摘要
目的观察中西医结合治疗社区获得性肺炎(CAP)延迟吸收的临床疗效。方法36例社区获得性肺炎延迟吸收患者,根据病情严重程度,分别予以继续抗感染加中医药治疗或单纯中医药治疗的方式。中医药治疗,结合《社区获得性肺炎中医诊疗指南》,根据症状、舌象、脉象进行证型分组。风热袭肺组1例,采用银翘散加减;外寒内热组1例,采用麻杏石甘汤加减;痰热壅肺组14例,自拟清热化痰方;痰湿阻肺5例,自拟化饮清肺方;肺脾气虚2例,采用参苓白术散加减;气阴两虚13例,自拟加味屏风饮。所有患者均在以上组方基础上酌情加入活血化瘀类药物。结果36例中,痊愈8例,显效22例,有效2例,无效4例,总有效率88.89%。结论(1)中医认为导致社区获得性肺炎患者出现延迟吸收的主要原因:瘀血阻滞、痰热化毒、气阴两虚、风邪内动,采用中西医结合的方法治疗社区获得性肺炎延迟吸收疗效确切。(2)发现易出现社区获得性肺炎延迟吸收患者基本特征:高龄,基础疾病病史,尤以呼吸系统疾病、肾脏疾病、中枢神经系统疾病、肿瘤性疾病最为著,胸部CT表现为多肺叶浸润伴肺结构破坏,凝血指标异常,临床工作中对此类患者予预防性中药治疗,对防止CAP延迟吸收的出现,取得了一定临床意义。
Objective To observe the clinical effect of combined traditional Chinese and western medicine in the treatment of delayed absorption of community acquired pneumonia.Method According to the severity of the disease,36 patients with delayed absorption of community acquired pneumonia were treated with continuous anti infection and traditional Chinese medicine or traditional Chinese medicine alone.TCM treatment,combined with Guidelines for TCM Diagnosis and Treatment of Community Acquired Pneumonia,is divided into syndrome types according to symptoms,tongue conditions and pulse conditions.One case in the wind-heat attacking lung group was treated with Yinqiao Powder(银翘散).One case in the external cold and internal heat group was treated with Maxing Shigan Decoction(麻杏石甘汤).Fourteen cases in the phlegm-heat stagnating lung group were treated with Self-made Qingre Huatan Formula(自拟清热化痰方).Phlegm-dampness obstructing lung in 5 cases which were treated with Self-made Huayin Qingfei Formula(自拟化饮清肺方).Two cases of lung and spleen Qi deficiency were treated with Shenling Baizhu Powder(参苓白术散).Thirteen patients suffered from deficiency of both Qi and Yin were treated with Self-made Modified Pingfeng Drink(自拟加味屏风饮).All patients were added blood activating and stasis removing drugs according to the above prescriptions.Result The 36 cases,8 were cured,22 were significant effective,2 were effective and 4 were ineffective.The total effective rate was 88.8%.Conclusion(1)Traditional Chinese medicine believes that the main reasons for delayed absorption of patients with community acquired pneumonia are blood stasis,phlegm-heat transforming toxin,deficiency of both Qi and Yin,and internal movement of wind evil.It is effective to treat delayed absorption of community acquired pneumonia by combining traditional Chinese medicine with western medicine.(2)It was found that the basic characteristics of patients prone to delayed absorption of community acquired pneumonia were old age,basic disease history,especially respiratory diseases,kidney diseases,central nervous system diseases and tumor diseases.Chest CT showed multi lobar infiltration with destruction of lung structure,and abnormal blood coagulation indicators.Preventive traditional Chinese medicine treatment for such patients in clinical work has achieved certain clinical significance in preventing the occurrence of delayed absorption of community acquired pneumonia.
作者
胡晶
卢星
HU Jing;LU Xing(Jinan Hospital of Integrated Traditional Chinese and Western Medicine,Jinan 271100,Shandong,China)
出处
《实用中医内科杂志》
2022年第11期127-129,共3页
Journal of Practical Traditional Chinese Internal Medicine
基金
山东省中医药管理局基金(2021Q062)。
关键词
社区获得性肺炎
延迟吸收
中西医结合治疗
community acquired pneumonia
delayed absorption
traditional Chinese and western medicine
