中西医结合治疗重症肺炎临床研究  

Clinical Study on the Treatment of Severe Pneumonia with Integrated Traditional Chinese and Western Medicine

作　　者：韩峰[1] 刘凤婷[1] 薛敬伟[2] 

机构地区：[1]枣庄市妇幼保健院,山东枣庄277100 [2]泰安市中心医院,山东泰安271000

出　　处：《中医学报》2016年第10期1472-1474,共3页Acta Chinese Medicine

基　　金：山东省自然科学基金项目(ZR2015HL130)

摘　　要：目的:观察清金化痰汤联合常规抗生素序贯疗法治疗重症肺炎的临床疗效。方法:86例重症肺炎患者随机分为对照组和观察组,每组43例。对照组患者采用常规抗生素序贯疗法治疗,观察组在对照组治疗基础上加服清金化痰汤加减,方药组成:黄芩20 g,栀子10 g,桔梗12 g,生石膏30 g,川贝母10 g,鱼腥草30 g,橘红9 g,茯苓30 g,桑白皮15 g,知母15 g,栝楼仁20 g,甘草6 g。比较两组患者临床疗效,肺功能和生活质量评分。结果:两组患者的体温恢复时间(t=6.323,P<0.01)、呼吸恢复正常时间(t=9.552,P<0.01)、咳嗽消失时间(t=9.578,P<0.01)、肺啰音消失时间(t=3.661,P<0.01)、机械通气时间(t=12.845,P<0.01)、住院时间(t=5.827,P<0.01)均存在统计学差异;治疗后,对照组和观察组的白细胞介素-2(interleukin-2,IL-2)(t=2.555,P=0.012<0.01)、IL-6(t=14.985,P<0.01)、C反应蛋白(t=3.110,P=0.003<0.01)、第1秒用力呼气量(t=-4.747,P<0.01)、用力肺活量(t=-4.104,P<0.01)、第1秒用力呼气量(t=-5.461,P<0.01)、临床肺感染评价(t=-10.299,P<0.01)均存在统计学差异;两组体征分数均有改善,但观察组显著优于对照组;治疗后,对照组和观察组的Barthel指数评估量表评分(t=-8.987,P<0.01)和Rankin神经功能康复情况评估量表评分(t=-8.500,P<0.01)均存在统计学差异,两组的生活质量评分均提高,但观察组评分显著高于对照组。结论:清金化痰汤联合常规抗生素序贯疗法治疗重症肺炎临床疗效显著,能明显改善临床症状,提高患者的生活质量。Objective： To observe the clinical effect of the treatment of severe pneumonia with the combination of Qingjin Huatan Tang combined with routine antibiotic sequential therapy. Methods： 86 patients with severe pneumonia were randomly divided into the control group and the observation group,43 cases in each group. The control group was treated with conventional antibiotic sequential therapy,and the observation group was additionally given Qingjin Huatan Tang based on the control group,prescription composition： Huangqin（ Scutellaria） 20 g,Zhizi（ Gardenia） 10 g,Jiegeng（ Platycodon Grandiflorum） 12 g,Shengshigao（ Raw Gypsum） 30 g,Chuanbeimu（ Fritillaria） 10 g,Yuxingcao（ Houttuynia） 30 g,Juhong（ Red Tangerine Peel） 9 g,Fuling（ Poria） 30 g,Sangbaipi（ Mulberry） 15 g,Zhimu（ Rhizoma Anemarrhenae） 15 g,Gualouren（ Snakegourd Seed） 20 g,Gancao（ Licorice） 6 g.The clinical efficacy,lung function and quality of life were compared between the two groups. Results： Comparison of body temperature recovery time（ t = 6. 323,P〈0. 01）,breathing return to normal time（ t = 9. 552,P〈0. 01）,cough disappeared time（ t =9. 578,P〈0. 01）,pulmonary rales disappeared time（ t = 3. 661,P〈0. 01）,mechanical ventilation time（ t = 12. 845,P〈0. 01）,hospitalization time（ t = 5. 827,P〈0. 01） in the two groups of patients were all statistically significant differences; after treatment,interleukin-2（ t = 2. 555,P = 0. 012 0. 01）,IL-6（ t = 14. 985,P〈0. 01）,C reactive protein（ t = 3. 110,P = 0. 003 0. 01）,FEV1（ t =- 4. 747,P〈0. 01）,forced vital capacity（ t =- 4. 104,P〈0. 01）,forced expiratory volume（ t =- 5. 461,P〈0. 01）,evaluation of clinical pulmonary infection（ t =- 10. 299,P〈0. 01） between the two groups were statistically significant differences. The scores of the two groups were improved,but the observation group was significantly better than the control group; after treatment,there were significant differences of the two grou

关 键 词：重症肺炎 清金化痰汤 抗生素 白细胞介素 C反应蛋白 肺功能 BARTHEL指数 Rankin量表 中西医结合 

分 类 号：R259.631[医药卫生—中西医结合]