)；中药干预2个月后进行体质评分,研究显示三种体质患者体质分数前后比较均有统计学意义,平和质(P<0.05),气虚质、阳虚质(P<0.001)。④本研究中评价慢性咳嗽患者体质评分与症状评分中药干预前后相关性,结果显示,平和质干预前后体质分数与症状评分呈负相关,气虚质、阳虚质呈正相关。研究中观察三种体质患者有效率、治愈率,平和质、气虚质、阳虚质中药干预1个月与2个月比较有效率、治愈率,统计学有显著差异(P<0.001)
结论：①中药干预前后,患者以平和质、气虚质、阳虚质最为多见,且平和质为主要类型,中药干预后,平和质、气郁质较治疗前人数有所增多,气虚质、阳虚质、阴虚质干预后人数较治疗前减少,痰湿质、湿热质、瘀血质、特禀质干预前后人数无明显变化。②四季分布以春、冬季节分布较多,可能与岭南气候及岭南人饮食习惯有关,本研究收集样本量少,体质类型分布特点及季节发病特点只能是对病防治方面的初步探讨,还有待于今后大样本量的进一步研究。③研究中对平和质、气虚质、阳虚质三种体质患者中药干预1个月后,平和质、阳虚质患者前后差值有差异性,提示中药可改善两种体质患者体质分数,中药干预后有效；气虚质患者前后差值无差异性；对三种患者中药干预2个月后,显示三种体质患者体质分数前后比较均有差异性,可以认为延长中药干预时间,慢性咳嗽患者体质分数有明显的变化,中药可以提高平和质患者体质分数,降低阳虚质、气虚质患者体质分数,气虚质体质改善与干预时间长短有关。④本研究中评价体质评分与症状评分干预前后相关性,结果显示,慢性咳嗽患者平和质中药干预前后体质分数与症状评分呈负相关,提示干预前后平和质体质分数越低,症状评分越高,病情越重,反之,体质分数越高,症状评分越低,病情越轻；气虚质、阳虚质中药干预前后体质分数与症状评分呈正相关,提示干预前气虚质体质分数越高,症状评分越高,病情越重,干预后后体质分数和症状评分越低,病情越轻；因此从体质分数的升高和降低,可以反映有效率和治愈率。又对三种体质进行症状评分后,比较平和质、气虚质、阳虚质中药干预1个月与干预2个月的有效率、治愈率,显示三种体质中药干预1个月与干预2个月后有显著差异,表明延长中药干预时间还可增加有效率、治愈率,干预时间越长,有效率、治愈率越高。
Objective:Traditional physical scale investigation of patients with chronic cough, body, body types in patients with chronic cough, the season of disease characteristics; proposed by Chinese intervention in patients with different body mass, to analyze the statistical significance before and after intervention; And physical symptoms score and score in the evaluation of Chinese Herbal Medicine and efficient, the cure rate; evaluation of chronic cough medicine and traditional Chinese medicine physical therapy intervention for Chinese medicine in patients with chronic cough medicine and prevention of the cube selected to provide an important basis and clinical application.
Methods:The respondents were informed consent, based on questionnaires issued 130 Chinese constitution scale, self-administered questionnaire by the investigators, the investigators by one check to confirm eligibility information. Chinese intervention treatment, follow-up, and then the questionnaire. Records of patients with general conditions (including age, gender, disease duration, etc.) and in patients with history of present illness, past history, diagnosis, and drug use. The use of TCM constitution scale to collect all the clinical data, to establish a database, calculate the percentage of body type, come all physiques, composition ratio; and calculate the physical type of medicine before and after the physical intervention scores, statistical analysis before and after the Chinese intervention itself differences. Scores on physical symptom score, the correlative analysis, evaluation of efficiency and cure rate.
