| In recent years, it had coming to be realized by the modern medicine that cough, es-pecially chronic cough of unknown causes contact with the stomach, esophagus. These chronic cough of unknown causes often bring to patients with long-term pain. On the other hand, because of the examination and treatment patients always have a lot of eco-nomic burden, and even if diagnosed, there was still medicine resistance, withdrawal difficulties and a series of problems. From the "Huang Di Nei Jing· Su Wen", Chinese medicine had begun to have a cough discourse, and had recognized that the cough was link to other internal organs, emphasis on the link between the lung and stomach more, although the theoretical research was relatively earlier, from clinical practical, chronic cough, especially the Chinese medicine treatment of lung and stomach-related chronic cough was also very hard. In this case, explore the clinical features and effective treat-ment of lung and stomach related cough from the Chinese medical point of view have important practical significance.In this study, consists of three parts, which were summarized below.Part OneFactor analysis on TCM clinical features of lung and stomach-related chronic coughObjectiveExplore the TCM clinical features of lung and stomach-related chronic cough.Methods83cases with the chronic cough were observed. Using the Microsoft Office2010Chinese version of components in Excel2010to establish the data, and patients symp-toms, characteristics of finishing entry, import the IBM SPSS Statistics19.0for statistical analysis, to find a common factor to be able to describe the main features of the disease from the symptoms and characteristics by the method of application of factor analysis, and combined with the expertise to explain, summarize the lung and stomach-related chronic TCM clinical features of cough.ResultsThere were nine common factors got by studying. And the next were mainly com-posed of the variables (factor loadings) and the pathogenesis of the common factors.Fl The pathogenic sites were the lung and stomach, the pathogenesis was that the lung and the stomach content the evil influence, Lifting estranged, qiji-Shangni, the characteristic value was25.401%; F2The pathogenic sites were the liver lung and stomach, the mainthe evil of pathological elements was the dry, the pathogenesis was that tie lung and stomach content the evil influence, disharmony of liver and liver-fire, tribulations to the stomach, and because of the dry hurts the lung and stomach to make them lack of fluid, the characteristic value was11.095%; F3The main pathogenesis Phlegm internal resistance, characteristic value was7.969%; F4The pathogenic sites were the lung and stomach, the pathogenesis was that the lung and the stomach content the evil influence, Lifting estranged, the qi of the stomach was obstruct resistance, the characteristic value was7.066%; F5The pathogenic sites were the liver and lung, the pathogenesis was that the phlegm internal resistance and the liver qi stagnation, the characteristic value was6.455%; F6The pathogenic sites were the liver and lung, the pathogenesis was that the phlegm internal resistance and the liver qi stagnation, spleen qi was lack, the characteristic value was5.878%; F7The pathogenic sites was the lung, pathogenesis was weakness of qi, so that can’t defense any other evil influence from out-side, the characteristic value was5.756%; F8The pathogenic sites were the liver and stomach, disharmony of liver and stomach, air-lift disorders, intestinal organs barrier, the characteristic value was4.507%; F9The pathogenic sites were in the throat, Qi upside in the pharynx, the characteristic value was4.177%.ConclusionThe clinical features were showed.1) Lung and stomach-related chronic cough was belong to cough of internal injuries and exogenous on the basis of internal injuries, the core of the pathogenesis was that lung and stomach content the evil, and estranged lift, qi go upside.2) The disease was located in the lung and stomach, and liver were closely re-lated.Part TwoResearch of the tutor’s clinical drug law of lung and stomach-related chronic coughObjective:Explore tutor clinical drug law treatment of lung and stomach-related chronic cough.Methods:222cases with chronic cough were observed from outpatients,83cases of patients with lung and stomach-related cough,139cases of other cough patients. The data was used by Access2010of the Chinese version of Microsoft Office components to establish a database, Instructors clinical prescription entry database, then import to spssl9.0to finish the statistical analysis, According to the clinical use of drugs related applications of modern statistics If the number of analysis and cluster analysis methods to study and compare the drug law.Results:1. Frequency analysisTutor treatment of chronic cough, utilization rates over15%of the drug among the two groups which with or without stomach Department of symptoms consists of32 herbs. There were different utilization rates between two groups in dangshen, houpu, jiangbanxia, qianhu, quanxie, shengaiye, shengshigao, sugeng, suzi, zhimahuang, zhiqiao, zhishi; and the utilization rates of quanxie, shengshigao, zhimahuang in the group with stomach Department of symptoms were lower than another group; the utilization rates of dangshen, houpu, jiangbanxia, qianhu, shengaiye, sugeng, zhishi, zhiqiao in the group with stomach Department of symptoms were higher than the other group. There were statistical differences between two groups in utilization rate of Yujin, the group with stomach department symptoms was higher than another one. There were no difference between groups in utilization rates of Zhimu, Baishao, Baibu, Beishashen, Beimu, chaihu, chishao, daigesan, danshen, gualou, guizhi, huangqin, jiaomu, jinfeicao, niubangzi, shegan, suye, xinren, ziyuan. There were8drugs which utilization rates over15%only in the group which with the stomach department symptoms, they were huanglian, shudahuang, wuzhuyu, zhigancao, shengbaizhu, danggui, lugen, ganjiang; while11drugs only in the group which without the stomach department symptoms, the were baizhi, danpi, jingjie, lingyangfen, sangye, shenggancao, chanyi, xuanshen, tianma, chuanjiao, wuweizi.2. Cluster analysisLung and stomach correlation