加味麻杏石甘汤联合盐酸氨溴索治疗对痰热壅肺型老年重症肺炎患者中医证候积分的影响  

Effect of Modified Maxing Shigan Decoction Combined with Ambroxol Hydrochloride on Traditional Chinese Medicine Syndrome Scores in Elderly Patients with Severe Pneumonia of Phlegm-Heat Obstructing the Lungs Type

作　　者：陈碧虾 CHEN Bixia(Zhangzhou Second Traditional Chinese Medicine HospitalIntensive Care Medicine,Zhangzhou 363104,China)

机构地区：[1]漳州市第二中医院重症医学科,福建漳州363104

出　　处：《中华灾害救援医学》2024年第12期1413-1415,1419,共4页Chinese Journal of Disaster Medicine

摘　　要：目的对于痰热壅肺型老年重症肺炎患者采取加味麻杏石甘汤联合盐酸氨溴索治疗,探讨其临床疗效及对中医证候积分的影响。方法选择2020年6月至2023年6月就诊于漳州市第二中医院的100例痰热壅肺型老年重症肺炎患者为研究对象,根据随机数字表法分为观察组(采用加味麻杏石甘汤联合盐酸氨溴索治疗)和对照组(采用盐酸氨溴索治疗),每组50例。比较两组临床症状改善时间、中医证候积分、肺功能指标、炎症指标、临床疗效、不良反应发生情况。结果与对照组患者相比,观察组患者发热消失时间、咳嗽消失时间、喘息消失时间、肺部啰音消失时间更短(P<0.001)。治疗前,两组患者中医证候积分、第一秒用力呼气容积(FEV1)、第一秒用力呼气容积/用力肺活量(FEV1/FVC)、呼气流量峰值(PEF)以及C反应蛋白(CRP)、白介素-6(IL-6)、降钙素原(PCT)水平均无明显差异(P值均>0.05)。治疗后,两组患者以上中医证候积分和CRP、IL-6、PCT水平均显著下降(P值均<0.001),FEV1、FEV1/FVC、PEF均显著升高(P值均<0.001);且与对照组相比,观察组中医症状积分和CRP、IL-6、PCT水平更低,FEV1、FEV1/FVC、PEF更高。与对照组患者相比,观察组患者临床有效率明显更高(96.00%vs.82.00%,P=0.025),不良反应发生率无明显差异,(14.00%vs.8.00%,P=0.338)。结论对于痰热壅肺型老年重症肺炎患者,加味麻杏石甘汤联合盐酸氨溴索有效缓解其临床症状,降低患者中医证候积分,改善炎症反应,临床疗效显著,且具有较高的安全性。Objective To investigate the clinical efficacy and impact on Traditional Chinese Medicine(TCM)syndrome scores of modified Ma Xing Shi Gan Decoction combined with Ambroxol Hydrochloride in elderly patients with severe pneumonia of the phlegm-heat obstructing the lungs type.Methods A total of 100 elderly patients with severe pneumonia of the phlegm-heat obstructing the lungs type,who visited Zhangzhou Second Traditional Chinese Medicine Hospital from June 2020 to June 2023,were selected for the study.The patients were randomly divided into two groups using a random number table:the observation group(treated with modified Ma Xing Shi Gan Decoction combined with Ambroxol Hydrochloride)and the control group(treated with Ambroxol Hydrochloride alone),with 50 patients in each group.The clinical symptom improvement time,TCM syndrome scores,pulmonary function indicators,inflammatory markers,clinical efficacy,and adverse events were compared and analyzed.Results Compared with the control group,the observation group had significantly shorter times for fever resolution,cough resolution,wheezing resolution,and disappearance of lung rales(P<0.001).Before treatment,there were no significant differences between the two groups in TCM syndrome scores(main symptom score,secondary symptom score,total score),pulmonary function indicators(FEV1,FEV1/FVC,PEF),or inflammatory markers(CRP,IL-6,PCT).After treatment,both groups showed significant reductions in TCM syndrome scores and inflammatory markers(P<0.001),and significant improvements in pulmonary function indicators(P<0.001).Additionally,the observation group had lower main symptom scores,secondary symptom scores,total scores,CRP,IL-6,and PCT levels,and higher FEV1,FEV1/FVC,and PEF values compared to the control group.The clinical effective rate was significantly higher in the observation group than in the control group(96.00%vs.82.00%,P=0.025),while the incidence of adverse reactions did not differ significantly between the two groups(14.00%vs.8.00%,P=0.338).Conclusion For elderly

关 键 词：加味麻杏石甘汤 盐酸氨溴索 老年重症肺炎 

分 类 号：R24[医药卫生—中医临床基础]