摘要
目的探讨以宣闭解毒化瘀法治疗重症支原体肺炎毒热闭肺证的临床疗效。方法收集2019年1月—2021年12月于北京儿童医院住院治疗的重症支原体肺炎患者200例,按随机数字表法分为2组,治疗组、对照组各100例。对照组予以西医常规治疗,总疗程10~14 d;治疗组在西医治疗基础上联合宣闭解毒化瘀法治疗,西医治疗用药和疗程同对照组,中药治疗总疗程为6周。比较2组疗效,热退、咳嗽、喘息以及肺部啰音消失时间,治疗前后D-二聚体、乳酸脱氢酶(LDH),病灶吸收情况,肺不张、闭塞性支气管炎、胃肠功能紊乱的发生率。结果治疗1周,治疗组的临床显效率高于对照组(P=0.029);治疗4周,治疗组临床治愈率、显效率均高于对照组,但差异无统计学意义(P>0.05);12周时治疗组临床治愈率高于对照组(P=0.009)。治疗组热退时间、咳嗽消失时间和肺部啰音消失时间短于对照组(P<0.05),2组喘息消失时间比较差异无统计学意义(P>0.05);治疗1周,2组D-二聚体、LDH水平均较治疗前降低(P<0.05),且治疗组D-二聚体水平低于对照组(P<0.05),2组LDH水平比较差异无统计学意义(P>0.05);治疗组病灶完全吸收率较对照组高(P<0.05);治疗组肺不张、闭塞性支气管炎、胃肠功能紊乱发生率低于对照组(P<0.05)。结论中西医结合治疗重症支原体肺炎,可显著改善患儿临床症状,效果优于单纯西医治疗。
Objective To explore the clinical efficacy of the method of removing obstruction,clearing away toxin and removing blood stasis in the treatment of severe mycoplasma pneumonia with the syndrome of toxic heat obstructing the lung.Methods A total of 200 patients with severe mycoplasma pneumonia who were hospitalized in Beijing Children's Hospital from January 2019 to December 2021 were enrolled and divided into treatment group and control group of 100 cases in each one according to random number table method.The control group was treated with conventional western medicine for 10-14 days as total courses,and the treatment group was treated with traditional Chinese medicine by stages on the basis of western medicine.The curative effect,time of fever,cough,wheezing and lung rales disappearing,D-dimer,lactate dehydrogenase(LDH),lesion absorption,incidence of atelectasis,obstructive bronchitis and gastrointestinal dysfunction before and after treatment were compared between the two groups.Results After one week of treatment,the clinical effective rate in the treatment group was higher than that in the control group(P=0.029).After 4 weeks of treatment,the clinical cure rate and effective rate of the treatment group were higher than those of the control group,but the difference was not statistically significant(P>0.05);during the 12-week follow-up,the clinical cure rate of the treatment group was higher than that of the control group(P=0.009).Compared with the control group,the disappearance time of fever,cough and pulmonary rales in the treatment group was significantly shortened(P<0.05).There was no significant difference in disappearance time of wheezing between the two groups(P>0.05).After one week of treatment,the level of D-dimer and LDH was significantly decreased(P<0.05),and the level of D-dimer in the treatment group was lower than that in the control group(P<0.05),and there was no significant difference in LDH level between the two groups(P>0.05).The complete absorption rate of lesions in the treatment group was higher than that in the control group(P<0.05).The incidence of atelectasis,obliterative bronchitis,and gastrointestinal dysfunction was significantly reduced(P<0.05).Conclusion The treatment of severe mycoplasma pneumonia with integrated traditional Chinese and western medicine has obvious advantages in promoting the relief of clinical symptoms with better effect than western medicine only.
作者
曹童童
李亚男
胡艳
郝静
CAO Tong-tong;LI Ya-nan;HU Yan;HAO Jing(Department of Traditional Chinese Medicine,Beijing Children's Hospital,Capital Medical University,National Center for Children's Health,Beijing 100045,China)
出处
《北京中医药》
2023年第3期243-247,共5页
Beijing Journal of Traditional Chinese Medicine
基金
国家自然科学基金青年基金项目(81900004)。
关键词
重症支原体肺炎
儿童
中西医结合
毒热闭肺证
severe mycoplasma pneumonia in children
integrated traditional Chinese and western medicine
toxic heat obstructing lung syndrome
