中药加神灯透皮佐治小儿迁延性肺炎临床观察
|
摘要
目的：通过中药加神灯透皮治疗与单纯常规治疗小儿迁延性肺炎的疗效比较，观察中药加神灯透皮佐治小儿迁延性肺炎的临床疗效，以利于临床推广。
方法：把符合纳入标准的患儿60例，采用随机分组形式，分为两组，治疗组30例，对照组30例。对照组：给予常规治疗，五天一疗程，一般观察2-3个疗程。
治疗组：常规治疗+中药加神灯透皮治疗，中药药物组成：蛤蚧一对、丹参、桃仁、大黄、刘寄奴、白芥子、冰片按一定比例，将上药研磨成细末，用生姜汁调成糊状，外敷于背部肩胛间区或肺部听诊湿罗音密集处或者辅助检查如影像学检查阴影明显处,外用神灯即特定电磁波治疗器照射（型号:龙泉牌LQ2008AH，立式单头TDP灯，电源220V，功率280W，频率50-60HZ，贵阳龙泉医疗器械有限公司）。0.5～3岁每次10-15min，4～6岁每次15-20min，7～14岁每次15-25min，每日1次。5天为1疗程。可观察2-3个疗程。
结果：对照组30例总有效率83.3%，治疗组30例，总有效率为96.7%，经过统计学分析后，两组对比具有显著性差异（P<0.05），结果表明：治疗组优于对照组。
结论：针对于小儿迁延性肺炎病程长，病情迁延，肺部炎症吸收慢的特点，在常规治疗基础上，将中医特色外治（中药透皮）与现代仪器（神灯特定电磁波治疗器）有机结合，加快肺部啰音吸收，在改善症状，缩短疗程等方面明显优于常规治疗（对照组）。本课题研究为临床提供了简洁、高效、安全的新型疗法，丰富及扩展了小儿迁移性肺炎的治疗手段，值得临床推广。
Purpose: By comparing the curative effect between Chinese medicine throughing skinwith the magic lamp and routine therapy in children with protracted pneumonia, we observethe clinical curative effect of Chinese medicine throughing skin with the magic lamp treatingpediatric protracted pneumonia in order to promote the therapy.
Method:60cases meeting the criteria were randomly divided into two groups: treatmentgroup of30cases and control group of the left30cases. Control group: give the routinetreatment, five days as a period, generally observe1-2periods.
The treatment group: conventional treatment+Chinese medicine with the magic lamptransdermal therapy,the composition of the Chinese traditional medicine: a pair of Gecko,salvia, peach, rhubarb, siphonostegia, mustard seed, borneol.Grind the medicine aboveaccording to a certain proportion into powder, mixed with Ginger juice into paste, apply inback shoulder district or the area of the lung auscultation of wet rales or obvious shadowplaces of the chest radiograph, the magic lamp was the thermal design power herapeuticequipment (model: longquan brand LQ2008AH, vertical single head TDP lamp,220V powersupply, power280W, frequency50-60hz, guiyang longquan medical equipment Co., LTD).1~3years old:10-15min each time,4~6years old:15to20min each time,7-14years:15-25min each time, once a day. Five days for a period of treatment. Observe1-2periods.
Result: the effective rate of the control group was83.3%, the effective rate of thetreatment group was96.7%, with a significant difference (P <0.05) of the statistical analysis,,the treatment group was more effective than control group.
Conclusion: The protracted pneumonia in children is characterised as longer duration,protracted illness and the slow absorption of the lung inflammation. According to thecharacteristics above, based on the routine treatments, combining the external treatment ofTCM (traditional Chinese medicine transdermal) with modern equipment (lamp-specificelectromagnetic therapy devices) could accelerate the absorption of pulmonary rales,andwould be much better than conventional treatment (control group) in improving the symptomsand shortening the course of treatment. This clinical study provides an efficient, simple andsafe new therapy, enriches the content of treatment of the protracted pneumonia in children, is worthy promotion.
