普济宣肺消毒饮替代抗生素治疗社区获得性肺炎多中心随机双盲对照研究  

Effect of Puji Xuanfei Xiaodu Decoction as an Alternative for Antibiotics in Treatment of Community-Acquired Pneumonia:A Multicenter Double-blind Randomized Controlled Trial

作　　者：刘畅[1] 远庚[1] 马石征 朱立[1] 杨金亮[1] 赵昕[1] 赵明彰 李宛珊[2] 励国 刘福生[4] 王蓓[5] 房颖 陈维志 齐文升[1] LIU Chang;YUAN Geng;MA Shi-zheng;ZHU Li;YANG Jin-liang;ZHAO Xin;ZHAO Ming-zhang;LI Wan-shan;LI Guo;LIU Fusheng;WANG Bei;FANG Ying;CHEN Wei-zhi;QI Wen-sheng(Emergency Department,Guang'anmen Hospital,China Academy of Chinese Medical Sciences,Beijing,100053;Emergency Department and Intensive Care Unit,South Division of Guang'anmen Hospital,China Academy of Chinese Medical Sciences,Beijing,102618;Emergency Department,Beijing Fengtai Hospital of Integrated Traditional and Western Medicine,Beijing,100072;Emergency Department and Intensive Care Unit,Dongfang Hospital of Beijing University of Chinese Medicine,Beijing,100078;Intensive Care Unit,Wangjing Hospital of China Academy of Chinese Medical Sciences,Beijing,100102;The Second Internal Medicine,Beijing Daxing District Hospital of Integrated Chinese and Western Medicine,Beijing,100076;Respiratory Department,Beijing Pinggu Hospital of Traditional Chinese Medicine,Beijing,101200)

机构地区：[1]中国中医科学院广安门医院急诊科,北京100053 [2]中国中医科学院广安门医院南区急诊/重症监护室科,北京102618 [3]北京市丰台中西医结合医院急诊科,北京100072 [4]北京中医药大学东方医院急诊/重症监护室科,北京100078 [5]中国中医科学院望京医院重症监护室科,北京100102 [6]北京市大兴区中西医结合医院内二科,北京100076 [7]北京市平谷区中医院呼吸科,北京101200

出　　处：《中国中西医结合杂志》2020年第12期1448-1453,共6页Chinese Journal of Integrated Traditional and Western Medicine

基　　金：中国中医科学院基本科研业务费自主选题项目。

摘　　要：目的观察普济宣肺消毒饮替代抗生素治疗社区获得性肺炎的疗效。方法采用前瞻性、多中心、双盲、随机、对照的研究方法,观察2017年3月—2019年3月收治的社区获得性肺炎患者66例,应用SAS 9.3统计学软件随机分为中药组和抗生素组,每组33例。中药组予普济宣肺消毒饮(200 mL,每日4次)及抗生素安慰剂(0.5 g,每日2次),抗生素组予头孢呋辛酯胶囊(0.5 g,每日2次)及中药安慰剂(200 mL,每日4次),疗程5日。比较两组患者治疗前后的症状体征、白细胞计数(WBC)、中性粒细胞比例(NEUT%)及胸片肺炎吸收情况。结果共63例纳入统计分析,中药组33例,抗生素组30例。与本组治疗前比较,治疗后两组患者体温均降低(P<0.05),抗生素组肺炎胸片吸收评价量表评分降低(P<0.05),中药组评分差异无统计学意义(P>0.05),两组WBC差异均无统计学意义(P>0.05),中药组NEUT%治疗后降低(P<0.05),抗生素组差异无统计学意义(P>0.05)。治疗后两组体温、体温下降程度、体温复常天数、肺炎胸片吸收评价量表、WBC、NEUT%比较,差异均无统计学意义(P>0.05)。结论普济宣肺消毒饮可有效控制社区获得性肺炎患者体温、炎症反应指标,并改善胸片表现,疗效与抗生素大致相当。Objective To observe the clinical efficacy of Chinese medicine(CM)Puji Xuanfei Xiaodu De-coction(PXXD)to confirm whether it can be used as an alternative for antibiotics in the treatment of community-acquired pneumonia(CAP).Methods A prospective,multicenter,double-blind,randomized,controlled trial was conducted.Totally 66 patients with CAP admitted from March 2017 to March 2019 were assigned to CM group and antibiotic group by statistical software SAS 9.3,33 cases in each group.Patients in the CM group received PXXD(200 mL,4 times daily)and antibiotic placebo(0.5 g,twice daily),while those in the antibiotic group were given cefuroxime axetil capsules(0.5 g,twice daily)and CM placebo(200 mL,4 times daily).The treatment course was 5 days for all.The patients'symptoms and signs,white blood cell count(WBC),neutrophil ratio(NEUT%),and lung inflammation absorption evaluation score were compared.Results A total of 63 patients were included,inclu-ding 33 cases in the CM group and 30 cases in the antibiotic group.After treatment,the body temperature in both groups were significantly reduced(P<0.05),the lung inflammation absorption score in the antibiotic group signifi-cantly decreased(P<0.05).There was no statistical difference in the scores in the CM group(P>0.05).There was no statistically significant difference in WBC before and after treatment in both groups(P>0.05).NEUT%of the CM group was significantly reduced after treatment(P<0.05),and the difference in the antibiotic group was not sta-tistically significant(P>0.05).There was no significant difference in body temperature,the degree of body tempera-ture decrease,the time for body temperature recovery,the lung inflammation absorption evaluation score,WBC,and NEUT%after treatment in both groups(P>0.05).Conclusions PXXD can effectively control the temperature of patients with CAP,as well as inflammation index,and improve the lung inflammation absorption.The effect of PXXD is roughly equivalent to antibiotics in treatment of CAP.

关 键 词：社区获得性肺炎 抗生素替代 普济宣肺消毒饮 

分 类 号：R259[医药卫生—中西医结合]