麻杏石甘汤加减结合中医定向透药疗法治疗风热犯肺证小儿肺炎

Clinical Efficacy of Maxing Shigan Tang Combined with Traditional Chinee Medicine Directed Penetrating Medicine for Pediatric Pneumonia Asthmatic with Syndrome of Wind-heat Invading Lung

目的:评价麻杏石甘汤加减结合中医定向透药疗法治疗风热犯肺证小儿肺炎喘嗽治疗的有效性及安全性。方法:将120例肺炎喘嗽风热犯肺证患儿作为研究对象,随机分为麻杏石甘汤组,阿奇霉素、利巴韦林联合治疗组以及麻杏石甘汤结合中医定向透药组,每组40例。麻杏石甘汤组采用麻杏石甘汤加减进行治疗,阿奇霉素、利巴韦林联合治疗组采用阿奇霉素和利巴韦林注射液联合治疗,麻杏石甘汤结合中医定向透药组采用麻杏石甘汤加减结合中医定向透药疗法进行治疗,3组的疗程均为10 d,治疗后,观察3组的临床疗效以及3组在热退时间、咳嗽消失时间、啰音消失时间以及全胸片治疗前后的差异。结果:麻杏石甘汤结合中医定向透药组患儿治疗的总有效率为95.0%,明显高于阿奇霉素、利巴韦林联合治疗组的77.5%(P<0.05);麻杏石甘汤结合中医定向透药组治疗后主、次要症状及体征积分分别为(3.90±2.06),(1.88±0.85)分,显著低于其他两组(P<0.01);中药结合中医定向透药组热退时间为(2.30±0.76)d,与麻杏石甘汤组以及阿奇霉素、利巴韦林联合治疗组比较明显下降(P<0.05,P<0.01);中药加中医定向透药组以及麻杏石甘汤组咳嗽消失时间分别为(6.15±1.30),(6.25±1.11)d,与阿奇霉素、利巴韦林联合治疗组比较显著缩短(P<0.01);中药结合中医定向透药组肺啰音消失时间为(5.20±1.08)d,与其他两组比较时间显著缩短(P<0.01)。结论:麻杏石甘汤加减结合中医定向透药疗法治疗小儿肺炎喘嗽风热闭肺证疗效显著,使用安全。

Objective： To observe the clinical efficacy and safety of Maxing Shigan Tang combined with traditional Chinese medicine（TCM） directed penetrating medicine in treatment of pediatric pneumonia asthmatic with syndrome of wind-heat invading lung. Method： The 120 cases of pediatric pneumonia with syndrome of windheat invading lung were randomly divided into Maxing Shigan Tang group,western medicine（Azithromycin ＋ribavirin） group and Maxing Shigan Tang combined with TCM directed penetrating medicine group,with 40 cases in each group. The patients in Maxing Shigan Tang group were treated with Maxingshigan Tang adjusted for children,western medicine group were received azithromycin and ribavirin combination therapy injection. Maxing Shigan Tang combined with TCM directed penetrating medicine group received Maxing Shigan Tang and TCM directed penetrating medicine in treatment of pediatric pneumonia asthmatic. The treatment course was 10 days for three groups. After treatment,the clinical efficacy,as well as the changes in average time of fever regression,cough disappearance,and pulmonary rales disappearance were observed in three groups. Result： The overall response rate was 95. 0% in Maxing Shigan Tang combined with TCM directed penetrating medicine group,significantly higher than 77. 5% in western medicine group（P〈0. 05）,the scores of major and secondary symptoms and signs in Maxing Shigan Tang combined with TCM directed penetrating medicine group were（3. 90 ±2. 06） and（1. 88 ± 0. 85） points,significantly lower than those of the other two groups（P〈0. 01）. The average time of fever regression was（2. 30 ± 0. 76） day in Maxing Shigan Tang combined with TCM directed penetrating medicine group,significantly shorter than that of the other two groups（P〈0. 05 or P〈0. 01）,the cough disappearing time was（6. 15 ± 1. 30） and（6. 25 ± 1. 11） d respectively in Maxing Shigan Tang combined with TCM directed penetrating medicine group and Maxing Shigan Tang group,significantly shorter than that in western medicine group（P〈0. 01）,the pulmonary rales disappearing time was（5. 20 ± 1. 08） d in Maxing Shigan Tang combined with TCM directed penetrating medicine group,significantly shorter than those of the other two groups（P〈0. 01）. Conclusion： Maxing Shigan Tang combined with TCM directed penetrating medicine has significant clinical efficacy and safety in the treatment of pediatric pneumonia asthmatic（syndrome of wind-heat invading lung）.