方法：把符合纳入标准的患儿60例，采用随机分组形式，分为两组，治疗组30例，对照组30例。对照组：给予常规治疗，五天一疗程，一般观察2-3个疗程。
治疗组：常规治疗+中药加神灯透皮治疗，中药药物组成：蛤蚧一对、丹参、桃仁、大黄、刘寄奴、白芥子、冰片按一定比例，将上药研磨成细末，用生姜汁调成糊状，外敷于背部肩胛间区或肺部听诊湿罗音密集处或者辅助检查如影像学检查阴影明显处,外用神灯即特定电磁波治疗器照射（型号:龙泉牌LQ2008AH，立式单头TDP灯，电源220V，功率280W，频率50-60HZ，贵阳龙泉医疗器械有限公司）。0.5～3岁每次10-15min，4～6岁每次15-20min，7～14岁每次15-25min，每日1次。5天为1疗程。可观察2-3个疗程。
结果：对照组30例总有效率83.3%，治疗组30例，总有效率为96.7%，经过统计学分析后，两组对比具有显著性差异（P<0.05），结果表明：治疗组优于对照组。
结论：针对于小儿迁延性肺炎病程长，病情迁延，肺部炎症吸收慢的特点，在常规治疗基础上，将中医特色外治（中药透皮）与现代仪器（神灯特定电磁波治疗器）有机结合，加快肺部啰音吸收，在改善症状，缩短疗程等方面明显优于常规治疗（对照组）。本课题研究为临床提供了简洁、高效、安全的新型疗法，丰富及扩展了小儿迁移性肺炎的治疗手段，值得临床推广。
Purpose: By comparing the curative effect between Chinese medicine throughing skinwith the magic lamp and routine therapy in children with protracted pneumonia, we observethe clinical curative effect of Chinese medicine throughing skin with the magic lamp treatingpediatric protracted pneumonia in order to promote the therapy.
Method:60cases meeting the criteria were randomly divided into two groups: treatmentgroup of30cases and control group of the left30cases. Control group: give the routinetreatment, five days as a period, generally observe1-2periods.
The treatment group: conventional treatment+Chinese medicine with the magic lamptransdermal therapy,the composition of the Chinese traditional medicine: a pair of Gecko,salvia, peach, rhubarb, siphonostegia, mustard seed, borneol.Grind the medicine aboveaccording to a certain proportion into powder, mixed with Ginger juice into paste, apply inback shoulder district or the area of the lung auscultation of wet rales or obvious shadowplaces of the chest radiograph, the magic lamp was the thermal design power herapeuticequipment (model: longquan brand LQ2008AH, vertical single head TDP lamp,220V powersupply, power280W, frequency50-60hz, guiyang longquan medical equipment Co., LTD).1~3years old:10-15min each time,4~6years old:15to20min each time,7-14years:15-25min each time, once a day. Five days for a period of treatment. Observe1-2periods.
Result: the effective rate of the control group was83.3%, the effective rate of thetreatment group was96.7%, with a significant difference (P <0.05) of the statistical analysis,,the treatment group was more effective than control group.
Conclusion: The protracted pneumonia in children is characterised as longer duration,protracted illness and the slow absorption of the lung inflammation. According to thecharacteristics above, based on the routine treatments, combining the external treatment ofTCM (traditional Chinese medicine transdermal) with modern equipment (lamp-specificelectromagnetic therapy devices) could accelerate the absorption of pulmonary rales,andwould be much better than conventional treatment (control group) in improving the symptomsand shortening the course of treatment. This clinical study provides an efficient, simple andsafe new therapy, enriches the content of treatment of the protracted pneumonia in children, is worthy promotion.
