基于阴虚内热辨证治疗颈椎脊髓休克大剂量激素冲击后顽固性发热的临床研究  

Effect of YunXuNeiLe BianZheng for refractory fever after large dose methylprednisolone for cervical spinal shock

作　　者：张作丹 黄雯雯 章珍凤 吕辉照 梁志白 ZHANG Zuodan;HUANG Wenwen;ZHANG Zhenfeng(Department of Clinical Medicine of Quanzhou Medical College,Quanzhou Fujian 362000,China)

机构地区：[1]泉州医学高等专科学校临床医学院,福建泉州362000 [2]中国人民解放军联勤保障部队第910医院骨科,福建泉州362000

出　　处：《四川中医》2024年第2期156-159,共4页Journal of Sichuan of Traditional Chinese Medicine

摘　　要：目的:探讨基于阴虚内热辨证治疗颈椎脊髓休克大剂量激素冲击后顽固性发热的临床疗效。方法:选取2003年10月至2022年1月在中国人民解放军联勤保障部队第910医院脊柱外科治疗的63例颈椎脊髓休克患者,经大剂量甲基强的松龙冲击治疗后出现顽固性发热证属阴虚内热者作为研究对象。将其分为观察组33例,对照组30例。其中对照组采用综合疗法治疗,观察组在对照组基础上给予清骨散加味治疗。记录两组患者术前、术后的中医证候积分、有效率和起效时间及炎性指标。结果:观察组治疗后中医证候积分优于治疗前(P<0.01),但对照组治疗前、后积分差异无统计学意义(P>0.05);观察组治疗前积分与对照组无差异(P>0.05),但治疗后积分低于对照组(P<0.01)。观察组有效率87.88%,优于对照组的10.00%(P<0.01)。观察组治疗起效时间(4.27±1.05)天,低于对照组的(8.67±2.08)天(P<0.01)。观察组治疗后的血沉、C反应蛋白均低于对照组(P<0.01),但白细胞计数与对照组无差异(P>0.05)。结论:对于颈椎脊髓休克大剂量激素冲击后顽固性发热证属阴虚内热型者,在综合治疗的基础上,联合清骨散加味,可提高治愈率,缩短治疗时间,效果显著,值得推广。Objective:To investigate the effect of YunXuNeiLe BianZhengfor refractory fever after large dose methylprednisolone for cervical spinal shock.Method:Between October 2003and January 2022,63patients with refractory fever after large dose methylprednisolone for cervical spinal shock were treated in 910th hospital of Chinese PLA,and all patients belonged to YunXuNeiLeZheng.30patients in control group were treated with conventional therapies,and 33patients in observation group were treated with QingGuSan.Preoperative and afteroperative score of traditional medical syndrome(STMS),effective rate,time to onset and inflammation indicators were recorded.Result:In observational group,afteroperative STMS was superior to preoperative(P<0.01),but in control group there was no significant difference between preoperative and afteroperative STMS(P>0.05).Preoperative STMS in observation group was similar to control group(P>0.05),but afteroperative STMS was lower than control group(P<0.01).Effective rate in observation group(87.88%)was superior to control group(10.00%)(P<0.01),and time to onset(4.27±1.05)days was lower than control group(8.67±2.08)days(P<0.01).Erythrocyte sedimentation rate(ESR)and C-reactive protein(CRP)in observation group was lower than control group(P<0.01),but white blood cell count(WBC)was similar to control group(P>0.05).Conclusion:For refractory fever after large dose methylprednisolone for cervical spinal shock,on the basis of conventional therapies,QingGuSan can increase cure rate,and reduce treatment time,and it was worthy of promotion because of its significant effect.

关 键 词：颈椎脊髓休克 大剂量激素冲击 顽固性发热 阴虚内热证 清骨散 

分 类 号：R255.1[医药卫生—中医内科学]