麻杏石甘汤随症施量模式治疗小儿支气管肺炎18例临床研究  

Clinical Observation on Modified Maxing Shigan Decoction According to Symptoms for 18 Children With Bronchial Pneumonia

作　　者：杜洪喆[1] 晋黎[1] 陈汉江[2] 韩耀巍[1] 

机构地区：[1]天津中医药大学第一附属医院 [2]天津中医药大学

出　　处：《中医杂志》2014年第10期842-845,共4页Journal of Traditional Chinese Medicine

基　　金：国家重点基础研究发展计划("973"计划)资助项目(2010CB530601)

摘　　要：目的观察麻杏石甘汤随症施量策略治疗小儿支气管肺炎(风热闭肺)的疗效。方法将37例支气管肺炎患儿随机分为随症施量组18例和不随症施量组19例。两组均给予西医基础用药,不随症施量组在基础用药同时给予麻杏石甘汤,每日1剂,分早、中、晚3次服用,每两次间隔不少于4h;随症施量组在基础用药同时根据体温分别给予不随症施量组每日量的1、1.5、2、2.5、3倍的麻杏石甘汤。记录两组患儿完全退热时间、痊愈时间、中医单项症状(咳嗽、痰鸣、喘促)的消失率及消失时间、不良反应发生率。治疗后评价两组临床疗效和中医证候疗效。结果随症施量组临床疗效总有效率为100%,高于不随症施量组的94.73%,但差异无统计学意义(P>0.05)。随症施量组中医证候疗效愈显率为88.89%,明显高于不随症施量组的15.79%(P<0.01)。随症施量组完全退热时间和咳嗽、痰鸣消失时间明显短于不随症施量组(P<0.05);随症施量组咳嗽、痰鸣消失率明显高于不随症施量组(P<0.01)。两组均未出现不良反应。结论采用以发热为主要指征,以热退为标志,以倍增药物剂量为调整方式的随症施量策略的麻杏石甘汤治疗小儿支气管肺炎疗效优于非随症施量策略,能缩短发热、咳嗽、痰鸣时间。Objective To compare the efficacy of modified Maxing Shigan Decoction according to symptoms for children with bronchial pneumonia. Methods Totally 37 children with bronchial pneumonia were randomized into the modified dosage （dosage modified according to symptoms） group and fixed dosage （dosage not modified according to symptoms） group, with 18 and 19 in each. Both groups were given basic western medication. The fixed dosage group was added with Maxing Shigan Decoction one dose daily. Based on the body temperature of patients, the modified dosage group was added with 1, 1.5, 2, 2. 5 or 3 times daily volume of Maxing Shigan Decoction as in the fixed dosage group. The complete cooling time, recovery time, recovery rate and recovery time of TCM individual symptom, and incidence of adverse reactions were recorded. The clinical efficacy and TCM syndrome efficacy were evaluated after treatment. Results The total effective rate of the modified dosage group and fixed dosage group was 100% and 94.73% respectively, with no significant difference between groups （P 〉 0. 05 ）. The total effective rate of TCM syndromes in the modified dosage group and fixed dosage group was 88.89% and 15.79% respectively, with a significant difference between groups （P 〈0.01 ）. The complete cooling time, cough time and expectoration time in the modified dosage group was significantly shorter than those in the fixed dosage group （ P 〈 0.05 ）. The recovery rates of cough and expectoration in the modified dosage group were significantly higher than those in the fixed dosage group （P 〈 0. 05 ）. There was no adverse reaction in both groups. Conclusion Maxing Shigan Decoction is effective for bronchial pneumonia in children, especially modifying dosage according to symptoms with a shorter duration of fever, cough and expectoration.

关 键 词：小儿支气管肺炎 麻杏石甘汤 复方量效学 随症施量 

分 类 号：R272[医药卫生—中医儿科学]