三子养亲汤合香砂六君子汤治疗气虚痰阻型卒中相关性肺炎的临床研究

Clinical Study of Sanziyangqin Decoction Combined with Xiangsha Liujunzi Decoction in the Treatment of Stroke Associated-pneumonia with Qi Deficiency and Phlegm Obstruction Syndrome

目的:观察三子养亲汤合香砂六君子汤治疗气虚痰阻型卒中相关性肺炎的临床疗效。方法:通过随机数表法将广州市中西医结合医院60例卒中相关性肺炎患者分为对照组和观察组,每组各30例。对照组给予经验性抗生素治疗,观察组在对照组的基础上,给予三子养亲汤合香砂六君子汤口服或鼻饲。比较两组治疗前后中医症候积分、NIHSS评分、血清白细胞(WBC)、C反应蛋白(CRP)、降钙素原(PCT)水平的变化,并评估临床疗效。结果:两组治疗前后,中医症候积分比较,差异有统计学意义(P<0.05),其中,观察组中医症情改善更明显(P<0.05);观察组总有效率为93.30%,对照组总有效率为80.00%,两组比较差异有统计学意义(P<0.05);两组治疗后,患者血清WBC、CRP、PCT明显低于治疗前,差异有统计学意义(P<0.05),其中以观察组降低更显著(P<0.05);两组治疗后NIHSS评分均明显降低(P<0.05),其中以观察组降低更显著(P<0.05);治疗期间两组均未发现不良反应。结论:采用三子养亲汤合香砂六君子汤治疗卒中相关性肺炎,能降低炎症指标WBC、CRP、PCT的水平,控制肺部感染,改善中医临床症状,提高临床疗效,促进患者受损神经功能尽早恢复,且不会增加不良反应,值得临床推广应用。

Objective:Observe the clinical efficacy of Sanziyangqin decoction combined with Xiangsha Liujunzi decoction in the treatment of stroke associated-pneumonia with qi deficiency and phlegm obstruction.Methods:60 patients with stroke associatedpneumonia were randomly divided into control group and observation group by simple randomized control,30 cases in each group.The control group was treated with empirical antibiotics.Observation group was additively given Sanziyangqin decoction and Xiangsha Liujunzi decoction by oral or nasal feeding base on the empirical antibiotics.Compared the two groups with the changes of TCM syndrome score,NIHSS score,changes of WBC,CRP and PCT and the clinical efficacy before and after treatment.Results:The scores of TCM symptoms of control group and observation group was significantly different after treatment than that before treatment(P<0.05).Between them,the improvement of TCM symptoms in the observation group was statistically significant(P<0.05).The total effective rate of the observation group was 93.30%,and the total effective rate of the control group was 80.00%,the difference between the two groups was statistically significant(P<0.05).Serum levels of WBC,CRP and PCT of the two treatment groups were significantly lower after treatment than before treatment,with statistically significant differences(P<0.05).Between them,the observation group had the better effect(P<0.05).NIHSS scores were significantly decreased in both groups after treatment(P<0.05),and the decrease was more significant in the observation group(P<0.05).There were no adverse reactions in the two groups during treatment.Conclusion:Sanziyangqin decoction combined with Xiangsha Liujunzi decoction in the treatment of stroke-related pneumonia can reduce the levels of inflammatory indicators WBC,CRP and PCT,control pulmonary infection,improve the clinical symptoms of traditional Chinese medicine,improve clinical efficacy,promote the early recovery of patients'damaged neurological function without increasing adverse reactions,which is worthy of clinical promotion and application.