中医药治疗社区获得性肺炎述评

A Review of Traditional Chinese Medicine in the Treatment of Community Acquired Pneumonia

中医药治疗肺炎有着较大的优势,但对其研究也存在一些问题有待解决:(1)目前缺乏关于肺炎中医证候及演变规律的系统研究,特别是缺乏肺炎证候病机的流行病学调查。(2)目前试验的选择、疾病的诊断、辨证分型、疗效的判定缺乏统一标准;证候诊断多以宏观症状为依托,缺少特异性微观指标与证候相关的研究;缺乏客观的能体现中医药辨证论治,整体调节的量化标准。(3)研究发现中药治疗肺炎其作用靶点很可能不是针对病原体起作用,而是通过调节机体的免疫力,抵御病邪入侵,但其作用机理研究尚不够系统、全面,特别是关于免疫炎症调节机理研究较少。针对以上的问题,应制定统一、客观的疗效评价标准,在研究中应采用多中心、盲法、大样本研究,充分利用迅速发展的现代免疫学技术,结合中医学理论,进一步阐明中医药在感染性疾病治疗中的作用机制;对于中药复方抗细菌或病毒的研究进一步深入;探索中医药在肺炎治疗中的疗效优势,减少抗生素使用,减轻医疗负担等。

Traditional Chinese medicine has a great advantage in the treatment of pneumonia,but there are also some problems in its research,which needs to be solved.1.There is a lack of systematic research on TCM syndromes and evolution rules of pneumonia,especially the lack of epidemiological investigation of pneumonia syndromes.2.At present,the test selection,diagnosis of diseases,dialectical type,and efficacy measurement lack of uniform standards.Syndrome diagnosis is based on macro symptoms,lacks of research related to specific microscopic indexes and syndromes,lacks of objective quantitative criteria to reflect the TCM syndrome differentiation and overall adjustment.3.The study has found that the target of Chinese medicine for the treatment of pneumonia is likely not to play a role in the pathogen,but by regulating the immunity of the body to resist the invasion of disease and evil.However,the study of its mechanism is not systematic and comprehensive,especially on the mechanism of immunoregulatory regulation.In view of the above problems,we should develop a unified,objective evaluation criteria.The study should focus on multi center and large sample studies,using blind method,and make full use of modern immunology technology combine traditional Chinese medicine theory,to further clarify the mechanism of Chinese medicine in the treatment of infectious disease.The study of Chinese herbal compound anti bacteria or viruses should be furthered.We should explore effect advantages of Chinese medicine in the treatment of pneumonia,and reduce the usage of antibiotics,reduce the medical burden.Traditional Chinese medicine attaches great importance to disease prevention.For respiratory tract infection,we should center on how to further enhance the defense ability of human body by using Chinese medicine,so as to prevent disease from happening.