活血化瘀法治疗社区获得性肺炎肺实变疗效观察

Treatment of Community Acquired Pneumonia Pulmonary Metastasis with Activating Blood and Removing Blood Stasis Method

目的:观察活血化瘀法联合抗生素治疗社区获得性肺炎(community-acquired pneumonia,CAP)肺实变的临床疗效。方法:60例CAP肺实变患者随机分为观察组和对照组各30例。对照组患者给予抗生素和对症基础治疗,观察组在对照组治疗基础上加用活血化瘀中药,两组均治疗10 d。治疗后,比较两组患者临床疗效,咳嗽咳痰消失时间,体温、白细胞计数恢复正常时间,湿性啰音消失时间,肺实变吸收时间及主要证候体征评分。结果:治疗后,观察组有效率为93.3%,对照组有效率为83.3%,两组有效率比较,差异有统计学意义(P<0.05)。观察组患者咳嗽咳痰、湿性啰音消失时间,白细胞计数、体温恢复正常时间,肺实变吸收时间,均短于对照组(P<0.05);其中观察组湿性啰音消失时间、肺实变吸收时间与对照组比较,差异有显著统计学意义(P<0.01)。治疗后两组主要证候体征(发热、咳嗽咳痰、肺部啰音)评分均低于治疗前,差异有统计学意义(P<0.05);且观察组治疗后优于对照组治疗后,差异有统计学意义(P<0.05)。结论:活血化瘀法联合抗生素治疗CAP伴肺实变临床疗效显著;可缩短咳嗽咳痰、湿性啰音消失时间,白细胞计数、体温恢复正常时间,肺实变吸收时间;且可降低中医证候积分。

Objective： To observe the clinical effect of activating blood circulation and removing blood stasis combined with antibiotics in treatment of community-acquired pneumonia（ CAP） pulmonary consolidation. Methods： Sixty patients with CAP lung consolidation were randomly divided into observation group（ 30 cases） and control group（ 30 cases）. Patients in the control group were treated with antibiotics and symptomatic treatment. The observation group was treated with traditional Chinese medicine of activating blood circulation and removing blood stasis in addition to that of the control group. Both groups were treated for 10 days. After treatment,cough and sputum,body temperature,white blood cell count,wet rales and lung consolidation of the two groups were compared. Results： After treatment,the effective rate in the observation group was 93. 3% and that was in the control group 83. 3%. There was significant difference between the two groups in the effective rate（ P 〈0. 05）. The period of cough and sputum,the disappearance of wet rales,the white blood cell count,the normal time of body temperature recovery and the time of lung consolidation in the observation group were significantly shorter than those in the control group（ P 〈0. 05）. The disappearance time of wet rales and the absorption time of pulmonary consolidation of the observation group was significantly short compared with that of the control group（ P 〈0. 01）. After treatment,the scores of the main syndromes and signs（ fever,cough and sputum,pulmonary rales） in the two groups were all significantly lower than those before treatment（ P〈 0. 05）,after treatment,the clinical performance of the observation group was significantly superior to that of the control group after treatment（ P〈 0. 05）.