摘要
目的观察中西医结合治疗老年风温肺热病痰热壅肺证的效果。方法选择2011年10月—2013年10月收治的符合诊断标准的老年风温肺热病痰热壅肺证患者80例,随机分为治疗组与对照组各40例。依照病情给予吸氧、监测生命体征,止咳、祛痰、解痉、平喘等对症支持治疗。经验性使用β-内酰胺类+大环内酯类抗生素联合治疗,同时连续2次送检痰细菌培养,如患者体温39.0℃以上,留取血细菌培养。随后根据细菌培养药敏试验结果再调整敏感的抗生素治疗。治疗组在以上治疗基础上服用复方清金化痰汤,水煎服,日1剂。两组均治疗10 d,对比两组疗效、中医证候积分、住院时间及日均费用。结果总有效率治疗组95.0%,对照组80.0%,比较差异有统计学意义(χ2=4.114,P<0.05)。治疗后治疗组咳嗽、痰量、痰质、舌质、舌苔、脉评分[(1.32±0.21)、(0.45±0.21)、(1.63±0.35)、(1.51±0.24)、(0.19±0.15)、(0.20±0.16)分]与对照组[(1.44±0.27)、(0.58±0.30)、(1.81±0.39)、(1.65±0.26)、(0.27±0.17)、(0.29±0.18)分]比较差异均有统计学意义(t=2.219、2.245、2.172、2.502、2.232、2.364,均P<0.05)。治疗组住院时间及日均住院费用[(11.8±4.6)d、(626.3±23.4)元/d]均少于对照组[(14.3±5.5)d、(711.8±35.6)元/d],比较差异均有统计学意义(t=2.205、12.693,均P<0.05)。结论中西医结合治疗老年风温肺热病痰热壅肺证疗效确切,在中医症状改善方面有明显优势,能够加快患者恢复,降低医疗费用及缩短住院时间,值得临床推广应用。
Abstract： Objective To observe the clinical efficacy of combined traditional Chinese and western medicine in treating lung heat in the elderly due to wind-warmth（pattern of phlegm-heat obstructing the lung）.nethods Form October 2011 to October 2013,80 senile patients meeting the inclusion criteria of lung heat due to wind-warmth（pattern of phlegm-heat obstructing lung）were ran- domly divided into treatment group and Control group,each containing 40 patients.Oxygen inhalation therapy and monitoring vital signs were given to all patients as well as symptomatic treatment,such as antitussive,antiexpectorant,antispasmodic and anti-asth-matic management.Beta-lactam antibiotics were empirically used with macrolides antibiotics,meanwhile sputum bacterial culture was conducted for two consecutive times.If the patient had a temperature over 39.0℃,blood should be collected for bacterial cul-ture.Sensitive antibiotics were adjusted according to the results of antimicrobial susceptibility testing.Oral compound Qingjin Hu-atan decoction was given to treatment group in addition,one dose daily.Both groups were treated for 10 days,and then were com-pared for clinical efficacy,scores of TCM symptoms,hospital stay and average daily cost.Results The total effective rate was 95.0% in treatment group and 80.0% in control group,the difference in two groups was statistically siguificant（X^2=4.114,P〈0.05）. After treatment,scores of cough,sputum volume,sputum consistency,tongue,tongue coating,pulse were （1.32 ± 0.21）,（0.45 ± 0.21）, （1.63 ± 0.35）,（1.51 ± 0.24）,（0.19 ± 0.15）,and （0.20 ± O.16）respectively in treatment group,which were significantly different from those in control group[（1.44 ± 0.27）,（0.58 ± 0.30）,（1.81 ± 0.39）,（1.65 ± 0.26）,（0.27 ± 0.17）,（0.29 ± 0.18）]（t=2.219,2.245,2.172,2.502, 2.232,2.364,P〈0.05）.The average length of hospital stay and average daily cost Of hospital stay were （11.8 ± 4.6）d and （626.3 ± 23.4）yuan/d respectively in treatment group,which were significantly different from those in control group [（14.3 ± 5.5）d,（711.8 ± 35.6） yuan/d]（t=2.205,12.693,P〈0.05）.Conehtsion Combined traditional Chinese and western medicine for lung heat in the elderly due to wind-warmth（pattern of phlegm-heat obstructing the lung） is of potent efficacy and has obvious advantages in improving symptoms,promoting recovery,reducing medical costs and hospital stay,which is worth of further clinical application.
出处
《社区医学杂志》
2014年第3期23-26,共4页
Journal Of Community Medicine
关键词
中西医结合
清热宣肺化痰法
风温肺热病
痰热壅肺证
社区获得性肺炎
复方清金化痰汤
Combined traditional Chinese and western medicine
the method of clearing heat,diffusing the lung and dissolvingphlegm
Lung heat due to wind-warmth
Pattern of phlegm-heat obstructing the lung
Community-acquired pneumonia
CompoundQingjin Huatan decoction