引文
[1]诸福棠主编.实用儿科学.第7版.北京:人民卫生出版社,2002:1174-1180
[2]孙海英，孙红梅.芎桃丹汤治疗小儿肺炎40例.河北中医1999，21（2）:93-94
[3]陈莲香,汪一林.小儿迁延性肺炎病因探讨.浙江预防医学2000,12(9):43-45
[4]江英能.中医药治疗小儿迁延性肺炎45例.新中医0256-7415（2003）01-0059-02
[5]侯春光.二陈汤儿科临床运用举隅.江西中医药2003,34(245)
[6]梁文旺.理肺通络、培土生金法治疗小儿迁延性肺炎36例.广西中医药1998-03-016
[7]陈旭东.中药治疗小儿迁延性肺炎的疗效评价[J].辽宁中医杂志R259.631B2003，102一0118一02
[8]杨明.益气化痰祛癖汤治疗小儿迁延性肺炎43例.新中医2006,2(38)2:0256一7415(2006)02一0075一02
[9]朱红赤.补气活血汤治疗小儿迁延性肺炎65例分析.中医药学刊2003,4(21)4,1009-5276（2003）04-0620-01
[10] Marguet C, Dean TP, Warner Jo. Solute intercellular adhesionmolecule-1(SICAM-1) andinterferon-gama in bronchoalveolarlavage fluid from children with airway diseases.AJRCCM,162(3pt1):1016
[11]何学华．肺炎支原体患儿血清T-IgE和ECP检测及其临床意义［J］．中国当代儿科杂志2003，5（5）：475－476．
[12] Marc E,Chaussain M,Moulin F,et al.Reduced lung diffusion ca-pacity after Mycoplasmapneumoniae pneumonia.Pediatr Infect DisJ,2000,19(8):706
[13]郑华月.小儿社区获得性迁延性肺炎的病原学分析，2008年研究生毕业论文
[14]陈香连,汪天林.小儿迁延性肺炎病因探讨.浙江预防医学2000，12（9）8
[15]丁环英.儿童迁延性肺炎辨治42例[J].四川中医2004,22(12):70
[16]亢志兰.中医治疗小儿迁延性肺炎[J].实用医技杂志2006,13(6):920
[17]李乃庚主任医师治疗小儿迁延性肺炎经验.中医儿科杂志(2006)05-004-02
[18]李文,霍磊.祛瘀化痰汤辅助治疗小儿迁延性肺炎84例疗效观察.中国中医基础医学杂志2010,5(16)5:412-413
[19]李宪义.参苓百丹汤治疗小儿迁延性肺炎46例.新中医2008,2(24)2:86
[20]张军平.健脾益肺汤治疗小儿迁延性肺炎100例.新中医2008,2(40)2:83-84
[21]陈旭东.中药治疗小儿迁延性肺炎的疗效评价[J].辽宁中医杂志R259.631B1000-171912003102一0118一02
[22]朱红赤.补气活血汤治疗小儿迁延性肺炎65例分析.中医药学刊2003,4(21)4:1009-5276（2003）04-0620-01
[23]杨明.益气化痰祛癖汤治疗小儿迁延性肺炎43例.新中医2006,2(38)2:0256一7415(2006)02一0075一02
[24]江英能,肖旭腾,邓国安.中医药治疗小儿迁延性肺炎45例.新中医2003,1(35)1:02567415(2003)01005902
[25]张洪丽.中医药治疗小儿迁延性肺炎6O例.医学理论与实践2005,(8)8:10017585(2005)08095001
