清热泄浊法对外感高热40例(重症肺炎)影响的临床研究  

Clinical Study of Clearing Heat and Discharging Turbidity Method Treating 40 Cases of Severe Pneumonia with External High Fever Syndorme

作　　者：奚肇庆[1] 孟红亮[1] 

机构地区：[1]江苏省中医院南京中医药大学附属医院,江苏南京400021

出　　处：《中国中医急症》2014年第11期1976-1979,共4页Journal of Emergency in Traditional Chinese Medicine

基　　金：国家重点临床专科外感高热临床路径实施科研协作项目

摘　　要：目的通过清热泄浊法对外感高热(重症肺炎)治疗前后的体温、体征、理化指标、积分,评估临床疗效,中医药临床路径的可执行性。方法 60例患者按2∶1比例随机分为治疗组(清热泄浊+基础治疗)40例,对照组(基础治疗:抗感染及呼吸支持、营养支持等对症治疗)20例,7d为1个疗程,随访3d。观察治疗前后的中医症状、体温、即刻退热时间、解热时间、改善肺炎指数积分、影像学、氧合指数、外周血白细胞和中性粒细胞等急性临床指标。结果 4 h内体温下降0.5℃治疗组38例,对照组3例;7d内体温下降至37.2℃治疗组38例,对照组13例。影像学显示治疗后炎症较前吸收35例,对照组13例。治疗组、对照组治疗前后平均氧合指数为(209.49±35.46)mm Hg、(207.13±41.56)mm Hg,治疗后为(307.24±59.97)mm Hg、(267.24±37.29)mm Hg。治疗组治疗前平均白细胞计数为(13.13±5.47)×109/L,治疗后(10.66±4.39)×109/L,对照组为(12.73±6.66)×109/L,治疗后(7.6±2.02)×109/L。治疗组治疗前后肺炎指数积分(8.35±1.29)分、(1.63±0.95)分,对照组治疗前后肺炎指数积分(8.4±1.05)分、(3.0±0.79)分。综合疗效治疗组、对照组总有效率分别为92.50%、70%。结论清热泄浊法对外感高热(重症肺炎)疗效确切,在即刻退热时间、解热时间、改善肺炎指数积分、影像学、氧合指数、外周血白细胞和中性粒细胞等急性临床疗效方面,优于对照组,有较好的中医药特色,值得临床推广应用。Objective：To evaluate the clinical curative effect and enforceability of clinical pathway of traditional Chinese medicine through the clearing heat and discharging turbidity method in the exogenous high fever before and after treatment in the body temperature,the symptoms,the physical and chemical indicators.Methods：60 patients were randomly divided by the ration with 2：1 into the treatment group,which were used the method of the cleaningr heat and discharge turbidity plus foundation treatment in 40 cases and the control group,which were given the foundation treatment,such as the resistance to infection,the respiratory support,the nutritional support and other symptomatic treatment in 20 cases.In the 7 days for a period of treatment and follow-up of 3 d,some indices were observed before and after treatment of including TCM symptoms,body temperature,instantly antifebrile time,antipyretic time,improve pneumonia integral,imaging and oxygenation indices,peripheral blood leukocyte and neutrophil acute clinical indicators.Results：Hypothermia within 4 h 0.5 ℃ was 95% in the treatment group,and it was15% in the control group.In the 7 days,the temperature dropped to normal was 95% in the treatment group,and it was 20% in the control group.Imaging showed inflammation after treatment compared with the previous absorbs was 87.5% in the treatment group,and it was 65% in the control group.Treatment group and control group before and after treatment,on average,oxygenation index was respectively （209.49±35.46）mmHg,（207.13±41.56） mmHg,（307.24±59.97） mmHg and （267.24±37.29） mmHg.In the treatment group,the average white blood cell count was （13.13±5.47）×109/L before treatment and it was （10.66±4.39）×109/L after treatment.In the control group,it was （12.73±6.66）×109/L before treatment and it was （7.60±2.02）×109/L after treatment.In the treatment group,the pneumonia index score before and after treatment of points was respectively （8.35±1.29） and （1.63±0.95）.In the contr

关 键 词：外感高热 重症肺炎 解热时间 肺炎指数 清热泄浊 复方薤白胶囊 

分 类 号：R255.5[医药卫生—中医内科学]