宣白承气汤治疗老年社区获得性肺炎痰热壅肺型的临床观察

Clinical observation of Xuan Bai Cheng Qi decoction on senile community acquired pneumonia with phlegm heat obstructing lung type

目的观察宣白承气汤治疗老年社区获得性肺炎(CAP)痰热壅肺型的临床疗效。方法将63例老年CAP痰热壅肺型患者随机分为2组。对照组33例予西医常规治疗;治疗组30例在对照组治疗基础上予宣白承气汤治疗。2组疗程均为7 d。比较2组治疗前后临床肺部感染评分(CPIS)、炎症指数[包括C反应蛋白(CRP)、降钙素原(PCT)、白细胞计数(WBC)及中性粒细胞百分比]及主要症状消失时间,并统计疗效及不良反应发生情况。结果治疗组总有效率86.67%,对照组总有效率48.48%,治疗组疗效优于对照组(P<0.05)。2组治疗后CPIS评分中体温、WBC、气道分泌物评分及CPIS总积分均降低(P<0.05),且治疗组均低于对照组(P<0.05)。2组治疗前后氧合指数、微生物学及胸部X线评分均无明显改善(P>0.05)。治疗组治疗后WBC、中性粒细胞百分比、CRP、PCT均降低(P<0.05),且均低于对照组同期(P<0.05)。对照组治疗后WBC、中性粒细胞百分比、CRP均降低(P<0.05),PCT无明显变化(P>0.05)。治疗组发热、咳嗽症状消失时间短于对照组(P<0.05);2组气促消失时间比较差异无统计学意义(P>0.05)。结论宣白承气汤能有效改善老年CAP痰热壅肺型患者的各项临床症状,并降低患者炎症指标,改善患者病情。

Objective To observe the effect of Xuan Bai Cheng Qi decoction on senile community acquired pneumonia（ CAP） with phlegm heat obstructing lung type. Methods 63 elderly CAP patients with phlegm heat obstructing lung type were randomly divided into 2 groups. 33 cases in control group were treated by routine western medicine. 30 cases in treatment group were treated by Xuanbai Chengqi decoction on the basis of the control group.Both groups were treated for 7 d. The clinical lung infection score（ CPIS）,inflammation parameters [C-reactive protein（ CRP）,procalcitonin（ PCT）,white blood cell count（ WBC） and neutrophil percentage],and the disappearance time of main symptoms were compared before and after treatment. The efficacy and adverse reactions were statistically analyzed. Results The total effective rate was 86. 67% in treatment group and 48. 48 % in the control group. The treatment group was better than the control group（ P〈0. 05）. The body temperature,WBC,airway secretion score and CPIS total score of CPIS scores in the two groups were decreased（ P〈0. 05）,and the treatment group was lower than the control group（ P〈0. 05）. There was no significant improvement in oxygenation index,microbiology and chest X-ray score before and after treatment（ P〈0. 05）. The WBC,percentage of neutrophils,CRP and PCT were decreased in the treatment group（ P〈0. 05）,and were lower than the control group（ P〈0. 05）. After treatment,the percentage of WBC,neutrophils and CRP decreased（ P〈0. 05）,and there was no significant change in PCT（ P〈0. 05）. The disappearance time of fever and cough in treatment group was shorter than that in the control group（ P〈0. 05）. There was no significant difference in the time of anhelation between the 2 groups（ P〈0. 05）. Conclusion Xuanbai Chengqi decoction can effectively improve the clinical symptoms of CAP elderly patients with phlegm heat obstructing lung type,and reduce the patient＇s inflammation index and improve the patient＇s condition.