Results:①medicine before and after intervention are peaceful nature, Qi deficiency, yang quality major share of which the largest proportion of moderate quality, traditional Chinese medicine after the intervention, peaceful nature, Qi Yu quality than before treatment after the intervention of Chinese medicine have increased the number, Qi deficiency, of yang, yin deficiency before treatment after the intervention than the number of reduced phlegm, heat transfer, stasis, the number of special intrinsic quality no significant changes before and after intervention. Statistics show that more than nine kinds of Chinese medicine before and after intervention was no difference in body mass distribution (P> 0.05).②130 patients, spring and winter distribution of higher.③on the peaceful nature of this study, Qi deficiency, yang deficiency were treated by physical quality of three score before and after intervention,1 month after the Chinese intervention, peaceful quality difference before and after patients have differences (P <0.05), yang quality difference before and after patients had significantly different (P<0.01), quality deficiency in patients with no difference before and after difference (P> 0.05); Chinese intervention 2 months after the physical.score, studies have shown that three types of physical constitution of patients before and after scores were statistically significant, moderate quality (P<0.05), Qi deficiency, yang quality (P<0.001).④In this study, evaluation of patients with chronic cough medicine physical score and symptom score before and after intervention, the results show that moderate physical quality scores before and after the intervention was a negative correlation with symptom score, Qi deficiency, a positive correlation of yang. Observed three types of patients and efficient body, the cure rate, gentleness, Qi deficiency, yang quality of Chinese intervention in 1 month and 2 months, more efficient, the cure rate was statistically significant (P<0.001).
Conclusions:①Chinese medicine before and after intervention, patients in a calm nature, Qi deficiency, the most common of yang and peace as the main type of quality, traditional Chinese medicine after the intervention, Qi Yu quality than before treatment had increased the number, peaceful nature, Qi deficiency, yang deficiency, yin deficiency of quality than the number of treatment after the intervention reduced phlegm quality, heat transfer, stasis, the number of special intrinsic quality no significant changes before and after intervention.①seasonal distribution in spring and winter distribution and the possibility of climate and Lingnan Lingnan people with eating habits, less sample in this study, physical type of distribution and the characteristics of seasonal incidence of disease prevention and control is only a preliminary study, a large sample size has yet to be in the future further research.③ Study on the peaceful nature, Qi deficiency, yang nature of Chinese medicine in patients with three types of physical intervention 1 month after the peaceful nature, the difference before and after patients of yang are different, suggesting that patients with traditional Chinese medicine can improve the physical constitution of two scores, traditional Chinese medicine After the intervention force; deficiency of quality difference between patients with no difference before and after; on three kinds of Chinese medicine treatment of patients after 2 months, showed three types of physical constitution of patients before and after scores were different, and it can interfere with the time that the extension of traditional Chinese medicine, body.mass in patients with chronic cough significant changes in traditional Chinese medicine can improve the quality of patients with moderate physical scores, lower quality yang, qi quality physical scores of patients, deficiency of quality and organizational improvement and the duration of the intervention.④In this study, physical score and symptom score evaluation before and after intervention relevance, results showed that patients with mild chronic cough medicine before and after intervention of quality physical scores and symptom scores were negatively correlated, suggesting that intervention before and after the moderate physical scores, the lower the quality, the higher the symptom score, disease The more severe the contrary, the constitution the higher the score, symptom score, the lower, the more light condition; Qi deficiency, yang deficiency before and after the physical quality of Chinese intervention scores and symptom scores were positively correlated, suggesting that intervention before the deficiency of quality higher physical scores, higher symptom score, The degree of post-intervention scores and physical symptom score, the lower, the more light condition; therefore increased from the scores and lower body, can reflect the efficiency and the cure rate. Also for the three physical symptom score, the relatively mild nature, Qi deficiency, yang quality of Chinese intervention in 1 month and 2 months of intervention efficiency, the cure rate, show three kinds of physical medicine intervention in a month and Intervention 2 months were significantly different, that Chinese intervention to extend the time also increase efficiency, the cure rate, the longer the intervention, efficiency, the higher the cure rate.
引文
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[21]刘国华.辨证分型治疗慢性咳嗽刍议[J].实用中医内科杂志,2007；21(8)26.
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[23]黄梓平.分型辨治感冒后咳嗽体会.实用中医药杂志[J],2008；28(3)：177.
[24]粱松健.中医辨治慢性咳嗽.河北中医[J],2006；28(5)：379.
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