摘要
目的评价自拟化痰方贴敷结合西医常规疗法治疗重症肺炎痰浊阻肺证的临床疗效。方法随机对照试验设计。选择2020年7月-2021年12月本院114例重症肺炎痰浊阻肺证患者为观察对象,采用随机数字表法分为2组,每组57例。在西医常规治疗基础上,治疗组贴敷自拟化痰方,对照组贴敷安慰剂。2组均连续贴敷5 d。分别于治疗前后进行中医证候评分,采用序贯器官衰竭评分(SOFA)、急性生理和慢性健康状况评分Ⅱ(APACHEⅡ)评估疾病严重程度,采用全自动血液分析仪检测WBC、降钙素原(PCT)水平,ELISA法检测血清CRP、IL-6水平,记录治疗期间的不良反应,评价临床疗效。结果治疗组总有效率为92.98%(53/57)、对照组为70.18%(40/57),2组比较差异有统计学意义(χ^(2)=9.87,P=0.002)。治疗后,治疗组发热、神昏、咳嗽咳痰、恶心呕吐、舌象、脉象评分及总分低于对照组(t值分别为8.95、7.30、6.93、7.37、12.02、12.59、14.29,P<0.01);SOFA评分[(18.12±3.55)分比(21.46±3.58)分,t=5.00]、APACHEⅡ评分[(13.39±2.72)分比(16.52±3.13)分,t=5.70]低于对照组(P<0.01);WBC[(11.12±1.61)×10^(9)/L比(12.69±1.82)×10^(9)/L,t=4.88]、PCT[(3.72±0.81)μg/L比(5.19±0.92)μg/L,t=9.05]水平及血清CRP[(62.09±11.41)mg/L比(91.77±15.54)mg/L,t=11.62]、IL-6[(193.14±32.28)ng/L比(235.68±38.75)ng/L,t=6.37]水平低于对照组(P<0.01)。治疗期间2组均未见明显不良反应。结论自拟化痰方贴敷结合西医常规疗法可明显改善重症肺炎痰浊阻肺证患者的临床症状,抑制炎症反应,有效缓解患者病情,改善预后,且用药安全。
Objective To evaluate the clinical efficacy of external therapy with self-made Huatan Prescription combined with conventional western medicine therapy in the treatment of severe pneumonia of phlegm turbidity obstructing lung.Methods Randomized controlled trial.A total of 114 patients with severe pneumonia of phlegm turbidity obstructing lung in the hospital between July 2020 and December 2021 were enrolled in this study.The patients were divided into two groups by the random number table method,with 57 in each group.On the basis of conventional western medicine therapy,the treatment group was given external therapy of self-made Huatan Prescription,and the control group was given the placebo.Both groups were applied continuously for 5 days.The TCM syndromes were scored before and after treatment.The disease severity was evaluated by Sequential Organ Failure Assessment(SOFA)and Acute Physiology and Chronic Health EvaluationⅡ(APACHEⅡ).The levels of WBC and procalcitonin(PCT)were detected by automatic blood analyzer.The levels of serum CRP and IL-6 were detected by ELISA.The adverse reactions during treatment were recorded and the clinical efficacy was evaluated.Results After treatment,the total respinse rate was 92.98%(53/57)in treatment group and was 70.18%(40/57)in control group(χ^(2)=9.87,P=0.002).The scores of fever,unconsciousness,cough and expectoration,nausea and vomiting,tongue coating and pulse and total score in treatment group were significantly lower than those in the control group(t=8.95,7.30,6.93,7.37,12.02,12.59,14.29,P<0.01).SOFA(18.12±3.55 vs.21.46±3.58,t=5.00)and APACHEⅡ(13.39±2.72 vs.16.52±3.13,t=5.70)in treatment group were significantly lower than those in the control group(P<0.01).The levels of WBC[(11.12±1.61)×10^(9)/L vs.(12.69±1.82)×10^(9)/L,t=4.88],PCT[(3.72±0.81)μg/L vs.(5.19±0.92)μg/L,t=9.05],serum CRP[(62.09±11.41)mg/L vs.(91.77±15.54)mg/L,t=11.62]and IL-6[(193.14±32.28)ng/L vs.(235.68±38.75)ng/L,t=6.37]in treatment group were significantly lower than those in the control group(P<0.01).During treatment,there were no obvious adverse reactions in both groups.Conclusion Self-made Huatan Prescription external therapy combined with conventional western medicine therapy can improve the clinical symptoms,inhibit the inflammatory response,relieve the disease condition and improve the prognosis of patients with severe pneumonia of phlegm turbidity obstructing lung safely.
作者
唐林
周松晶
黎宗宝
Tang Lin;Zhou Songjing;Li Zongbao(Department of Traditional Chinese Medicine,Hainan Provincial People's Hospital,Hainan Hospital Affiliated Hainan Medical University,Haikou 570311,China;Emergency Center,Hainan Provincial People's Hospital,Hainan Hospital Affiliated Hainan Medical University,Haikou 570311,China)
出处
《国际中医中药杂志》
2023年第5期553-557,共5页
International Journal of Traditional Chinese Medicine
基金
2021年度海南省卫生健康行业科研项目(21A200295)。
关键词
肺炎
痰浊阻肺
自拟化痰方
穴位贴敷疗法
Pneumonia
Turbid phlegm obstructing lung
self-made Huatan prescription
Acupoint sticking therapy
