白虎汤加减联合针灸治疗痰热腑实型卒中相关性肺炎的临床疗效以及对血清炎症因子的影响
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摘要
目的:研究白虎汤加减联合针灸治疗痰热腑实型卒中相关性肺炎的临床疗效,并分析其对血清炎症因子水平的影响。方法:将2016年2月—2018年2月期间本院收治的痰热腑实型卒中相关性肺炎患者108例随机分成观察组与对照组,对照组采用抗生素治疗,观察组在对照组基础上联合白虎汤加减、针灸治疗。比较两组的临床疗效、症状缓解时间以及血清炎症因子水平。结果:观察组与对照组治疗后的临床总有效率分别为88. 89%以及73. 47%,观察组明显的高于对照组;观察组患者的退热时间、咳嗽缓解时间、肺部啰音消失时间以及住院时间均明显的短于对照组;治疗后,观察组的血清IL-6、TNF-α以及CRP水平显著的低于对照组;比较差异均具有显著性(P <0. 05)。结论:白虎汤加减联合针灸治疗卒中相关性肺炎促进了病情缓解,提高了临床疗效,降低了机体炎症反应,安全性好。
Objective: To study the clinical efficacy of Baihu Decoction combined with acupuncture and moxibustion in the treatment of phlegm-heat syndrome of stroke-associated pneumonia and analyze its effect on serum inflammatory factors. Methods: A total of 108 patients with phlegm-heat syndrome of stroke-associated pneumonia treated in our hospital from February2016 to February 2018 were randomly divided into observation group and control group. The control group was treated with antibiotics. The observation group was combined with Baihu Decoction and acupuncture and moxibustion on the basis of the control group. The clinical efficacy,symptom relief time and serum inflammatory factors were compared between the two groups. Results:The total clinical effective rate of the observation group and control group after treatment was 88. 89% and 73. 47%,respectively,which was significantly higher in the observation group than that in the control group. The time of fever withdrawal,cough remission,lung voice disappearance and hospital stay were observed in the observation group. All of them were significantly shorter than those of the control group. After treatment,serum IL-6,TNF-α and CRP levels in the observation group were significantly lower than those in the control group. The differences were all significant( P < 0. 05). Conclusion: Baihu Decoction and acupuncture and moxibustion of phlegm-heat syndrome of stroke-associated pneumonia promoted the remission of the disease,improved the clinical efficacy,reduced the body's inflammatory response and had good safety.
Objective: To study the clinical efficacy of Baihu Decoction combined with acupuncture and moxibustion in the treatment of phlegm-heat syndrome of stroke-associated pneumonia and analyze its effect on serum inflammatory factors. Methods: A total of 108 patients with phlegm-heat syndrome of stroke-associated pneumonia treated in our hospital from February2016 to February 2018 were randomly divided into observation group and control group. The control group was treated with antibiotics. The observation group was combined with Baihu Decoction and acupuncture and moxibustion on the basis of the control group. The clinical efficacy,symptom relief time and serum inflammatory factors were compared between the two groups. Results:The total clinical effective rate of the observation group and control group after treatment was 88. 89% and 73. 47%,respectively,which was significantly higher in the observation group than that in the control group. The time of fever withdrawal,cough remission,lung voice disappearance and hospital stay were observed in the observation group. All of them were significantly shorter than those of the control group. After treatment,serum IL-6,TNF-α and CRP levels in the observation group were significantly lower than those in the control group. The differences were all significant( P < 0. 05). Conclusion: Baihu Decoction and acupuncture and moxibustion of phlegm-heat syndrome of stroke-associated pneumonia promoted the remission of the disease,improved the clinical efficacy,reduced the body's inflammatory response and had good safety.
引文
[1]郭欢.半夏厚朴汤加减治疗卒中相关性肺炎的临床观察[J].中国中医急症,2016,25(7):1447-1449.
[2]Westendorp WF,Nederkoorn PJ,Vermeij JD,et al. Post-stroke infection:a systematic review and meta-analysis[J]. BMC Neurol,2011,11:110.
[3]张淑霞,潘晓华,刘国荣,等.卒中相关性肺炎的发病机制及预测因素的研究进展[J].医学综述,2016,22(23):4637-4640.
[4]Craig J. Smith,Amit K. Kishore,Andy Vail,等.卒中相关性肺炎的诊断卒中肺炎共识小组的推荐意见[J].国际脑血管病杂志,2016,24(2):97-102.
[5]崔颖.老年急性缺血性卒中相关性肺炎的易患因素及其对预后的影响[J].浙江医学,2017,39(13):1116-1117.
[6]熊昕,杨健,翁栩,等.清金化痰汤对卒中相关性肺炎高危病人的预防作用研究[J].中西医结合心脑血管病杂志,2017,15(4):479-480.
[7]黄璐,张月娟,廖若夷,等.中医药辅助治疗卒中相关性肺炎的Meta分析[J].湖南中医药大学学报,2016,36(1):81-84.
[8]中华神经科学会中华神经外科学会.各类脑血管疾病诊断要点[J].中华神经科杂志,1996,29(6):379-381.
[9]卒中相关性肺炎诊治中国专家共识组.卒中相关性肺炎诊治中国专家共识[J].中华内科杂志,2010,49(12):1075-1079.
[10]国家中医药管理局.中医病症诊断疗效标准[M].南京:南京大学出版社,1994:1-2.