between chronic cough medication have8Class, the1st class, suzi, sugeng, zhiqiao, zhishi, qianhu, gualou, houpu, jinfeicao, yujin:to make the qi of lung and stomach downside to eliminate bloating. The2nd class, beimu, zhimu, daigesan:to clear the hot of the lung and moist the dry of the lung. The3rd class, baishao, chishao, jiaomu, quanxie, zhimahuang, shegan, shigao, ganjiang, shengaiye, zhigancao: warm the lung, stop cough and asthma, nourishing Softening. The4th class, shudahuang, danshen, baizhu, danggui; Promoting blood circulation Runchang purge. The5th class, niubangzi, beishashen, lugen:to moist the yin of stomach. The6th class, Xingren, Baibu, Ziyuan. The7th class, Suye, Dangshen, Guizhi, Huangqin, Chaihu, Jiangbanxia. The8th class, Huanglian, Wuzhuyu.Conclusion:1. The drugs which can order the qi to downsides were used more often in the lung-stomach-related cough than the other cough patients, and the main pathogenesis lung and stomach content the evil, and estranged lift, qi go upside.2. Tutorial treatment of lung and stomach related cough medication characteristics: good at grasping the main pathogenesis of the state to identify the incidence of exoge-nous and internal injuries on the basis of injuries, and attach importance to the drugs and the triple drug with to Gansu lung down the stomach as the key link, taking into account the liver and the relationship of lung and stomach.Part ThreeClinical Research of treatment syndrome of Stomach qi stagnation of lung and stom-ach-related chronic cough by the application of depressing Qi of lung and stomach ObjectiveExplore the efficacy and safety of using the application of depressing Qi of lung and stomach to treat syndrome of Stomach qi stagnation of lung and stomach-related chronic cough.Methods120cases which have chronic cough were observed. According to the random num-ber table, these120cases were randomly divided into2groups of60cases. In the tradi-tional Chinese medicine treat group,1case had quit, observed59cases in fact; in the western medicine treat group,3cases had quit, observed57cases in fact; The two groups of patients in the overall age, sex, mean disease duration and disease severity and symptoms of cough severity were statistically both P>0.05, no statistically significant dif-ferences, so they were comparable. The group with Chinese medicine were treated by the formula of lung and stomach:xinren9g, zhimu lOg, beimu10g, suzi15g, suye15g, chishao12g, baishao12g, zhiqiao12g, zhishi12g, houpu10g, qianhu15g, baibu10g, zi-yuanl5g. Those ware boiled to200ml (100ml/bag), and took100ml bid po, The control group was treated with omeprazole magnesium enteric-coated tablets,20mg qd po, domperidone10mg tid po; After six weeks, those were observed in patients with cough, acid reflux, belching, cough, dry oropharyngeal main symptoms, and score records, and Leicester questionnaire were filled before and after treatment, the symptoms were fol-lowed up for3months to observe the recurrence of chronic cough.Results1. The total efficiency of the traditional Chinese medicine group was94.9%was higher than54.4%of the control group (P<0.01); The main symptoms of efficacy evalua-tion can be seen that the two groups of Chinese medicine treatment, cough symptoms in81.4%of the efficiency of79.7%and treatment belching symptoms better than the con-trol group with49.1%and68.4%respectively, P<0.01; The treatment efficiency of acid reflux symptoms of the two groups were72.9%,68.4%, statistical analysis was P>0.05, no significant difference. Compared with treatment in its own before and after treatment, individual symptoms were Improvement. Compared with two group after treatment, cough, belching, cough, oropharyngeal dryness, bloating, epigastric noisy statistically sig-nificant differences. TCM group scores were significantly lower than the control group; acid reflux, chest tightness, shortness of breath, chest pain treatment, no statistically sig-nificant differences in traditional Chinese medicine group and the control group no dif-ference. One level to reduce the cough as a mitigation standard, two groups of patients with cough symptoms begin to ease the time were14.01±4.99days and24.49±1.48days, after more statistically significant differences, indicating that the Chinese Medicines the cough symptoms became better quickly than the control group.2. LCQ score of patients, physiological dimension score, score of the psychological dimension, the social dimension scores in the two groups before treatment were not sta-tistically different, comparability, all P>0.05; LCQ score, physical dimension score, the so-cial dimension score in the two groups of patients after therapy were statistically signifi-cant differences, P<0.01; Psychological dimension score of patients in the two groups af-ter treatment (P<0.05) were significantly different; Description LCQ score changes in the value of two groups of patients, the physical dimension score changes in the value be-tween the two groups, P<0.01, significant difference; The two groups of patients with the value of social dimension score changes P<0.05, significant difference; There was no significant difference between the score of the psychological dimension of the two groups of patients the change (#P>0.05).ConclusionIt was effective and safe with treatment syndrome of Stomach qi stagnation of lung and stomach-related chronic cough by the application of depressing Qi of lung and stom-ach.Total ConclusionIn this study, we proposed a new point of view, that the main pathogenesis of lung and stomach-related chronic cough was lung and stomach content the evil influence, loss and lifting, qi stagnation. Through the clinical research of the application of depressing Qi of lung and stomach to treat syndrome of Stomach qi stagnation of stomach-related chronic cough, using Chinese medicine syndromes assessed symptom score assessment and the application of Leicester scores to evaluate the treatment of chronic cough from multiple dimensions as Chinese medicine, Western medicine, physiology, psychology, so-ciety. It was effective and safe with treatment syndrome of Stomach qi stagnation of lung and stomach-related chronic cough by the application of depressing Qi of lung and stom-ach. |
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