千金苇茎汤合大承气汤加味治疗脑卒中合并肺部感染临床研究  

Clinical Study on Modified“Qianjin Weijing Decoction Combined with Dachengqi Decoction”for Stroke Complicated with Pulmonary Infection

作　　者：王松鹤 周笑非 张亚丽 WANG Songhe;ZHOU Xiaofei;ZHANG Yali(Kaifeng People's Hospital,Kaifeng Henan 475000,China)

机构地区：[1]开封市人民医院,河南开封475000

出　　处：《新中医》2024年第8期51-56,共6页New Chinese Medicine

基　　金：开封市科技发展计划项目(1903072)。

摘　　要：目的:观察千金苇茎汤合大承气汤加味治疗脑卒中合并肺部感染气阴两虚兼痰热蕴肺证的临床疗效。方法:选取96例脑卒中合并肺部感染气阴两虚兼痰热蕴肺证患者,采用随机数字表法分为对照组与观察组各48例。对照组行常规西医疗法治疗,观察组在对照组基础上给予千金苇茎汤合大承气汤加味治疗。2组均治疗14 d。比较2组临床疗效、临床症状体征改善时间、临床肺部感染评分(CPIS)、炎症指标[白细胞计数(WBC)、中性粒细胞百分比(NEUT%)、降钙素原(PCT)、C-反应蛋白(CRP)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)]水平及不良反应发生率。结果:治疗后,观察组总有效率97.92%,高于对照组85.42%(P<0.05)。观察组咳嗽、发热、肺部啰音消失时间及胸部影像恢复正常时间均短于对照组(P<0.05)。2组CPIS评分均较治疗前降低(P<0.05),观察组CPIS评分低于对照组(P<0.05)。2组WBC、NEUT%、PCT、CRP、IL-6、TNF-α水平均较治疗前降低(P<0.05),观察组上述6项炎症指标水平均低于对照组(P<0.05)。治疗期间,观察组不良反应发生率10.42%,与对照组6.25%比较,差异无统计学意义(P>0.05)。结论:在常规西医疗法基础上加用千金苇茎汤合大承气汤加味治疗脑卒中合并肺部感染气阴两虚兼痰热蕴肺证疗效显著,可促进临床症状改善,减轻机体炎症反应,且安全性较好。Objective:To observe the clinical effect of the therapy of modified“Qianjin Weijing Decoction combined with Dachengqi Decoction”on stroke complicated with pulmonary infection with syndrome of dual deficiency of qi and yin and syndrome of phlegm-heat in the lung.Methods:A total of 96 cases of patients with stroke complicated with pulmonary infection with syndrome of dual deficiency of qi and yin and syndrome of phlegm-heat in the lung were selected and divided into the control group and the observation group according to the random number table method,with 48 cases in each group.The control group was treated with routine western medicine,and the observation group was additionally given modified“Qianjin Weijing Decoction combined with Dachengqi Decoction”for treatment based on the treatment of the control group.The two groups were treated for 14 days.The clinical effects,improvement time of clinical symptoms and signs,clinical pulmonary infection scores(CPIS),levels of inflammation indexes[white blood cell(WBC)count,percentage of neutrophil granulocytes(NEUT%),procalcitonin(PCT),C-reactive protein(CRP),interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)]and incidence of adverse reactions were compared between the two groups.Results:After treatment,the total effective rate was 97.92%in the observation group,higher than that of 85.42%in the control group(P<0.05).The disappearance time of cough,heat and lung rales and recovery time of normal chest radiograph in the observation group were shorter than those in the control group(P<0.05).The CPIS scores in the two groups were decreased when compared with those before treatment(P<0.05),and the CPIS score in the observation group was lower than that in the control group(P<0.05).The levels of WBC,NEUT%,PCT,CRP,IL-6 and TNF-αin the two groups were decreased when compared with those before treatment(P<0.05),and the above six levels in the observation group were lower than those in the control group(P<0.05).During treatment,the incidence of adverse reactions was 1

关 键 词：脑卒中 肺部感染 气阴两虚证 痰热蕴肺证 千金苇茎汤 大承气汤 炎症反应 

分 类 号：R743.3[医药卫生—神经病学与精神病学]