中医药防治社区获得性肺炎的文献研究

Literature study on prevention and treatment of community acquired pneumonia by traditional Chinese medicine

基于近年来有关中医药防治社区获得性肺炎(CAP)的文献,以治疗措施不同进行分类整理,共16种经典名方,其中麻杏石甘汤有52篇RCT;中成药21种,药物说明书有适应症的有8种,其中痰热清注射液文献量最多,136篇RCT;非药物治疗包括:针灸、中药贴敷、灌肠、中药离子导入、中药熏蒸、竹罐疗法等。分析了经典名方、中成药及非药物疗法对CAP的优劣势,如经典名方加减治疗CAP难以标准化推广,中成药临床使用存在不辨证,疗效减低,不良反应增加等问题。进一步结合临床现状总结中医药替代/补充抗生素治疗CAP的优势点,如在CAP轻证、迁延期、病毒感染方面可以替代抗生素治疗;在西医抗感染的基础上,发挥中医扶正固本的优势,以协同增效,减少抗生素不良反应等。同时对中药治疗肺炎的基础研究进行归类分析,中医药可在CAP病程的个个环节,发挥其协同增效的作用。从而为CAP的中医药辨证治疗提供了重要依据,理清科研方向。

Among the literatures of the prevention and treatment of community-acquired pneumonia （CAP） published in recent years, there were 16 kinds of classic prescription, including 52 RCTs about Maxingshigan Decoction, 21Chinese patent medicines.There are eight kinds of indications for the drug specification, among which the literatures of Tan Reqing injection accounted for the most about 136 RCTs;There were literatures about non-drug treatment, including： acupuncture, Chinese medicine paste, enema, Chinese medicine ionization, Chinese medicine fumigation, bamboo cans and so on.In this study, author has analysed the classic prescription, Chinese patent medicine and non-drug therapy referring to advantages and disadvantages of CAP, which could be used to treat virus infection instead of antibiotic therapy.Based on antibiotic therapy, Chinese medicine treatment could increase synergistic interaction while decrease the antibiotic side-effects.In addition, Chinese medicine could perform synergistic interaction in CAP every period, which resulted from classified analysis of basic studies about Chinese medicine treatment in CPA.This study is aimed to provides an important basis for clarifying the direction of scientific research.