[26]王正仁.丙种球蛋白治疗小儿迁延性肺炎的疗效观察.赣南医学院报1001-5779（2007）02-0275-01
[27]韩杰,曾凡杰等.儿童反复迁延肺炎的临床治疗观察.中国妇幼保2006,21,1656
[28]夏云.东莨菪碱治疗儿童迁延性肺炎20例报告.中国基层医药2006,3(13)3
[29]孙萍.红霉素联合大蒜素治疗小儿迁延性肺炎31例.实用临床医学2007,8(9)91
[30]程向东.痰热清注射液配合西药治疗小儿迁延性肺炎100例临床观察.中国中医急症2006,4(15)4:352
[31]张爱宇,张铁,张维烨.小儿迁延性肺炎的中西医结合治疗.中华现代中西医杂志2005,(3)15:17266424(2005)15139002
[32]史成桂,任根魁.中西医结合治疗迁延性肺炎5O例.陕西中医2005,(26)1O
[33]刘明华,耿海.采用中西医结合方法治疗小儿迁延性肺炎56例.中华中西医结合杂志2005,(3)6
[34]何华云,袁晓丽.特定电磁波治疗仪辅助治疗新生儿重症肺炎的疗效观察.现代医药卫生2009,(25)4:510
[35]李红子,李今子等.电超导治疗小儿迁延性肺炎的疗效观察.延边大学医药学报2009,9(25)3:225
[36]谢红祥.中药经皮给药治疗小儿肺炎72例临床观察.中华现代儿科学杂志2005,(2)5:427-428
[37]朱明武,黄慧桃,谢丹.经皮给药佐治婴幼儿肺炎116例疗效观察.中医现代儿科学杂志2005,(2)6:539-540。
[38]张小平,郑华等.超短波治疗小儿迁延性肺炎80例疗效观察.九江医2001,(16)2
[39]宁海燕.红外线照射治疗小儿肺炎后期湿罗音48例.实用中医药杂志2002,11(18)11:41
[40]李晓联,杨亚莉.红外线理疗配合人参五味子汤治疗小儿难治性肺炎28例.现代中医药2009,1(29)1:21
[41]藏成玲.迁延性肺炎综合治疗在儿科的疗效观察.中国医药指南2007,11(5)11:0301
[42]张艳宏.穴位贴敷疗法的理论基础及目前应用现状.甘肃中医,2007;20(20):1-2
[43]张晓明,庞巧玲.穴位贴敷疗法的作用机理,2005;13(8):18-19
[44]何兴伟.中药穴位贴敷疗法探析[J].江西中医药,1999;30(6):36
[45]陶翠玲,赵桂芝,王晓惠.浅谈穴位贴敷给药法[J].针灸临床杂志,2000;16(2):3
[46]张连娟，敷胸散治疗小儿肺炎80例临床观察.医学理论与实践,2010;23(5):544
[47]钱玉萍.白芥子散外用治疗小儿肺炎罗音吸收不良84例.河南大学学报,2006;25(1):60-61
[48]张会娜、刘卫红、李萍.中药贴敷法预防和治疗常见呼吸系统疾病应用概况.北京中医药,2008年11月第27卷第11期896-898
[49]刘书杰.经皮给药佐治小儿支气管肺炎临床观察.四川医学杂志，2008;29(2):232-233
[50]年建华.透皮给药系统及其常用的中药透皮促进剂.浙江中西医结合杂志，2008年18卷6期394-396
[51]徐莲英,蔡贞贞,张形.中医经皮给药实验研究--中药透皮特性研究的思路与方法,Chinese Joureal of Current Practical Medicine,January,2004;Vo1.3,No.
[52]张春丽.探讨经皮给药治疗仪治疗小儿肺炎的价值.吉林医学，2012,1.
[53]吴进喜.经皮给药佐治小儿肺炎临床分析.新乡医学院学报,2009;4(26):392-393.
[54]韩金春.经皮给药治疗仪佐治小儿肺炎30例临床疗效观察.《中国保健》医学研究版,2008;16(26):1236-1237.
