以症状为基础的程序化治疗方案对亚急性、慢性咳嗽的临床有效性研究(1)
摘要：目的 探讨以临床症状为基础的程序化治疗方案对亚急性、慢性咳嗽患者的有效性。方法 将56例亚急性、慢性咳嗽患者随机分为试验组和对照组各28例。试验组采用以临床指南制定《以症状为基础的亚急性、慢性程序化治疗方案评估表》进行临床症状评估后，针对指向病因进行治疗，对照组给予经验治疗，以“咳嗽症状积分表”对两组患者的临床疗效进行评估，比较两组咳嗽症状评分、临床有效性评价、安全性评价。结果 治疗后，试验组夜间和全日咳嗽症状积分中位数均低于对照组(P<0.05)。治疗2周后，试验组有效率为89.29%，高于对照组的52.17%，差异有统计学意义(P<0.05)。结论 以症状为基础程序化治疗对于亚急性、慢性咳嗽的临床疗效优于简单的经验性治疗。
关键词：临床症状;程序化治疗;亚急性;慢性咳嗽
中图分类号：R441.5;R363.1 文献标识码：A DOI：10.3969/j.issn.1006-1959.2019.08.030
文章编号：1006-1959(2019)08-0105-04
Abstract：Objective To investigate the effectiveness of clinical symptom-based programmed treatment regimens in patients with sub acute and chronic cough. Methods 56 patients with subacute and chronic cough were randomly divided into the experimental group and the control group， 28 cases each. The experimental group used the clinical guidelines to develop a "symptom-based sub acute， chronic programmed treatment evaluation form" for clinical symptom evaluation， for the treatment of the cause of the disease， the control group was given experience and treatment， with the "cough symptom score table" The clinical efficacy of the two groups of patients was evaluated， and the scores of cough symptoms， clinical efficacy evaluation， and safety evaluation were compared between the two groups. Results After treatment， the median scores of nighttime and total cough symptoms in the experimental group were lower than those in the control group (P<0.05). After 2 weeks of treatment， the effective rate of the experimental group was 89.29%， which was higher than that of the control group 52.17%，the difference was statistically significant (P<0.05). Conclusion The clinical efficacy of symptom-based programmed therapy for sub acute and chronic cough is superior to simple empirical treatment.
Key words：Clinical symptoms;Programmed treatment;Sub acute;Chronic cough
亚急性、慢性咳嗽是呼吸内科专科门诊和社区门诊最常见的临床症状，因其病因复杂且涉及面广，很多患者经反复检查和长期大量药物治疗后，收效甚微[1]。临床诊疗过程中，医师多根据个人经验进行治疗，缺少系统性。国外有研究报道通过系统评估方式验证了以症状推断亚急性、慢性咳嗽病因的有效性[2]，但国内相似报道罕见。本研究以临床指南为依据，通过患者的临床特点评估亚急性、慢性咳嗽的最可能病因，并推荐合理的诊疗方案，研究结果将会对规范临床医生，尤其是基层医院医生的经验性治疗起到一定的借鉴作用。
1资料与方法
1.1一般資料 2016年11月～2017年11月宁夏银川市第二人民医院呼吸内科门诊及住院病例共56例，采用随机分组的方法将患者分为试验组和对照组，每组28例。纳入标准：年龄≥18 岁，咳嗽时间>3周，常规体格检查、胸片和血常规检查。排除标准：①有慢性支气管炎、哮喘、支气管扩张、肺癌等明确肺部疾病者;②孕妇、有糖尿病、甲亢、慢性心功能不全心因性咳嗽者;③慢性肝肾功能不全等慢性疾病者;④服用ACEI类降压药物停药不足4周者及对拟使用药物中任一成分过敏者;⑤重度吸烟及职业性接触粉尘、化工物质不能脱离职业环境者。所有患者对研究方案知情并签署知情同意书。, 百拇医药(杨桦 杜慧敏)
关键词：临床症状;程序化治疗;亚急性;慢性咳嗽
中图分类号：R441.5;R363.1 文献标识码：A DOI：10.3969/j.issn.1006-1959.2019.08.030
文章编号：1006-1959(2019)08-0105-04
Abstract：Objective To investigate the effectiveness of clinical symptom-based programmed treatment regimens in patients with sub acute and chronic cough. Methods 56 patients with subacute and chronic cough were randomly divided into the experimental group and the control group， 28 cases each. The experimental group used the clinical guidelines to develop a "symptom-based sub acute， chronic programmed treatment evaluation form" for clinical symptom evaluation， for the treatment of the cause of the disease， the control group was given experience and treatment， with the "cough symptom score table" The clinical efficacy of the two groups of patients was evaluated， and the scores of cough symptoms， clinical efficacy evaluation， and safety evaluation were compared between the two groups. Results After treatment， the median scores of nighttime and total cough symptoms in the experimental group were lower than those in the control group (P<0.05). After 2 weeks of treatment， the effective rate of the experimental group was 89.29%， which was higher than that of the control group 52.17%，the difference was statistically significant (P<0.05). Conclusion The clinical efficacy of symptom-based programmed therapy for sub acute and chronic cough is superior to simple empirical treatment.
Key words：Clinical symptoms;Programmed treatment;Sub acute;Chronic cough
亚急性、慢性咳嗽是呼吸内科专科门诊和社区门诊最常见的临床症状，因其病因复杂且涉及面广，很多患者经反复检查和长期大量药物治疗后，收效甚微[1]。临床诊疗过程中，医师多根据个人经验进行治疗，缺少系统性。国外有研究报道通过系统评估方式验证了以症状推断亚急性、慢性咳嗽病因的有效性[2]，但国内相似报道罕见。本研究以临床指南为依据，通过患者的临床特点评估亚急性、慢性咳嗽的最可能病因，并推荐合理的诊疗方案，研究结果将会对规范临床医生，尤其是基层医院医生的经验性治疗起到一定的借鉴作用。
1资料与方法
1.1一般資料 2016年11月～2017年11月宁夏银川市第二人民医院呼吸内科门诊及住院病例共56例，采用随机分组的方法将患者分为试验组和对照组，每组28例。纳入标准：年龄≥18 岁，咳嗽时间>3周，常规体格检查、胸片和血常规检查。排除标准：①有慢性支气管炎、哮喘、支气管扩张、肺癌等明确肺部疾病者;②孕妇、有糖尿病、甲亢、慢性心功能不全心因性咳嗽者;③慢性肝肾功能不全等慢性疾病者;④服用ACEI类降压药物停药不足4周者及对拟使用药物中任一成分过敏者;⑤重度吸烟及职业性接触粉尘、化工物质不能脱离职业环境者。所有患者对研究方案知情并签署知情同意书。, 百拇医药(杨桦 杜慧敏)