中西医结合治疗登革热临床疗效观察

Clinical Observation of the Treatment of Dengue Fever with Integrated Traditional Chinese and Western Medicine

目的:观察中西医结合治疗登革热的临床疗效,为登革热的治疗寻找更好的治疗方案。方法:选取2018年9~12月暨南大学附属江门中医院感染科收治临床确诊的登革热患者190例,随机分为对照组90例和研究组100例。对照组给予西医常规治疗,研究组在对照组治疗的基础上,参照《中国登革热临床诊断和治疗指南(2018年版)》各分期和证型协定的相应方剂,再综合患者临床表现,辨证治疗。发热期为发病初期,中医辨证为湿热郁遏,卫气同病,分别给予银翘散加减或甘露消毒丹加减治疗。极期为病程发展高峰期,中医辨证分为毒瘀交结,扰营动血者,方选清瘟败毒饮加减;暑湿伤阳,气不摄血者,方选附子理中汤合黄土汤加减。恢复期为疾病后期,中医辨证为余邪未尽,气阴两伤,方选竹叶石膏汤合生脉饮加减。结果:研究组退热时间、住院时间、白细胞和血小板恢复时间低于对照组,差异有统计学意义(P<0.05);研究组治愈率91.00%,对照组治愈率81.11%,研究组治愈率高于对照组,差异有统计学意义(P<0.05);研究组谷丙氨酸氨基转移酶恢复时间低于对照组,但差异无统计学意义(P>0.05)。结论:中西医结合治疗登革热,可缩短退热时间、住院时间及白细胞和血小板恢复时间。

Objective:To observe the clinical curative effect of integrated traditional Chinese and Western medicine on dengue fever in order to find a better treatment for the disease.Methods:A total of 190 patients with dengue fever treated in Infectious Disease Department of Jiangmen Hospital of Traditional Chinese Medicine Affiliated to Jinan University from September to December of 2018 were randomly divided into the control group with 90 cases and the study group with 100 cases.The control group was given conventional western medicine treatment,and the study group was given the corresponding prescriptions in The Chinese Dengue Fever Clinical Diagnosis and Treatment Guidelines(2018 Edition)on the basis of the treatment of the control group,and then the clinical manifestations of the patients were integrated and the syndrome differentiation treatment was conducted.The fever stage was the early stage of the disease.The TCM syndrome differentiation was dampness-heat depression,and the disease of both defense and qi,so Modified Lonicera and Forsythia Powder,and Modified Sweet Dew Toxin-Removing Elixir were used respectively.The extreme stage was the peak period of the course of disease development.TCM syndrome differentiation could be divided into two types:For intermingled toxin and blood stasis,disturbing nutrient qi and blood,Modified Epidemic-Clearing Toxin-Resolving Beverage could be adopted.For summer dampness injury yang leading to qi failing to control blood,Aconite Center-Regulating Decoction combined with Modified Yellow Earth Decoction could be adopted.The recovery period was the later stage of the disease.The TCM syndrome differentiation was that the remaining pathogenic factors were not complete,both qi and yin were injured.Lophatherum and Gypsum Decoction combined with Modified Pulse-Engendering Beverage could be adopted.Results:The time of fever abatement,hospitalization time,white blood cell and platelet recovery time in the study group were lower than those in the control group,and all the differences were statistically significant(P<0.05).The cure rate of the study group was 91.00%,which was higher than that of the control group:81.11%,and the difference was statistically significant.The recovery time of alanine aminotransferase in the study group was lower than that in the control group,but the difference was not statistically significant(P>0.05).Conclusion:In terms of dengue fever,integrated traditional Chinese and Western medicine therapy can shorten the time of fever,hospital stay and recovery time of white blood cells and platelets.