[11]陈晓彬.预防性抗生素治疗对急性缺血性卒中病人肺炎发病率的影响[J].中西医结合心脑血管病杂志,2016,14(24):2964-2966.
[12]史凤磊,周震,孙丽双.芩芍颗粒雾化治疗卒中相关性肺炎疗效观察[J].中国急救医学,2016,36(1):191-192.
[13]李唯溱,王凌飞,赵颖.合用千金苇茎汤治疗脑卒中相关性肺感染32例[J].天津中医药,2017,34(6):398-399.
[14]李春华,樊红杰,王家玉.自拟清肺汤治疗卒中相关性肺炎疗效观察[J].现代中西医结合杂志,2016,25(24):2714-2716.
[15]张丽娜,孙波.清金化痰汤对于卒中相关性肺炎的疗效、白细胞计数及C反应蛋白的影响[J].长春中医药大学学报,2017,33(3):425-427.
[16]焦玉娟,孙培军,张连勇.自拟温阳化痰通络汤治疗卒中相关性肺炎(阳虚痰瘀阻络证)的临床观察[J].中国中医急症,2017,26(5):863-865.
[17]郭欢.半夏厚朴汤加减治疗卒中相关性肺炎的临床观察[J].中国中医急症,2016,25(7):1447-1449.
[18]张丽娜,孙波.清金化痰汤对于卒中相关性肺炎的疗效、白细胞计数及C反应蛋白的影响[J].长春中医药大学学报,2017,33(3):425-427.
[19]刘秋红,张杰文,杨景瑞.老年卒中相关性肺炎患者外周血T淋巴细胞亚群及血清炎症因子变化的临床分析[J].中国实用神经疾病杂志,2016,19(8):34-35.
[20]李亚宁.化痰通腑汤治疗卒中相关性肺炎疗效及对CRP、TNF-α及RAGE的影响[J].现代西医结合杂志,2017,26(20):2237-2240.
[2]Westendorp WF,Nederkoorn PJ,Vermeij JD,et al. Post-stroke infection:a systematic review and meta-analysis[J]. BMC Neurol,2011,11:110.
[3]张淑霞,潘晓华,刘国荣,等.卒中相关性肺炎的发病机制及预测因素的研究进展[J].医学综述,2016,22(23):4637-4640.
[4]Craig J. Smith,Amit K. Kishore,Andy Vail,等.卒中相关性肺炎的诊断卒中肺炎共识小组的推荐意见[J].国际脑血管病杂志,2016,24(2):97-102.
[5]崔颖.老年急性缺血性卒中相关性肺炎的易患因素及其对预后的影响[J].浙江医学,2017,39(13):1116-1117.
[6]熊昕,杨健,翁栩,等.清金化痰汤对卒中相关性肺炎高危病人的预防作用研究[J].中西医结合心脑血管病杂志,2017,15(4):479-480.
[7]黄璐,张月娟,廖若夷,等.中医药辅助治疗卒中相关性肺炎的Meta分析[J].湖南中医药大学学报,2016,36(1):81-84.
[8]中华神经科学会中华神经外科学会.各类脑血管疾病诊断要点[J].中华神经科杂志,1996,29(6):379-381.
[9]卒中相关性肺炎诊治中国专家共识组.卒中相关性肺炎诊治中国专家共识[J].中华内科杂志,2010,49(12):1075-1079.
[10]国家中医药管理局.中医病症诊断疗效标准[M].南京:南京大学出版社,1994:1-2.
[11]陈晓彬.预防性抗生素治疗对急性缺血性卒中病人肺炎发病率的影响[J].中西医结合心脑血管病杂志,2016,14(24):2964-2966.
[12]史凤磊,周震,孙丽双.芩芍颗粒雾化治疗卒中相关性肺炎疗效观察[J].中国急救医学,2016,36(1):191-192.
[13]李唯溱,王凌飞,赵颖.合用千金苇茎汤治疗脑卒中相关性肺感染32例[J].天津中医药,2017,34(6):398-399.
[14]李春华,樊红杰,王家玉.自拟清肺汤治疗卒中相关性肺炎疗效观察[J].现代中西医结合杂志,2016,25(24):2714-2716.
[15]张丽娜,孙波.清金化痰汤对于卒中相关性肺炎的疗效、白细胞计数及C反应蛋白的影响[J].长春中医药大学学报,2017,33(3):425-427.
[16]焦玉娟,孙培军,张连勇.自拟温阳化痰通络汤治疗卒中相关性肺炎(阳虚痰瘀阻络证)的临床观察[J].中国中医急症,2017,26(5):863-865.
[17]郭欢.半夏厚朴汤加减治疗卒中相关性肺炎的临床观察[J].中国中医急症,2016,25(7):1447-1449.
[18]张丽娜,孙波.清金化痰汤对于卒中相关性肺炎的疗效、白细胞计数及C反应蛋白的影响[J].长春中医药大学学报,2017,33(3):425-427.
[19]刘秋红,张杰文,杨景瑞.老年卒中相关性肺炎患者外周血T淋巴细胞亚群及血清炎症因子变化的临床分析[J].中国实用神经疾病杂志,2016,19(8):34-35.
[20]李亚宁.化痰通腑汤治疗卒中相关性肺炎疗效及对CRP、TNF-α及RAGE的影响[J].现代西医结合杂志,2017,26(20):2237-2240.