| Background:Laryngeal cough is an otolaryngology disease.In recent years,due to the accelerate d pace of social life,environmental pollution,and changes in people's lifestyles,the clinic al incidence of throat cough is increasing,which has caused people's lives and work.M any inconveniences,so the treatment and pathogenesis of the disease has become a hot spot in recent years.Modem medicine believes that the onsetof laryngeal cough may be related to allergies,air pollution,viral infections,throat regurgitation,and physical decli ne,but most of them are epidemiological and data research,and there are no clear and objective indicators to verify the pathogenesis of this disease.And the disease has a hi gh recurrence rate with modern medical treatment and unstable efficacy.The treatment of modern medicine is mainly based on antibiotics such as anti-infection,anti-reflux,anti tussive,anti-cough,and anti-allergy.Although the symptoms can be relieved after a period of treatment,the recurrence rate is high,and a stable effect has not been achieved.In r ecent years,Chinese medicine treatment for laryngogenic cough has received more and more attention;therefore,the research group used the method of reconciling Shaoyang ac cording to the "Shaoyang pivot" theory to treat laryngogenic cough.Xiaochaihu decocti on was added and subdivided,and it was made of throat cough Ling granules to mak e Cardio Shaoyang unobstructed,Qi machine up and down was normal,liver and lung o rgan function was normal,and righteousness was sufficient and healed.Through the preli minary clinical observations of this group,Hou Ke Ling Granule has a significant effec t on the treatment of throat-induced cough,but more research is still needed on its me chanism of action and pathogenesis of this disease.Studies have found that neurogenic inflammation plays an important role in the pathogenesis of some chronic coughs,and laryngogenic cough is mainly due to cough caused by inflammation of the throat or o ther factors that stimulate sensory nerve endings,so the sensory nerve endings in the t hroat(cough receptors).The neurogenic inflammation mediated by the released neurope ptides or neurotransmitters plays a key role in the pathogenesis of laryngeal cough.The refore,the clinical efficacy of Hou Ke Ling granules in the treatment of throat cough and the relationship between throat cough and airway neurogenic inflammation need f urther study.Purpose:1.Objectively evaluate the clinical efficacy of Hou Ke Ling Granule in treating laryngeal cough by observing changes in clinical indicators such as the Visual Analog Scale and Leicester Cough Life Quality Questionnaire before and after treatment;2.By comparing the changes in peripheral blood EOS,sputum supernatant EOS,sputum pepsin content,sputum supernatant TRPV1,SP,CGRP content before and after treatment,to explore the treatment of Hou Ke Ling Granule by regulating airway neurogenic inflammation and the mechanism of action of source cough and the pathogenesis of laryngeal cough.Method:The eligible subjects were numbered according to the order of inclusion,and divided into two groups according to the random number table,a total of 66 cases.Group one was the treatment group,given Hou Ke Ling granules(Chinese medicine granules),and group two was the control group,Given a simulated placebo,both groups took the drug for two weeks.The clinical indicators of patients(visual analog scale,Leicester cough quality of life questionnaire)were evaluated before and two weeks after treatment,and their peripheral blood EOS counts,induced sputum supernatants TRPV1,SP,and the content of CGRP and the content of pepsin in sputum were analyzed statistically.Result:1.General InformationA total of 66 patients meeting the criteria were included in this study,including 33 patients in the treatment group and the control group,and 3 patients in each of the two groups.Finally,60 patients were included.The age distribution of 60 patients ranged from 21 to 65 years old,among which the majority were young and middle-aged,accounting for 76.7%.There was no significant difference in age distribution between the treatment group and the control group.The sex ratio was>males,34 females(56.7%)and 26 males(43.3%).There was no significant difference between the two groups.2.Evaluation of clinical efficacy(1)In this study,the difference scores of each symptom score before treatment between the two groups of patients were calculated,P>0.05,indicating that there was no statistical difference between the two groups of patients before treatment.(2)Comprehensive effective rate of the two groups:The total effective rate of the two groups of patients was calculated by the nimodipine method.The total effective rate of the treatment group was 90%,and the total effective rate of the control group was 43.3%.The statistical difference between the treatment group and the control group before and after treatment was statistically significant(P<0.05).(3)VAS score:The effectiveness of each symptom treatment was calculated by nimodipine method.The effective rate of the pharyngeal symptom treatment group was 83.3%and the control group was 60%;The effective rate was 50%;the effective rate was 93.3%in the cough symptom treatment group and 46.6%in the control group;the effective rate was 90%in the laryngeal symptom treatment group and 50%in the control group.Comparison of symptom scores:within the group,the scores of the experimental group and the control group after treatment were lower than those before the treatment,and the differences were statistically significant(P<0.05):the comparison between the groups,the treatment group and the control group after treatment Compared with the treatment group>control group,the difference was statistically significant(P<0.05).(4)LCQ-MC score:in terms of total score,physiological score,and psychological score,the comparison within the group:the scores of the experimental group and the control group increased after treatment and before treatment,and the differences were statistically significant(P<0.05);Comparison between the groups:Compared with the control group after the treatment,the treatment group>control group,the difference was statistically significant(P<0.05);according to the evaluation criteria of the efficacy,the difference between the treatment group before and after treatment was greater than 1.3,Has a certain therapeutic value,the difference between the scores of the control group before and after treatment is less than 1.3,so it has no therapeutic value.In terms of social scores,the scores of the experimental group and the control group both increased after treatment and before treatment,and the differences were statistically significant(P<0.05);but there was no signifucant statistical difference between the two groups(P<0.05),and The difference between the two groups before and after treatment was less than 1.3,which did not have a certain therapeutic value.3.Laboratory index results(1)In this study,the differences in the laboratory indexes of the two groups of patients before treatment were calculated,P>0.05,indicating that there was no statistical difference in the laboratory indexes of the two groups of patients before treatment.(2)Peripheral blood EOS count detection:comparison within the group:the experimental group and the control group decreased slightly after treatment and before the treatment,and the differences were statistically significant(P<0.05);comparison between the groups:the experimental group and the control group After treatment,the difference was not statistically significant(P>0.05),indicating that although the two groups of treatments had a certain effect on reducing peripheral blood EOS counts,there was no significant difference between the two groups.(3)Detection of TRPV1,SP,CGRP and sputum pepsin concentration in induced sputum supernatant,comparison within the group:the experimental group and the control group both decreased after treatment and before treatment,and the differences in the experimental group were statistical Academic significance(P<0.05),but there was no statistical difference between the control group(P>0.05);comparison betweeen groups:the difference between the experimental group and the control group after treatment was statistically significant(P<0.05),indicating that Although the two groups of treatment have a certain effect on reducing the concentration of TRPV1,compared with the effect,the treatment group>the control group,the results are statistically significant.Conclusion:1.Hou Ke Ling granules have obvious curative effect on the treatm ent of Shaoyang stagnation type throat cough,mainly in improving cough symptoms,reducing itch,cough,overall throat symptom scores,and improving the quality of life of cough patients.2.The occurrence of laryngeal cough is closely related to airway neurogenic inflammation.The effective mechanism of Hou Ke Ling granules in treating laryngeal cough may be that it reduces the stimulation of the throat caused by reflux,etc.,down-regulates TRPV1 and reduces nerves.Peptides(SP,CGRP)are released to regulate airway neurogenic inflammation and reduce the incidence of cough. |
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