蒿芩清胆汤治疗儿童社区获得性肺炎(湿热内闭证)临床研究
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摘要
目的观察蒿芩清胆汤治疗儿童社区获得性肺炎(湿热内闭证)的临床疗效。方法将112例社区获得性肺炎(湿热内闭证)患儿随机分为对照组和治疗组各56例,对照组给予常规西医治疗,治疗组在对照组常规西医治疗的基础上加用蒿芩清胆汤口服。比较两组的临床疗效、中医证候积分、起效时间及超敏C反应蛋白(hs-CRP)、白细胞计数(WBC)、降钙素原(PCT)的水平。结果治疗后,治疗组的总有效率为98.21%,明显高于对照组的89.29%(P <0.05);两组治疗后中医证候积分、hs-CRP、WBC、PCT水平均较治疗前降低,且治疗组的改善程度优于对照组。同时治疗组平均住院天数、体温恢复正常时间、咳嗽消失时间、肺部阴影消失时间短于对照组,差异均具有统计学意义(均P <0.05)。结论蒿芩清胆汤治疗儿童社区获得性肺炎(湿热内闭证)可以提高临床疗效,改善症状,抑制炎症反应。
Objective: To observe the clinical efficacy of Haoqin Qingdan Decoction on children with community acquired pneumonia of damp-heat syndrome. Methods: 112 patients were randomly divided into the control group and the treatment group,56 cases in each. The control group was treated with conventional Western medicine,and the treatment group was treated with Haoqin Qingdan Decoction on that basis. The clinical effect,TCM syndrome scores,onset time,hypersensitive C-reactive protein(hs-CRP),leukocyte count(WBC) and procalcitonin(PCT) were compared between the two groups. Results: After treatment,the clinical efficacy of the treatment group(98.21%) was significantly higher than that of the control group(89.29%)(P < 0.05). TCM syndrome scores,levels of hs-CRP,WBC and PCT were lower than those before treatment(P < 0.05),and the improvement of the treatment group was better than that of the control group(P < 0.05). Meanwhile,some indices of the treatment group were shorter than those of the control group including the hospitalization time,the temperature recovery time,the cough disappearance time and the pulmonary shadow disappearance time(all P < 0.05). Conclusion: Haoqin Qingdan Decoction can improve the clinical efficacy and symptoms,and inhibit inflammatory reaction in children with community acquired pneumonia of damp-heat syndrome.
Objective: To observe the clinical efficacy of Haoqin Qingdan Decoction on children with community acquired pneumonia of damp-heat syndrome. Methods: 112 patients were randomly divided into the control group and the treatment group,56 cases in each. The control group was treated with conventional Western medicine,and the treatment group was treated with Haoqin Qingdan Decoction on that basis. The clinical effect,TCM syndrome scores,onset time,hypersensitive C-reactive protein(hs-CRP),leukocyte count(WBC) and procalcitonin(PCT) were compared between the two groups. Results: After treatment,the clinical efficacy of the treatment group(98.21%) was significantly higher than that of the control group(89.29%)(P < 0.05). TCM syndrome scores,levels of hs-CRP,WBC and PCT were lower than those before treatment(P < 0.05),and the improvement of the treatment group was better than that of the control group(P < 0.05). Meanwhile,some indices of the treatment group were shorter than those of the control group including the hospitalization time,the temperature recovery time,the cough disappearance time and the pulmonary shadow disappearance time(all P < 0.05). Conclusion: Haoqin Qingdan Decoction can improve the clinical efficacy and symptoms,and inhibit inflammatory reaction in children with community acquired pneumonia of damp-heat syndrome.
引文
[1]中华医学会儿科学分会呼吸学组.儿童社区获得性肺炎管理指南(2013修订)(上)[J].中华儿科杂志,2013,51(10):745-752.
[2]沈晓明,王卫平.儿科学[M].北京:人民卫生出版社,2008:272.
[3] Rudan I,EI Arifeen S,Bhutta ZA,et al. Setting research priorities to reduce global mortality from childhood diarrhoea by2015[J]. PloS Med,2011,8(9):e100109.
[3]廖莉,文香,李芹,等.单一和二联抗菌药物治疗小儿社区获得性肺炎效果观察[J].中国综合临床,2013,29(9):994-997.
[4]中华医学会呼吸病学分会.社区获得性肺炎诊断和治疗指南(草案)[J].中华结合呼吸杂志,1999,12(4):199.
[5] Rudan,Igor,Tomaskovic,et al. Global estimate of the incidence of clinical pneumonia among children under five years of age[J]. Bulletin of the World Health Organization,2004,82(12):895-903.
[6]刘轶,张兰豫,孟作龙,等. 5岁以下儿童社区获得性肺炎住院病例疾病负担调查分析[J].中国妇幼保健,2016,31(4):810-811.
[7] Li A,Newall AT,Britt H,et al. The cost and disease burden of pneumonia in general practice in Australia[J]. Vaccine,2012,30(5):830-831.
[8]陆权,李昌崇.再论儿童社区获得性肺炎[J].中华儿科杂志,2013,51(10):721-723.
[9]王雪峰,董丹,虞坚尔,等.儿童肺炎常见病原学分析及中医证候演变规律的多中心随机双盲安慰剂对照试验研究[J].中国循证儿科杂志,2006,1(3):170-176.
