牛黄平喘散联合推拿辅助治疗小儿支气管肺炎痰热壅肺证49例临床观察  

Clinical observation on the adjuvant therapy of Niuhuang Pingchuan San(牛黄平喘散)combined with tuina in 49 pediatric patients with bronchopneumonia of phlegm heat obstructing the lung pattern

作　　者：刘丽华 范钧 张宪明 LIU Lihua;FAN Jun;ZHANG Xianming(Department of Pediatrics,Xinxiang Xinhua Hospital of Traditional Chinese Medicine,Xinxiang,Henan,453000,China)

机构地区：[1]新乡新华医院中医儿科,河南新乡453000

出　　处：《中医儿科杂志》2025年第1期83-89,共7页Journal of Pediatrics of Traditional Chinese Medicine

摘　　要：目的观察牛黄平喘散联合推拿辅助治疗小儿支气管肺炎痰热壅肺证的临床疗效。方法选取2021年10月至2023年5月在新乡新华医院中医儿科就诊的196例支气管肺炎痰热壅肺证患儿,按照随机数字表法分为常规组、推拿组、牛黄平喘散组和联合组,各49例。常规组给予常规西医治疗,推拿组在常规组治疗方法的基础上给予推拿治疗,牛黄平喘散组在常规组治疗方法的基础上给予牛黄平喘散口服,联合组在常规组治疗方法的基础上联合推拿、牛黄平喘散口服治疗,4组均治疗7 d后,比较临床症状、体征消退时间以及治疗前后中医证候积分、临床肺部感染评分(CPIS)、血清相关指标[白介素-1β(IL-1β)、白介素-6(IL-6)、白介素-8(IL-8)、肿瘤坏死因子-α(TNF-α)、降钙素原(PCT)、C反应蛋白(CRP)]水平以及临床疗效和不良反应。结果推拿组、牛黄平喘散组及联合组的退热、咳嗽停止、气促喘息消失、肺部啰音消失、胸片肺部阴影消失时间均短于常规组,组间比较,差异有统计学意义(P<0.05);联合组上述临床症状消失时间均短于推拿组和牛黄平喘散组,差异有统计学意义(P<0.05)。4组治疗前中医证候积分和CPIS评分比较,差异无统计学意义(P>0.05),具有可比性;治疗后4组的中医证候积分、CPIS评分均明显下降,与同组治疗前比较,差异有统计学意义(P<0.05);推拿组、牛黄平喘散组及联合组下降更显著,与常规组比较,差异有统计学意义(P<0.05);与推拿组和牛黄平喘散组比较,联合组中医证候积分和CPIS评分最低,差异有统计学意义(P<0.05)。4组治疗前血清IL-1β、IL-6、IL-8、TNF-α、PCT、CRP水平比较,差异无统计学意义(P>0.05),具有可比性;治疗后4组上述指标水平均明显下降,与同组治疗前比较,差异有统计学意义(P<0.05);与常规组比较,推拿组、牛黄平喘散组和联合组下降更显著,差异有统计学意义(P<0.05);与推拿组�Objective To observe the clinical efficacy of Niuhuang Pingchuan San(牛黄平喘散)combined with Tuina as adjuvant therapy in pediatric patients with bronchopneumonia of phlegm heat obstructing the lung pattern.Methods A total of 196 pediatric patients with bronchopneumonia of phlegm heat obstructing the lung pattern who visited the Department of Pediatrics,Xinxiang Xinhua Hospital of Traditional Chinese Medicine from October 2021 to May 2023 were enrolled and randomly divided into a conventional group,a Tuina group,a Niuhuang Pingchuan San group,and a combination group,with 49 patients in each.The conventional group received conventional western medicine treatment.The Tuina group received Tuina therapy on the basis of the conventional treatment.The Niuhuang Pingchuan San group received oral Niuhuang Pingchuan San on the basis of the conventional treatment.The combination group received both Tuina therapy and oral Niuhuang Pingchuan San on the basis of the conventional treatment.After 7 days of treatment,the clinical symptoms,disappearance time of signs,scores of traditional Chinese medicine(TCM)syndromes before and after treatment,clinical pulmonary infection score(CPIS),levels of serum-related indicators[interleukin-1β(IL-1β),interleukin-6(IL-6),interleukin-8(IL-8),tumor necrosis factor-α(TNF-α),procalcitonin(PCT),and C-reactive protein(CRP)],clinical efficacy,and adverse reactions were compared among the four groups.Results The Tuina group,the Niuhuang Pingchuan San group,and the combination group had shorter times for fever reduction,cough cessation,disappearance of dyspnea and wheezing,disappearance of lung rales,and disappearance of lung shadows on chest radiographs compared with the conventional group,with statistically significant differences(P<0.05).The combination group had shorter disappearance times for the above-mentioned clinical symptoms compared with the Tuina group and the Niuhuang Pingchuan San group,with statistically significant differences(P<0.05).There were no statistically significant

关 键 词：支气管肺炎 小儿 痰热壅肺证 牛黄平喘散 推拿 肺部感染评分 炎症因子 临床观察 

分 类 号：R725.6[医药卫生—儿科]