银翘散加减对风热犯肺型重症肺炎患者中医症候积分及动脉血气指标的影响

Influence of Yinqiaosan Addition and Subtraction on TCM Symptom Score and Arterial Blood Gas Index in Patients with Severe Pneumonia due to Wind-Heat

目的:观察风热犯肺型重症肺炎患者经银翘散加减治疗后的中医症候与动脉血气变化,分析治疗获益,为银翘散加减法在重症肺炎治疗中的应用提供参考。方法:选择2018年2月~2020年2月本院内符合条件的90例重症肺炎患者作为研究对象,依随机数字表法分为观察组和对照组,每组45例。对照组采用常规综合治疗,观察组在对照组基础上联合银翘散加减治疗,两组均持续治疗14天。记录并对比两组患者治疗前和治疗后的中医症候积分、动脉血气指标[氧分压(PaO_(2))、二氧化碳分压(PaCO_(2))],以及治疗期间不良反应(胃肠道反应、头晕、头痛、血小板减少)发生情况。结果:治疗14天时,两组患者的主症积分、次症积分、总积分均较治疗前降低(P <0.05),且观察组低于对照组(P <0.05);治疗14天时,两组患者的PaO_(2)高于治疗前、Pa CO_(2)低于治疗前(P <0.05),且观察组患者的PaO_(2)高于对照组、PaCO_(2)低于对照组(P <0.05);治疗期间,两组各不良反应发生率及不良反应总发生率比较,无统计学差异(P> 0.05)。结论:在常规综合治疗基础上联合银翘散加减法能进一步改善风热犯肺型重症肺炎患者的中医症候与动脉血气状况,且用药安全性高,具有较高的临床应用价值。

Objective:To observe the changes of TCM symptoms and arterial blood gas in patients with severe pneumonia caused by wind-heat,and to analyze the therapeutic benefits of Yinqiao powder addition and subtraction,so as to provid basis for clinical application.Methods:From February 2018 to February 2020,90 eligible patients with severe pneumonia admitted in our hospital were included in the research and divided into observation group and control group according to random number table method,with 45 cases in each group.Control group received conventional comprehensive treatment,while observation group with additional Yinqiaosan addition and subtraction treatment on the basis of control group.Both groups were treated for 14 consecutive days.TCM symptom scores,arterial blood gas indexes[oxygen partial pressure(PaO_(2)),carbon dioxide partial pressure(PaCO_(2))]and adverse reactions(gastrointestinal reactions,dizziness,headache,thrombocytopenia)of two groups before and after treatment were recorded and analyzed.Results:At the 14th day of treatment,the scores of main symptoms,secondary symptoms,and total points in both groups were lower than before treatment(P<0.05),and observation group was lower than control group(P<0.05);at the 14th day of treatment,the PaO_(2) of two groups was higher than before treatment,while PaCO 2 was lower than before treatment(P<0.05).and the PaO_(2) of observation group was higher than control group,and PaCO_(2) was lower than control group(P<0.05);During treatment,the incidence of adverse reactions between two groups was not significantly different(P>0.05).Conclusion:On the basis of conventional comprehensive treatment,the application of Yinqiaosan addition and subtraction can further improve TCM symptoms and arterial blood gas in patients with severe pneumonia caused by wind-heat,and with high safety and clinical value.