[10]何廉儒,王琦,梁若冰.中西医结合治疗小儿支气管肺炎[J].中国实验方剂学杂志,2013,19(18):318-319.
[11]中华医学会儿科学分会呼吸学组.儿童社区获得性肺炎管理指南(2013修订)(下)[J].中华儿科杂志,2013,51(11):856-862.
[12]中华人民共和国卫生部.中药新药临床研究指导原则(试行)[M].北京:中国医药科技出版社,2002.
[13]王力宁,王雪峰,原晓风,等.中医药治疗儿童肺炎喘嗽风热闭肺证、痰热闭肺证临床验证方案的多中心随机对照研究[J].中国中西医结合儿科学,2010,2(5):386-391.
[14]张晓慧,李光韬,张卓莉. C反应蛋白与超敏C反应蛋白的检测及其临床意义[J].中华临床免疫和变态反应杂志,2011,5(1):74-79.
[15] Niederman MS. Biological markers to determine eligibility in trialsfor community-acquired pneumonia:a focus on procalcitonin[J]. Clin Infect Dis,2008,47(Suppl 3):S127-132.
[16] Hatzistilianou M. Diagnostic and prognostic role of procalcitonin ininfections[J]. Scientific World Journal,2010,10:1941-1946.
[17]王勇.浅析白细胞增多的临床意义[J].社区医学杂志,2011,9(20):9-10.
[18]廖若莎,许尤佳,胡彬文.儿童肺炎证候特点与中医分型关系的研究[J].浙江中医药大学学报,2009,33(3):323-325.
[19]李鹏.蒿芩清胆汤的免疫作用研究[J].中医研究,2004,17(5):22-23.
[20]卢志刚,韩雪梅.蒿芩清胆汤解热抗炎作用的实验研究[J].中华中医药学刊,2005,23(3):454-455.
[2]沈晓明,王卫平.儿科学[M].北京:人民卫生出版社,2008:272.
[3] Rudan I,EI Arifeen S,Bhutta ZA,et al. Setting research priorities to reduce global mortality from childhood diarrhoea by2015[J]. PloS Med,2011,8(9):e100109.
[3]廖莉,文香,李芹,等.单一和二联抗菌药物治疗小儿社区获得性肺炎效果观察[J].中国综合临床,2013,29(9):994-997.
[4]中华医学会呼吸病学分会.社区获得性肺炎诊断和治疗指南(草案)[J].中华结合呼吸杂志,1999,12(4):199.
[5] Rudan,Igor,Tomaskovic,et al. Global estimate of the incidence of clinical pneumonia among children under five years of age[J]. Bulletin of the World Health Organization,2004,82(12):895-903.
[6]刘轶,张兰豫,孟作龙,等. 5岁以下儿童社区获得性肺炎住院病例疾病负担调查分析[J].中国妇幼保健,2016,31(4):810-811.
[7] Li A,Newall AT,Britt H,et al. The cost and disease burden of pneumonia in general practice in Australia[J]. Vaccine,2012,30(5):830-831.
[8]陆权,李昌崇.再论儿童社区获得性肺炎[J].中华儿科杂志,2013,51(10):721-723.
[9]王雪峰,董丹,虞坚尔,等.儿童肺炎常见病原学分析及中医证候演变规律的多中心随机双盲安慰剂对照试验研究[J].中国循证儿科杂志,2006,1(3):170-176.
[10]何廉儒,王琦,梁若冰.中西医结合治疗小儿支气管肺炎[J].中国实验方剂学杂志,2013,19(18):318-319.
[11]中华医学会儿科学分会呼吸学组.儿童社区获得性肺炎管理指南(2013修订)(下)[J].中华儿科杂志,2013,51(11):856-862.
[12]中华人民共和国卫生部.中药新药临床研究指导原则(试行)[M].北京:中国医药科技出版社,2002.
[13]王力宁,王雪峰,原晓风,等.中医药治疗儿童肺炎喘嗽风热闭肺证、痰热闭肺证临床验证方案的多中心随机对照研究[J].中国中西医结合儿科学,2010,2(5):386-391.
[14]张晓慧,李光韬,张卓莉. C反应蛋白与超敏C反应蛋白的检测及其临床意义[J].中华临床免疫和变态反应杂志,2011,5(1):74-79.
[15] Niederman MS. Biological markers to determine eligibility in trialsfor community-acquired pneumonia:a focus on procalcitonin[J]. Clin Infect Dis,2008,47(Suppl 3):S127-132.
[16] Hatzistilianou M. Diagnostic and prognostic role of procalcitonin ininfections[J]. Scientific World Journal,2010,10:1941-1946.
[17]王勇.浅析白细胞增多的临床意义[J].社区医学杂志,2011,9(20):9-10.
[18]廖若莎,许尤佳,胡彬文.儿童肺炎证候特点与中医分型关系的研究[J].浙江中医药大学学报,2009,33(3):323-325.
[19]李鹏.蒿芩清胆汤的免疫作用研究[J].中医研究,2004,17(5):22-23.
[20]卢志刚,韩雪梅.蒿芩清胆汤解热抗炎作用的实验研究[J].中华中医药学刊,2005,23(3):454-455.