麻杏石甘汤合葶苈大枣泻肺汤加减辅助治疗社区中老年患者获得性肺炎的疗效分析

Clinical Observation of Maxin Shigan Tang Combined with Tingli Dazao Xiefei Tang as Modified Auxiliary Therapy for Community Acquired Pneumonia in Middle-aged and Old Patients

目的:观察麻杏石甘汤合葶苈大枣泻肺汤加减辅助治疗社区中老年患者获得性肺炎(CAP)(痰热壅盛证)的疗效及对C-反应蛋白(CRP),血沉(ESR),降钙素原(PCT)的影响。方法:106例CAP患者采用随机按入院先后分为对照组52和试验组54例。对照组注射用头孢哌酮钠舒巴坦钠,3 g,静脉滴注,2次/d;和注射用阿奇霉素,0.5 g,静脉滴注,1次/d。疗程共14 d。试验组西医处理方法同对照组,并加用麻杏石甘汤合葶苈大枣泻肺汤加减内服,1剂/d。疗程为14 d。记录治疗前后主要临床症状、体征评分;记录发热、咳嗽、咯痰、肺部湿啰音、肺片、血象转归情况和平均住院时间;检测治疗前后CRP,ESR,PCT的变化情况。结果:经Ridit分析,试验组临床疗效优于对照组(P<0.05);治疗后试验组主要临床症状、体征(咳嗽、咯痰、黄脓痰、喘息、气短、气急、反应迟钝、湿啰音、痰多、支气管音)评分均低于对照组(P<0.01);治疗后试验组发热、咳嗽、肺部湿啰音消失时间,肺片、血象恢复正常时间和平均住院时间均短于对照组(P<0.05,P<0.01);治疗后试验组CRP,ESR,PCT水平低于对照组(P<0.05,P<0.01)。结论:麻杏石甘汤合葶苈大枣泻肺汤加减辅助治疗中老年患者社区获得性肺炎能减轻临床症状、体征,缩短病程,降低CRP,ESR,PCT,提高临床疗效。

Objective： To observe the clinical efficacy of Maxin Shigan Tang combined with Tingli Dazao Xiefei Tang as modified auxiliary therapy for community acquired pneumonia （CAP） in middle-aged and old patients as well as its effect on C-reactive protein （CRP）, erythrocyte sedimentation rate （ESR） and procalcitonin （PCT）. Method： One hundred and six cases patients with CAP were divided into control group （52 cases） and experimental group （54 cases） by random number table. Patients in control group received cefoperazone sodium and sulbactam sodium for intravenous infusion, 3 g, 2 times/day and azithromycin injection for intravenous infusion, 0.5 g, 1 time/day, with a treatment course of 14 days in total. Based on the treatment of control group, patients in experimental group added Maxin Shigan Tang combined with Tingli Dazao Xiefei Tang, 1 dose/day, with a treatment course of 14 days. Before and after treatment, scores of main symptoms and signs were recorded;fevers, cough, expectoration, lung rale, lung slices, the blood and average stay were recorded. Before and after treatment, levels of CRP, ESR and PCT were detected. Result： In Ridit analysis, clinical effect in experimental group was superior to that in control group （P〈0.05）. After treatment, scores of the main symptoms and sings （cough, expectoration, sputum, wheeze, breathe hard, flustered and exasperated, lags in response, moist rales, excessive phlegm and bronchophony） were lower than those in control group （P〈0.01）. After treatment, time of fevers, cough, lung rale, recovery time in lung slices and blood examination as well as the average stay in experimental group were shorter than those in control group （P〈0.05, P〈0.01）. Levels of CRP, ESR and PCT were also lower than those in control group after treatment （P〈0.05, P〈0.01）. Conclusion： Maxin Shigan Tang combined with Tingli Dazao Xiefei Tang can relieve symptoms and signs, shorten courses, reduce levels of CRP, ESR and PCT, and improve clinical effect for the treatment of community acquired pneumonia （CAP） in middle-aged and old patients.