[55]朱华，王孝勋．蛤蚧研究进展[J]．中药材，2002，25(4)：295296．
[56]瑞英．复方丹参注射液佐治小儿肺炎．临床医学，2001；21(5)：19
[57]赵磊,蒲小平.丹参粉针剂对大鼠心肌缺血／再灌注损伤的保护作用[J].中国新药杂志,2006;15(14):39-41
[58]修婵.大黄芒硝外敷佐治小儿肺炎50例疗效观察[J].中医儿科杂志,2009;5(4):13
[2]孙海英，孙红梅.芎桃丹汤治疗小儿肺炎40例.河北中医1999，21（2）:93-94
[3]陈莲香,汪一林.小儿迁延性肺炎病因探讨.浙江预防医学2000,12(9):43-45
[4]江英能.中医药治疗小儿迁延性肺炎45例.新中医0256-7415（2003）01-0059-02
[5]侯春光.二陈汤儿科临床运用举隅.江西中医药2003,34(245)
[6]梁文旺.理肺通络、培土生金法治疗小儿迁延性肺炎36例.广西中医药1998-03-016
[7]陈旭东.中药治疗小儿迁延性肺炎的疗效评价[J].辽宁中医杂志R259.631B2003，102一0118一02
[8]杨明.益气化痰祛癖汤治疗小儿迁延性肺炎43例.新中医2006,2(38)2:0256一7415(2006)02一0075一02
[9]朱红赤.补气活血汤治疗小儿迁延性肺炎65例分析.中医药学刊2003,4(21)4,1009-5276（2003）04-0620-01
[10] Marguet C, Dean TP, Warner Jo. Solute intercellular adhesionmolecule-1(SICAM-1) andinterferon-gama in bronchoalveolarlavage fluid from children with airway diseases.AJRCCM,162(3pt1):1016
[11]何学华．肺炎支原体患儿血清T-IgE和ECP检测及其临床意义［J］．中国当代儿科杂志2003，5（5）：475－476．
[12] Marc E,Chaussain M,Moulin F,et al.Reduced lung diffusion ca-pacity after Mycoplasmapneumoniae pneumonia.Pediatr Infect DisJ,2000,19(8):706
[13]郑华月.小儿社区获得性迁延性肺炎的病原学分析，2008年研究生毕业论文
[14]陈香连,汪天林.小儿迁延性肺炎病因探讨.浙江预防医学2000，12（9）8
[15]丁环英.儿童迁延性肺炎辨治42例[J].四川中医2004,22(12):70
[16]亢志兰.中医治疗小儿迁延性肺炎[J].实用医技杂志2006,13(6):920
[17]李乃庚主任医师治疗小儿迁延性肺炎经验.中医儿科杂志(2006)05-004-02
[18]李文,霍磊.祛瘀化痰汤辅助治疗小儿迁延性肺炎84例疗效观察.中国中医基础医学杂志2010,5(16)5:412-413
[19]李宪义.参苓百丹汤治疗小儿迁延性肺炎46例.新中医2008,2(24)2:86
[20]张军平.健脾益肺汤治疗小儿迁延性肺炎100例.新中医2008,2(40)2:83-84
[21]陈旭东.中药治疗小儿迁延性肺炎的疗效评价[J].辽宁中医杂志R259.631B1000-171912003102一0118一02
[22]朱红赤.补气活血汤治疗小儿迁延性肺炎65例分析.中医药学刊2003,4(21)4:1009-5276（2003）04-0620-01
[23]杨明.益气化痰祛癖汤治疗小儿迁延性肺炎43例.新中医2006,2(38)2:0256一7415(2006)02一0075一02
[24]江英能,肖旭腾,邓国安.中医药治疗小儿迁延性肺炎45例.新中医2003,1(35)1:02567415(2003)01005902
[25]张洪丽.中医药治疗小儿迁延性肺炎6O例.医学理论与实践2005,(8)8:10017585(2005)08095001
