清金化痰汤内服合耳穴贴压外治对社区获得性肺炎痰热郁肺证疗效观察  

Clinical Effect of Oral Administration of Qingjin Huatan Decoction Combined with Auricular Point Sticking in Treatment of Community-acquired Pneumonia with Phlegm-Heat Obstructing the Lungs

作　　者：吕园园[1] 张念志[1] 陈炜[1] LYU Yuanyuan;ZHANG Nianzhi;CHEN Wei(The First Affiliated Hospital of Anhui University of Chinese Medicine,Anhui Hefei 230031,China)

机构地区：[1]安徽中医药大学第一附属医院,安徽合肥230031

出　　处：《安徽中医药大学学报》2025年第2期20-24,共5页Journal of Anhui University of Chinese Medicine

基　　金：国家自然科学基金项目(82174312);国家中医优势专科建设项目(Z155080000004)。

摘　　要：目的观察清金化痰汤内服联合耳穴贴压治疗社区获得性肺炎(community acquired pneumonia,CAP)痰热郁肺证的临床疗效。方法将62例CAP痰热郁肺证患者随机分为对照组和观察组,每组31例;对照组接受常规西医抗感染及化痰对症治疗,观察组在对照组治疗基础上加用清金化痰汤加减内服合耳穴贴压外治,疗程均为10 d;比较两组患者治疗前后中医证候积分、血常规[白细胞(white blood cell,WBC)计数、中性粒细胞百分比(neutrophil percentage,N%)]、炎症指标[C反应蛋白(C-reactive protein,CRP)、白细胞介素-6(interleukin-6,IL-6)、降钙素原(procalcitonin,PCT)、血清淀粉样蛋白A(serum amyloid A,SAA)]、肺部病灶影像学变化及临床疗效。结果两组患者治疗后主要症状、次要症状和体征积分以及总积分,WBC计数,N%,CRP、IL-6、PCT、SAA水平均较治疗前显著降低(P<0.05),且观察组降低程度较对照组更为显著(P<0.05);观察组肺部病灶吸收程度及疗效显著优于对照组(P<0.05)。结论清金化痰汤内服合耳穴贴压治疗CAP疗效显著,能显著改善患者临床症状和体征,有效降低血液炎症因子水平,促进肺部炎症吸收。Objective To investigate the clinical effect of oral administration of Qingjin Huatan Decoction combined with auricular point sticking in the treatment of community-acquired pneumonia(CAP)with phlegm-heat obstructing the lungs.Methods A total of 62 CAP patients with phlegm-heat obstructing the lungs were randomly divided into control group and observation group,with 31 patients in both groups.The patients in the control group received conventional Western medicine treatment(anti-infective therapy and symptomatic treatment for resolving phlegm),while those in the observation group received oral administration of modified Qingjin Huatan Decoction combined with auricular point sticking in addition to the treatment in the control group;the course of treatment was 10 days for both groups.The two groups were compared in terms of traditional Chinese medicine(TCM)syndrome score,routine blood test results[white blood cell count(WBC)and percentage of neutrophils(N%)],inflammatory markers[C-reactive protein(CRP),interleukin-6(IL-6),procalcitonin(PCT),and serum amyloid A(SAA)],imaging findings of lung lesion,and clinical outcome before and after treatment.Results After treatment,both groups had significant reductions in the scores of major symptoms,minor symptoms or signs,total symptom score,WBC,N%,and the levels of CRP,IL-6,PCT,and SAA(P<0.05),and the observation group had significantly greater reductions than the control group(P<0.05).Compared with the control group,the observation group had a significantly greater improvement in lung lesion absorption and a significantly better clinical outcome(P<0.05).Conclusion Oral administration of Qingjin Huatan Decoction combined with external auricular point sticking and Western medicine treatment has a marked clinical effect in the treatment of CAP and can significantly improve clinical symptoms and signs,effectively reduce the levels of inflammatory factors,and promote the absorption of inflammation in lungs.

关 键 词：社区获得性肺炎 痰热郁肺证 清金化痰汤 耳穴贴压 炎症因子 

分 类 号：R563.1[医药卫生—呼吸系统]