【目的】 探究健脾舒咽汤（由黄芪、党参、白术、当归、法半夏、厚朴、僵蚕、桔梗等中药组成）联合揿针治疗脾气虚 弱型慢喉痹（慢性咽炎）的临床疗效。【方法】 将68例脾气虚弱型慢喉痹患者随机分为对照组和试验组，每组各34例。对照组 给予西地碘含片含服治疗，试验组在对照组的基础上加用健脾舒咽汤联合揿针浅刺“咽疾六穴”（扶突穴、哑门穴、廉泉 穴、天突穴、列缺穴、照海穴）治疗，2组均以7 d为1个疗程，共治疗2个疗程，并于治疗结束后进行1个月和3个月的远期 随访。观察2组患者治疗前后病情程度视觉模拟量表（VAS）评分分级、炎性指标[C反应蛋白（CRP）、白细胞介素2（IL-2）]以 及中医证候积分的变化情况，并评价2组治疗方案的临床疗效、复发情况和安全性。【结果】（1）脱落情况方面，研究过程中， 2组均有 2例患者脱落，最终各有 32例患者完成全部疗程的治疗。（2）疗效方面，治疗 2周后，试验组的总有效率为 90.63% （29/32），对照组为 75.00%（24/32），组间比较，试验组的总有效率（χ2检验）和总体疗效（秩和检验）均明显优于对照组（P＜ 0.05）。（2）病情程度改善方面，治疗 2周后，2组患者的病情程度 VAS评分分级均较治疗前改善（P＜0.05），且试验组对病情 程度VAS评分分级的改善幅度明显优于对照组（P＜0.05）。（3）炎性指标方面，治疗2周后，2组患者的血清CRP、IL-2水平均 较治疗前降低（P＜0.05），且试验组对血清CRP、IL-2水平的降低幅度均明显优于对照组（P＜0.05）。（4）中医证候积分方面， 治疗2周后及治疗结束后1个月、3个月，2组患者的中医证候积分均较治疗前降低（P＜0.05），但治疗结束后3个月与治疗结 束后1个月的中医证候积分比较，差异无统计学意义（P＞0.05）；组间比较，试验组在治疗2周后及治疗结束后1个月、3个 月对中医证候积分的降低幅度均明显优于对照组（P＜0.05）。（5）安全性方面，治疗过程中，2组患者均无明显不良反应发生， 且患者的血常规和肝肾功能等安全性指标均未出现明显异常，具有较高的安全性。（6）远期随访方面，试验组的复发率为 9.38%（3/32），对照组为18.75%（6/32），组间比较，差异有统计学意义（P＜0.05），结合2组患者的中医证候积分变化，可以得出试验组对于远期治疗效果的维持明显优于对照组。【结论】 在含服西地碘含片的基础上加用健脾舒咽汤联合揿针浅刺 “咽疾六穴”治疗脾气虚弱型慢喉痹患者疗效确切，相比单独含服西地碘含片，其能更有效地缓解临床症状、减轻机体炎症 反应和维持远期疗效。

Objective To explore the clinical efficacy of Jianpi Shuyan Decoction（mainly composed of Astragali Radix，Codonopsis Radix，Atractylodis Macrocephalae Rhizoma，Angelicae Sinensis Radix，Pinelliae Rhizoma Praeparatum， Cortex Magnoliae Officinalis， Bombyx Batryticatus， and Platycodonis Radix） combined with thumbtack needling therapy（treated with thumbtack-type needle for subcutaneous embedding）in the treatment of chronic sore throat，i. e.，chronic pharyngitis，of spleen-qi weakness type. Methods Sixty-eight patients with chronic pharyngitis of spleen-qi weakness type were randomly divided into the control group and the trial group， with 34 patients in each group. The two groups were given buccal use of Cydiodine Buccal Tablets， and additionally，the trial group was treated with Jianpi Shuyan Decoction combined with thumbtack needling therapy at the six acupoints for pharyngeal disease， i. e.， Futu（LI18）， Yamen（GV15）， Lianquan（CV23）， Tiantu （CV22），Lieque（LU7），and Zhaohai（KI6）. Seven days constituted one course of treatment，and the two groups were treated for a total of two courses of treatment. One month and three months after the completion of treatment， the long-term follow-up of the patients was carried out. Before and after the treatment， the changes in visual analogue scale（VAS）score of the illness，inflammatory indicators of C-reactive protein（CRP）and interleukin 2 （IL-2），and traditional Chinese medicine（TCM）syndrome scores in the two groups were observed. Moreover， the clinical efficacy，recurrence rate and clinical safety of the two groups were evaluated. Results（1）During the study，2 patients in each of the two groups fell off，and finally 32 patients in each group completed the whole course of treatment.（2）After 2 weeks of treatment，the total effective rate of the trial group was 90.63%（29/32）， and that of the control group was 75.00%（24/32）. The total effective rate（tested by chi-square test）and overall efficacy（tested by rank sum test）of the trial group were significantly superior to those of the control group（P＜ 0.05）.（2）After 2 weeks of treatment，the VAS score of the illness in the two groups was improved compared with that before treatment（P＜0.05）， and the improvement of the VAS scores in the trial group was significantly superior to that in the control group（P＜0.05）.（3）After 2 weeks of treatment，the levels of serum inflammatory indicators of CRP and IL-2 in the two groups were decreased compared with those before treatment（P＜0.05）， and the decrease of serum CRP and IL-2 levels in the trial group was significantly superior to that in the control group（P＜0.05）.（4）After 2 weeks of treatment and one month and three months after the completion of treatment， the TCM syndrome scores of the two groups were lower than those before treatment（P＜0.05），but the scores in the two groups one month after the completion of treatment did not differ from those three months after the completion of treatment（P＞0.05）. The intergroup comparison showed that the decrease of the scores in the trial group was significantly superior to that in the control group after two weeks of treatment and one month and three months after the completion of treatment（P＜0.05）.（5）During the treatment， there were no obvious adverse reactions occurring in the two groups and there were no obvious abnormalities in the safety indexes of blood routine test and liver and kidney function， with high safety.（6）The results of long-term follow-up showed that the recurrence rate of the trial group was 9.38%（3/32）and that of the control group was 18.75%（6/32）， and the difference between the two groups was statistically significant（P＜0.05）. With the consideration of the changes of TCM syndrome scores in the two groups， it is indicated that the long-term efficacy of the trial group was significantly superior to that of the control group. Conclusion On the basis of buccal use of Cydiodine Buccal Tablets， the application of Jianpi Shuyan Decoction combined with thumbtack needling therapy at the six acupoints for pharyngeal disease exerts certain effectin the treatment of patients with chronic pharyngitis of spleenqi weakness type. The combined therapy is more effective on relieving clinical symptoms，inhibiting inflammatory response and maintaining long-term efficacy than Cydiodine Buccal Tablets alone.

R276.1

深圳市宝安区中医药发展基金科研项目（编号：2020KJCX-KTYJ-60）