[26]王正仁.丙种球蛋白治疗小儿迁延性肺炎的疗效观察.赣南医学院报1001-5779（2007）02-0275-01
[27]韩杰,曾凡杰等.儿童反复迁延肺炎的临床治疗观察.中国妇幼保2006,21,1656
[28]夏云.东莨菪碱治疗儿童迁延性肺炎20例报告.中国基层医药2006,3(13)3
[29]孙萍.红霉素联合大蒜素治疗小儿迁延性肺炎31例.实用临床医学2007,8(9)91
[30]程向东.痰热清注射液配合西药治疗小儿迁延性肺炎100例临床观察.中国中医急症2006,4(15)4:352
[31]张爱宇,张铁,张维烨.小儿迁延性肺炎的中西医结合治疗.中华现代中西医杂志2005,(3)15:17266424(2005)15139002
[32]史成桂,任根魁.中西医结合治疗迁延性肺炎5O例.陕西中医2005,(26)1O
[33]刘明华,耿海.采用中西医结合方法治疗小儿迁延性肺炎56例.中华中西医结合杂志2005,(3)6
[34]何华云,袁晓丽.特定电磁波治疗仪辅助治疗新生儿重症肺炎的疗效观察.现代医药卫生2009,(25)4:510
[35]李红子,李今子等.电超导治疗小儿迁延性肺炎的疗效观察.延边大学医药学报2009,9(25)3:225
[36]谢红祥.中药经皮给药治疗小儿肺炎72例临床观察.中华现代儿科学杂志2005,(2)5:427-428
[37]朱明武,黄慧桃,谢丹.经皮给药佐治婴幼儿肺炎116例疗效观察.中医现代儿科学杂志2005,(2)6:539-540。
[38]张小平,郑华等.超短波治疗小儿迁延性肺炎80例疗效观察.九江医2001,(16)2
[39]宁海燕.红外线照射治疗小儿肺炎后期湿罗音48例.实用中医药杂志2002,11(18)11:41
[40]李晓联,杨亚莉.红外线理疗配合人参五味子汤治疗小儿难治性肺炎28例.现代中医药2009,1(29)1:21
[41]藏成玲.迁延性肺炎综合治疗在儿科的疗效观察.中国医药指南2007,11(5)11:0301
[42]张艳宏.穴位贴敷疗法的理论基础及目前应用现状.甘肃中医,2007;20(20):1-2
[43]张晓明,庞巧玲.穴位贴敷疗法的作用机理,2005;13(8):18-19
[44]何兴伟.中药穴位贴敷疗法探析[J].江西中医药,1999;30(6):36
[45]陶翠玲,赵桂芝,王晓惠.浅谈穴位贴敷给药法[J].针灸临床杂志,2000;16(2):3
[46]张连娟，敷胸散治疗小儿肺炎80例临床观察.医学理论与实践,2010;23(5):544
[47]钱玉萍.白芥子散外用治疗小儿肺炎罗音吸收不良84例.河南大学学报,2006;25(1):60-61
[48]张会娜、刘卫红、李萍.中药贴敷法预防和治疗常见呼吸系统疾病应用概况.北京中医药,2008年11月第27卷第11期896-898
[49]刘书杰.经皮给药佐治小儿支气管肺炎临床观察.四川医学杂志，2008;29(2):232-233
[50]年建华.透皮给药系统及其常用的中药透皮促进剂.浙江中西医结合杂志，2008年18卷6期394-396
[51]徐莲英,蔡贞贞,张形.中医经皮给药实验研究--中药透皮特性研究的思路与方法,Chinese Joureal of Current Practical Medicine,January,2004;Vo1.3,No.
[52]张春丽.探讨经皮给药治疗仪治疗小儿肺炎的价值.吉林医学，2012,1.
[53]吴进喜.经皮给药佐治小儿肺炎临床分析.新乡医学院学报,2009;4(26):392-393.
[54]韩金春.经皮给药治疗仪佐治小儿肺炎30例临床疗效观察.《中国保健》医学研究版,2008;16(26):1236-1237.
[55]朱华，王孝勋．蛤蚧研究进展[J]．中药材，2002，25(4)：295296．
[56]瑞英．复方丹参注射液佐治小儿肺炎．临床医学，2001；21(5)：19
[57]赵磊,蒲小平.丹参粉针剂对大鼠心肌缺血／再灌注损伤的保护作用[J].中国新药杂志,2006;15(14):39-41
[58]修婵.大黄芒硝外敷佐治小儿肺炎50例疗效观察[J].中医儿科杂志,2009;5(4):13