麻杏石甘汤合苇茎汤治疗老年痰热郁肺型吸入性肺炎临床观察

Clinical Observation of Maxing Shigan Tang Combined with Weijingtang in Treating Elderly Patients with Aspiration Pneumonia with Phlegm-heat Stagnating

目的:探讨麻杏石甘汤合苇茎汤治疗老年痰热郁肺型吸入性肺炎患者的临床疗效。方法:将120例老年吸入性肺炎患者随机分为研究组、对照组,各60例。两组均予以头孢哌酮钠舒巴坦钠,3 g/次,静脉滴注,2次/d,对照组加用肺力咳合剂,口服15 m L/次,3次/d,研究组加用麻杏石甘汤合苇茎汤内服,1剂/d,疗程为14 d。比较两组治疗前后临床疗效、中医证候积分,外周血炎症指标白细胞,C反应蛋白,降钙素原水平,主要症状、体征复常时间和平均住院时间等。结果:研究组总有效率为95.0%,对照组总有效率为81.7%,研究组优于对照组(P<0.05)。研究组治疗后临床疗效、中医证候积分优于对照组(P<0.05)。研究组体温恢复正常时间,咳嗽、气促消失时间,双肺啰音消失时间,平均住院天数均优于对照组(P<0.05,P<0.01)。治疗后研究组白细胞,C反应蛋白,降钙素原,肿瘤坏死因子-α,白细胞介素-6水平低于对照组(P<0.05,P<0.01)。结论:麻杏石甘汤合苇茎汤治疗老年吸入性肺炎疗效肯定,能减轻患者临床症状、体征,缩短病程。

Objective： To observe the clinical efficacy of Maxin Shigan Tang combined with Weijingtang in treating elderly patients with aspiration pneumonia with phlegm-heat stagnating. Method： A total of 120 patients were randomly divided into treatment group and control group,with 60 cases in each group. Patients in both groups received cefoperazone sodium and sulbactam sodium for intravenous infusion,3 g/time,2 times/day. In addition to the therapy,patients in control group received Filike mixture,15 m L/time,tid; while patients in treatment group received Maxin Shigan Tang combined with Weijingtang,1 dose/day. The treatment course was 14 days. Clinical efficacy,scores of traditional Chinese medicine（ TCM） primary symptom,peripheral blood inflammatory marker white blood cells,C-reactive protein,calcitonin,recovery time for main symptoms and signs,average length of hospital stay were evaluated and compared. Result： The treatment group＇s total effective rate was 95. 0%,whereas the control group＇s total effective rate was 81. 7%, indicating that treatment group was superior to control group. Compared with control group,clinical efficacy,scores of TCM primary symptom in treatment group were higher（ P〈0. 05）. After treatment,temperature recovery time,recovery time for coughing and shortness of breath,rale disappearance time and average hospital stay were statistically significantly different between two groups（ P〈0. 05,P〈0. 01）,and the treatment group was superior to control group. Levels of white blood cells,Creactive protein,calcitonin,tumor necrosis factor-α,and interleukin-6 were lower than those in control group after treatment（ P〈0. 05,P〈0. 01）. Conclusion： Maxin Shigan Tang combined with Weijingtang have a curative effect in treating aspiration pneumonia of elderly patients,and can relieve symptoms and signs,and shorten the course of disease.