五虎汤合葶苈大枣泻肺汤加减治疗小儿支气管肺炎临床观察

Clinical Observation of Modified Wuhu Decoction Combined with Tingli Dazao Xiefei Decoction in Treatment of Children with Bronchial Pneumonia

目的:观察五虎汤合葶苈大枣泻肺汤加减治疗小儿支气管肺炎临床疗效。方法:选取120例支气管肺炎(痰热闭肺证)患儿,随机分为常规组(n=60)和治疗组(n=60);常规组予以西医常规治疗,治疗组在常规组基础上加用五虎汤合葶苈大枣泻肺汤加减治疗,疗程为7d;比较两组临床疗效、中医证候积分、主要症状体征消失时间、炎性因子水平及T淋巴细胞亚群变化。结果:治疗有效率上,治疗组为98.33%,明显高于常规组的88.33%(P<0.05)。治疗后,治疗组中医证候积分明显低于常规组(P<0.05),且治疗组完全退热时间、咳嗽消失时间、喘促消失时间、肺部罗鸣音消失时间均明显短于常规组(P<0.05)。治疗后,治疗组较常规组血清白细胞介素-4(IL-4)、IL-6、IL-8、IL-10水平明显降低(P<0.05)。治疗后,治疗组CD4^+、CD4^+/CD8^+均明显高于常规组,CD8^+明显低于常规组,差异均有统计学意义(P<0.05)。结论:五虎汤合葶苈大枣泻肺汤加减治疗小儿支气管肺炎疗效显著,能够明显改善中医证候积分,促进症状体征缓解,并可减轻机体炎性反应,增强免疫功能。

Objective:To observe the clinical curative effect of modified Wuhu Decoction combined with Tingli Dazao Xiefei Decoction in treatment of children with bronchial pneumonia. Methods:One hundred and twenty children with bronchial pneumonia(phlegm-heat obstructing lung syndrome)were randomly divided into the conventional group(n=60)and the treatment group(n=60). The conventional group was treated with conventional Western medicine and on this basis,the treatment group was treated with modified Wuhu Decoction combined with Tingli Dazao Xiefei Decoction for 7 days. The clinical curative effect,TCM syndrome scores,disappearance time of major symptoms and signs,levels of inflammatory factors and changes of T-lymphocyte subsets were compared between the two groups. Results:The effective rate of treatment in the treatment group was significantly higher than that in the conventional group(98.33% vs 88.33%)(P<0.05). After treatment,the TCM syndrome scores in the treatment group were significantly lower than those in the conventional group(P<0.05),and the complete fever clearance time,disappearance time of cough,dyspnea and tachypnea and pulmonary rales in the treatment group were significantly shorter than those in the conventional group(P<0.05). After treatment,levels of serum IL-4,IL-6,IL-8 and IL-10 were significantly lower in the treatment group than in the conventional group(P<0.05). After treatment,CD4^+ and CD4^+/CD8^+were significantly higher in the treatment group than in the conventional group,while CD8^+ was significantly lower than the conventional group(P<0.05). Conclusion:Modified Wuhu Decoction combined with Tingli Dazao Xiefei Decoction is significantly effective in treating children with bronchial pneumonia. It can significantly improve TCM syndrome scores,promote the remission of symptoms and signs,relieve inflammatory reactions,and enhance the immune function.