摘要
目的:观察耳穴压豆联合口服桑杏清肺汤治疗痰热壅肺型社区获得性肺炎(community-acquired pneumonia, CAP)患者的临床疗效与不良反应。方法:240例痰热壅肺型CAP患者随机平均分为对照组、耳穴组、模拟组、模拟联合组、联合组。对照组给予左氧氟沙星,其余4组均在对照组治疗基础上给予相应治疗:耳穴组给予胶布贴王不留行籽;模拟组给予胶布不贴王不留行籽;模拟联合组在模拟组的基础上给予口服桑杏清肺汤;联合组在耳穴组治疗基础上给予口服桑杏清肺汤。各组均治疗10 d,比较各组治疗前后的中医证候评分、影像CT评分及C-反应蛋白(C-reactive protein, CRP)、降钙素原(procalcitonin, PCT)及白细胞介素-6(interleukin-6,IL-6)水平。结果:治疗后,联合组有效率为95.83%、对照组为81.25%、耳穴组为87.5%、模拟组为83.33%、模拟联合组为89.58%,联合组的临床疗效优于其他4组(P<0.05)。治疗第3天,各组患者证候评分均显著低于治疗前,联合组中医证候评分显著低于其他各组,差异均有统计学意义(P<0.05);治疗第10天,各组患者证候评分均显著低于本组治疗第3天,耳穴压豆组、联合模拟组、联合组中医证候评分均显著低于对照组,联合组中医证候评分显著低于耳穴压豆组,差异均有统计学意义(P<0.05)。各组患者治疗后胸部CT评分均显著低于治疗前,耳穴压豆组、模拟联合组、联合组CT评分均显著低于对照组,联合组患者胸部CT评分显著低于其余4租,差异均有统计学意义(P<0.05)。治疗后,各组CRP、PCT、IL-6水平均显著低于治疗前,且联合组血清CRP、PCT、IL-6水平低于其他4组。结论:耳穴压豆联合桑杏清肺汤可降低痰热壅肺型CAP患者的中医证候评分及影像CT评分,降低血清CRP、PCT、IL-6水平,可明显改善症状体征,提高临床疗效。
Objective: To observe the clinical efficacy and side effects of pressing beans at ear acupoint combined with oral Sangxing Qingfei Decoction in the treatment of community-acquired pneumonia(CAP) with phlegm heat obstructing lung syndrome.Methods: 240 patients with phlegm heat obstructing lung syndrome were randomly divided into control group, ear acupoint group, simulation group, simulation combination group and combination group, with 48 patients in each group.The control group was given levofloxacin, and the other four groups were given corresponding treatment on the basis of the treatment of the control group: the auricular point group was given adhesive tape with wangbuliuxing seeds;the simulation group was given adhesive tape without Wang Buliuxing seeds;the simulated combined group was given Sangxing Qingfei Decoction on the basis of the simulated group;the combined group was treated with Sangxing Qingfei Decoction on the basis of ear acupoint group.All groups were treated for 10 days.The TCM syndrome score, image CT Score and the levels of C-reactive protein(CRP),procalcitonin(PCT) and interleukin-6(IL-6) were compared before and after treatment.Results: After treatment, the effective rates of the combined group were 95.83%,81.25% in the control group, 87.5% in the ear acupoint group, 83.33% in the simulation group and 89.58% in the simulation combined group.The clinical efficacy of the combined group was better than that of the other four groups(P<0.05).On the third day of treatment, the syndrome score of patients in each group was significantly lower than that before treatment, and the TCM syndrome score of the combined group was significantly lower than that of other groups(P<0.05);on the 10 th day of treatment, the syndrome score of patients in each group was significantly lower than that on the 3 rd day of treatment, the TCM syndrome score of pressing beans at ear acupoint group, combined simulation group and combined group was significantly lower than that of the control group, and the TCM syndrome score of combined group was significantly lower than that of pressing beans at ear acupoint group(P<0.05).After treatment, the chest CT scores of patients in each group were significantly lower than those before treatment.The CT scores of pressing beans at ear acupoint group, simulated combined group and combined group were significantly lower than those in the control group.The chest CT scores of patients in combined group were significantly lower than those in the other four groups(P<0.05).After treatment, the levels of CRP,PCT and IL-6 in each group were significantly lower than those before treatment, and the levels of serum CRP,PCT and IL-6 in the combined group were lower than those in the other four groups.Conclusion: Pressing beans at ear acupoint combined with oral Sangxing Qingfei Decoction can reduce the TCM syndrome score and image CT Score of patients with phlegm heat obstructing lung syndrome, reduce the levels of CRP,PCT and IL-6 in serum, significantly improve the symptoms and signs and improve the clinical curative effect.
作者
孟泳
MENG Yong(The Second Hospital Affiliated to Henan University of Chinese Medicine/Henan Hospital of Chinese Medicine,Zhengzhou Henan China 450002)
出处
《中医学报》
CAS
2022年第3期620-626,共7页
Acta Chinese Medicine
基金
河南省中医药科学研究专项课题资助项目(2018 JDZX025)。
关键词
社区获得性肺炎
耳穴压豆
桑杏清肺汤
痰热壅肺证
community-acquired pneumonia
pressing beans at ear acupoint
Sangxing Qingfei Decoction
phlegm heat obstructing lung syndrome
