自拟清源生化汤辅助治疗小儿重症肺炎痰热壅肺证40例临床观察  

Clinical observation on 40 cases of pediatric severe pneumonia of phlegm-heat obstructing the lung type treated with self-formulated Qingyuan Shenghua Tang(清源生化汤)as adjuvant therapy

作　　者：修乃冲 张鸿 周浩 XIU Naichong;ZHANG Hong;ZHOU Hao(Department of Emergency,Taizhou Municipal Hospital,Taizhou,Zhejiang,318000,China;Department of Pediatrics,Taizhou Municipal Hospital,Taizhou,Zhejiang,318000,China)

机构地区：[1]台州市立医院急诊科,浙江台州318000 [2]台州市立医院儿科,浙江台州318000

出　　处：《中医儿科杂志》2025年第2期71-75,共5页Journal of Pediatrics of Traditional Chinese Medicine

摘　　要：目的观察自拟清源生化汤辅助治疗小儿重症肺炎痰热壅肺证的临床疗效。方法选取2020年10月至2023年2月台州市立医院儿科收治的重症肺炎痰热壅肺证患儿80例,采用随机数字表法分为对照组和治疗组,各40例。对照组给予西医常规治疗,治疗组在对照组治疗方法的基础上给予自拟清源生化汤治疗,2组均治疗7 d后统计临床症状及体征消失时间,比较治疗前后血清炎症因子指标变化情况[C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)及白细胞介素-6(IL-6)]、肺功能指标[最大呼气中段流量(MMF)、最大吸气压(MIP)、峰流速(PEF)及最大呼气压(MEP)]改善情况以及患儿短期预后情况[急性生理与慢性健康评分系统(APACHEⅡ)评分]。结果治疗组发热、咳嗽咳痰、腹胀、肺部啰音及心率、呼吸异常消失时间均短于对照组,2组比较,差异有统计学意义(P<0.05)。治疗前,2组血清CRP、TNF-α和IL-6水平以及APACHEⅡ评分比较,差异无统计学意义(P>0.05),具有可比性;治疗后,2组上述指标值较治疗前均降低,与同组治疗前比较,差异有统计学意义(P<0.05),且治疗组下降更显著(P<0.05)。治疗前,2组PEF、MMF、MIP和MEP肺功能指标水平比较,差异无统计学意义(P>0.05),具有可比性;治疗后,2组上述指标值较治疗前均升高,与同组治疗前比较,差异有统计学意义(P<0.05),且治疗组升高更显著(P<0.05)。对照组不良反应发生率为5.0%(2/40),均表现为呕吐;治疗组为7.5%(3/40),其中1例出现呕吐,2例发生腹胀。2组不良反应发生率比较,差异无统计学意义(P>0.05)。结论自拟清源生化汤辅助治疗小儿重症肺炎痰热壅肺证疗效显著,能有效改善患儿临床症状及短期预后情况,降低血清炎症因子水平,改善肺功能,且无明显不良反应,值得临床推广应用。Objective To observe the clinical efficacy of self-formulated Qingyuan Shenghua Tang(清源生化汤)as an adjuvant therapy for pediatric severe pneumonia of phlegm-heat obstructing the lung type.MethodsA total of 80 children with severe pneumonia of phlegm-heat obstructing the lung type admitted to the De-partment of Pediatrics at Taizhou Municipal Hospital from October 2020 to February 2023 were selected and randomly divided into a control group and a treatment group,with 40 cases in each group.The control group received conventional Western medical treatment,while the treatment group received the self-formulated Qingyuan Shenghua Tang in addition to the control group's treatment regimen.After 7 days of treatment,the disappearance time of clinical symptoms and signs was recorded.Changes in serum inflammatory factors[C-reactive protein(CRP),tumor necrosis factor-α(TNF-α),and interleukin-6(IL-6)],lung function indicators[maximum mid-expiratory flow(MMF),maximum inspiratory pressure(MIP),peak expiratory flow(PEF),and maximum expiratory pressure(MEP)],and short-term prognosis[Acute Physiology and Chronic Health Evaluation II(APACHE II)score]were compared before and after treatment.ResultsThe disappearance times of fever,cough with sputum,abdominal distension,lung rales,and abnormal heart rate and respiration in the treatment group were shorter than those in the control group,with statistically significant differences(P<0.05).Before treatment,there were no significant differences in serum CRP,TNF-α,IL-6 levels and APACHE II score between the two groups(P>0.05),indicating comparability.After treatment,the levels of these indicators decreased in both groups compared to before treatment,with statistically significant differences(P<0.05),and the decrease was more significant in the treatment group(P<0.05).Before treatment,there were no significant differences in lung function indicators(PEF,MMF,MIP,and MEP)between the two groups(P>0.05),indicating comparability.After treatment,these indicators increased in both group

关 键 词：重症肺炎 小儿 痰热壅肺证 自拟清源生化汤 临床观察 

分 类 号：R256.1[医药卫生—中医内科学]