基于张氏热病理论治疗外感热病的随机对照临床研究

Treatment for patients with exogenous fever based on Zhang 's febrile disease theory: A randomized controlled clinical study

目的:评价根据海派中医张氏热病理论制定的清透达邪法治疗外感热病的临床疗效。方法:纳入160例病毒性上呼吸道感染(外感高热证)患者,采用区组随机分组的方法,将患者按1∶1比例分为治疗组和对照组,每组各80例。治疗组患者给予清透达邪方口服,对照组患者给予安慰剂口服,两组疗程均为3 d。比较两组患者的临床疗效、即刻退热效率、退热时间及临床主要症状积分的变化。结果:(1)临床疗效:治疗3 d后,治疗组的临床总有效率为88.75%,对照组为80.00%,两组临床疗效比较,差异有统计学意义(P<0.05),治疗组疗效优于对照组。(2)即刻退热效率:首次服药后4 h,治疗组中的即刻退热患者为53例(66.70%),对照组为54例(68.40%),两组的即刻退热效率比较,差异无统计学意义(P>0.05)。(3)退热时间:治疗组患者的平均退热时间为(12.63±17.52) h,对照组为(19.68±16.54) h,治疗组患者的平均退热时间明显短于对照组,差异有统计学意义(P<0.05)。(4)临床症状积分:治疗后,两组患者的发热、头痛、咽痛、咳嗽的症状积分均下降(P<0.05),且治疗组患者的头痛、咽痛症状积分低于对照组(P<0.05)。结论:清透达邪法治疗外感热病能有效退热,改善临床症状,具有较好的临床疗效,值得推广。

Objective: To evaluate the clinical efficacy of"Qingtou Daxie Therapy"( according to Zhang's febrile disease theory) inthe treatment of exogenous fever. Methods: One hundred and sixty patients with viral upper respiratory infection ( exogenous feversyndrome) were selected and divided into the treatment group and the control group at the ratio of 1 to 1 by block-randomized method,80cases in each group. The patients in the treatment group were orally treated with"Qingtou Daxie Decoction",and the patients in thecontrol group were orally treated with placebo,with a course of 3 days. The clinical efficacy,immediately defervescing efficiency,defervescing time and scores of clinical main symptoms were compared. Results: ①Clinical efficacy: 3 days after treatment,the totalclinical effective rates of the treatment group and the control group were 88. 75% and 80. 00% respectively. There was statisticallysignificant difference on the clinical efficacy between the two groups ( P<0.05) ,and the efficacy of the treatment group was better thanthat of the control group. ② Immediately defervescing efficiency: 4 hours after first oral administration,the number of immediatelydefervescing patients in the treatment group was 53 cases ( 66.70%) ,and that in the control group was 54 cases ( 68.40%) ,with nostatistically significant difference between the two groups ( P>0.05) . ③Defervescing time: The average defervescing time of the treatmentgroup was ( 12.63±17.52) h,and the control group was ( 19.68±16.54) h. The average defervescing time of the treatment group wasobviously shorter than that of the control group,with statistically significant difference ( P<0.05) . ④Clinical symptoms scores: Aftertreatment,the scores of fever,headache,pharyngalgia and cough were decreased in both groups ( P<0.05) ,and the scores of headacheand pharyngalgia in the treatment group were lower than those in the control group ( P<0.05) . Conclusion: "Qingtou Daxie Therapy"candefervesce effectively,improve the clinical symptoms,and shows good clinical efficacy in the treatment of exogenous fever,which is worthpromoting.?