大柴胡汤对老年急性缺血性脑卒中患者卒中相关性肺炎的临床疗效观察  

Clinical observation on therapeutic effect of Dachaihu decoction for treating stroke-associated pneumonia in senile patients with excess-heat syndrome

作　　者：刘琳[1] 王珩[1] 刘涛[1] 王瑾[1] 郭颖[1] 赵文莉[1] 李作伟[1] 赵金生[1] 辛永飞 Liu L;Wang H;Liu T;Wang J;Guo Y;Zhao WL;Li ZW;Zhao JS;Xin YF(Department of Neurology,Tianjin Nankai Hospital,Tianjin 300100,China;Tianjin University of Traditional Chinese Medicine,Tianjin 300193,Chin)

机构地区：[1]天津市南开医院神经内科,300100 [2]天津中医药大学,300193

出　　处：《中国中西医结合急救杂志》2018年第3期264-267,共4页Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care

基　　金：天津市医药卫生中医中西医结合科研课题（2015028）

摘　　要：目的观察大柴胡汤对老年急性缺血性脑卒中（AIS）实热证患者卒中相关性肺炎（SAP）临床疗效的影响。方法选择2015年8月至2016年9月天津市南开医院神经内科收治的老年实热证SAP患者100例。按随机数字表法分为对照组和观察组，每组50例。两组均给予内科常规治疗，观察组在常规治疗基础上给予大柴胡汤（柴胡15g、黄芩10g、半夏10g、枳实15g、白芍10g、大黄5g、生姜10g、大枣2枚）随证加减，每日1剂、分早晚2次服用，疗程为14d。观察两组患者体温恢复正常时间、抗菌药物应用时间和治疗前后临床肺部感染评分（CPIS）及美国国立卫生研究院卒中量表（NIHSS）评分的变化，并评价临床疗效。结果观察组体温恢复正常时间（d：6．56±2．70比8．08±3．23）和抗菌药物应用时间（d：8．78±2．80比10．02±2．90）均较对照组明显缩短（均P〈0．05）；随治疗时间延长，两组治疗后CPIS评分和NIHSS评分均明显降低，治疗14d达最低水平，且观察组的降低程度较对照组更显著[CPIS评分（分）：0．68±0．59比1．12±0．96，NIHSS评分（分）：6．38±2．31比7．44±2．74，均P〈0．05]；观察组总有效率明显高于对照组[92％（46／50）比76％（38／50），P〈0．05]。结论大柴胡汤可有效治疗老年AIS实热证SAP，且安全性较好。Objective To observe the clinical efficacy of Dachaihu decoction in treatment of stroke-associated pneumonia （SAP） in the elderly patients with excess-heat syndrome and acute isehemic stroke （AIS）. Methods One hundred elderly patients with excess-heat syndrome and SAP admitted to the Department of Neurology of Tianjin Nankai Hospital from August 2015 to September 2016 were enrolled, and they were divided into a control group and an observation group according to the random number table, 50 cases in each group. Both groups were given conventiona] neurological treatment, while the observation group additionally received Dachaihu decoction （the ingredients of the decoction： bupleurum 15 g, seutellariae 10 g, pinellia 10 g, fructus aurantii immaturus 15 g, radix paeoniae alba 10 g, rhubarb 5 g, ginger 10 g, jujube 2）, and according to the individual＇s symptoms and signs, the above ingredients can be added and/or subtracted, 1 dose per day, divided into two parts, 1 part taken in the morning and 1 part in the evening orally, 14 days as a therapeutic course. The body temperature recovery time, the duration of antibiotic treatment, the changes of Clinical Pulmonary Infection Score （CPIS） and National Institutes of Health Stroke Scale （NIHSS） score before and after treatment of the two groups were observed and the therapeutic effeets in the two groups were evaluated. Results The body temperature recovery time （days： 6.56 ± 2.70 vs. 8.08 ± 3.23） and the duration of antibiotic treatment （days： 8.78 ±2.80 vs. 10.02 ± 2.90） in the observation group were significantly shorter than those in the control group （both P 〈 0.05）; with the prolongation of treatment, after treatment, the CPIS and NIHSS score were decreased significantly in both groups, reaching the lowest levels on the 14th day, and the degrees of score descent in observation group were more significant than those of the control group （CPIS score： 0.68 ± 0.59 vs. 1.12 ± 0.96, NIHSS score： 6.38±2.31 vs. 7.44± 2.7

关 键 词：大柴胡汤 卒中相关性肺炎 老年 实热证 

分 类 号：R743.31[医药卫生—神经病学与精神病学]