加味麻杏石甘汤联合莫西沙星注射液治疗社区获得性肺炎(痰热壅肺证)的临床疗效观察

The curative effect of modified Maxing Shigan decoction combined moxifloxacin injection on community-acquired pneumonia(syndrome of phlegm-heat obstructing in lung)

目的探讨加味麻杏石甘汤联合莫西沙星注射液治疗社区获得性肺炎(CAP)(痰热壅肺证)的临床疗效。方法选取2013年3月至2015年10月由急诊收住院的98例CAP(痰热壅肺证)患者作为研究对象,采用随机数字表法,按1︰1比例分为治疗组和对照组各49例。治疗组采用加味麻杏石甘汤联合莫西沙星注射液治疗,对照组按照西医常规予抗感染、退热、化痰、平喘等对症治疗,于用药7,14 d后观察比较2组患者疗效及安全性和不良反应发生情况。结果研究过程中,治疗组脱落3例,对照组脱落5例。临床疗效治疗组总有效率为97.8%,对照组为93.2%,差异有统计学意义(P<0.05)。中医证候治疗组总有效率为100.0%,对照组为86.4%,差异有统计学意义(P<0.05)。治疗组治疗后发热、胸痛、咳嗽、口干、痰黄稠单项症状体征积分均较治疗前明显降低(P<0.05),与对照组比较,咳嗽、口干、痰黄稠积分差异有统计学意义(P<0.05)。治疗组治疗后白细胞(WBC)、C-反应蛋白(CRP)及血清降钙素原(PCT)水平均较治疗前明显降低(P<0.05),与对照组比较,差异有统计学意义(P<0.05)。治疗组胸片炎症吸收天数为(12.25±8.37)d,对照组为(16.42±11.87)d,差异有统计学意义(P<0.05)。2组用药期间患者生命体征、血尿便常规、心肝肾功能均未发现异常变化,未见不良反应。结论加味麻杏石甘汤联合莫西沙星注射液治疗CAP(痰热壅肺证)疗效可靠。

Objective To explore the curative effect of modified Maxing Shigan decoction combined moxifloxacin injection on community-acquired pneumonia（CAP）（syndrome of phlegm-heat obstructing in lung）.Methods 98 patients with CAP（syndrome of phlegm-heat obstructing in lung） accepted by emergency department from March,2013 to October,2015 were involved in this study.All the patients were randomly divided into treatment group and control group,with 49 cases in each.The treatment group was given modified Maxing Shigan decoction combined moxifloxacin injection,while the control group was given conventional treatment such as anti-infection,defervescence,removing phlegm,antiasthma,et al.7 d and 14 d after treatment,the effect,security and adverse effect were compared between two groups.Results The exclusive cases of treatment group were 3,and in control group,there were 5exclusive cases.The total effective rate of treatment group was 97.8%,and the control group was93.2%,the difference between two groups was significant（P〈0.05）.For Chinese medicine syndrome,the total effective rate of treatment group was 100.0%,and the control group was 86.4%,the difference was significant（P〈0.05）.After treatment,the single symptom score of fever,chest pain,cough,dry mouth and yellow and viscous phlegm was decreased significantly（P〈0.05）.Compared to the control group,the score of cough,dry mouth and yellow and viscous phlegm had significant difference（P 0.05）.In the treatment group,the content of WBC,C-reactive protein（CRP） and serum procalcitonin（PCT） after treatment decreased significantly than before treatment（P〈0.05）.Compared to the control group,the difference was significant（P〈0.05）.The absorption day of treatment group was（12.25 ±8.37） d,and the control group was（16.42 ± 11.87） d,and the difference was significant（P〈0.05）.No abnormal changes of vital signs,blood routine examination,urine and stool routines showed between two groups,and no adverse effect showed during the study.Conclusion Modified Maxing Shigan decoction combined moxifloxacin injection has good effect on community-acquired pneumonia（syndrome of phlegm-heat obstructing in lung）.