麻杏石甘汤加味联合吸入用布地奈德混悬液氧气雾化吸入治疗小儿肺炎临床研究

Clinical Study on Maxing Shigan Tang Combined with Oxygen Atomization Therapy with Budesonide Suspension for Inhalation in the Treatment of Pediatric Pneumonia

目的:观察麻杏石甘汤加味联合吸入用布地奈德混悬液氧气雾化吸入治疗小儿肺炎的临床疗效。方法:将98例肺炎患儿随机分为对照组和研究组各49例。对照组给予吸入用布地奈德混悬液氧气雾化吸入治疗,研究组给予麻杏石甘汤加味联合吸入用布地奈德混悬液氧气雾化吸入治疗。疗程均为2周,比较2组临床效果、咳嗽和发热改善情况、肺功能,以及治疗前后2组症状体征积分变化。结果:治疗1、2周,研究组总有效率分别为95.9%、100%,对照组分别为59.2%、87.8%,2组相同时间点总有效率比较,差异均有统计学意义(P<0.05)。研究组咳嗽完全消失47例(95.9%),对照组29例(59.2%),2组比较,差异有统计学意义(P<0.05)。治疗前,2组症状体征积分比较,差异无统计学意义(P>0.05)。治疗1、2周,2组症状体征积分均较治疗前明显降低(P<0.05),且研究组症状体征积分在相同时间点均低于对照组(P<0.05)。研究组平均咳嗽消失时间、平均退热时间均短于对照组,差异有统计学意义(P<0.05)。治疗前,2组用力肺活量占预计值百分比(FVC%)、半肺活量位呼气流量(FEF50%)、最大呼气流量(PEF)、第1秒呼气容积占预计值百分比(FEV1%)水平比较,差异均无统计学意义(P>0.05)。治疗2周,2组FVC%、FEF50%、PEF、FEV1%水平均较治疗前升高(P<0.05),且研究组FVC%、FEF50%、PEF、FEV1%水平均高于对照组(P<0.05)。结论:麻杏石甘汤加味联合吸入用布地奈德混悬液氧气雾化吸入治疗小儿肺炎,可提高临床总有效率,显著改善患儿临床症状、体征及肺功能,疗效优于单纯西药治疗。

Objective: To observe the clinical effect of Maxing Shigan tang combined with oxygen atomization therapy with budesonide suspension for inhalation in the treatment of pediatric pneumonia.Methods:A total of 98 cases of children with pediatric pneumonia were randomly divided into the control group and the study group, with 49 cases in each group. The control group was treated with oxygen atomization therapy with budesonide suspension for inhalation, and the study group was treated with Maxing Shigan tang combined with oxygen atomization therapy with budesonide suspension for inhalation.Both groups were treated for two weeks. The clinical effects,the improvement of cough and fever,the lung function[forced vital capacity(FVC),50%forced expiratory flow(FEF50%),peak expiratory flow(PEF)and the percentage of forced expiratory vdume in one second to the predicted value(FEV1%)], and the changes in scores of symptoms and signs before and after treatment in the two groups were compared.Results:After treatment for one and two weeks,the total effective rate was 95.9% and 100%in the study group,and 59.2%and 87.8% in the control group,and there being significant difference being found in the comparison of the total effective rate at the same time period between the two groups(P<0.05). There were 47 cases(95.9%) of complete disappearance of cough in the study group and 29 cases(59.2%) in the control group, the difference being significant(P<0.05). Before treatment, there was no significant difference being found in the comparison of scores of symptoms and signs between the two groups(P>0.05). After treatment for one and two weeks,the scores of symptoms and signs in the two groups were significantly decreased when compared with those before treatment(P<0.05),and the scores at the same period in the study group were lower than those in the control group(P<0.05). The average disappearance time of cough and average antipyretic time in the study group were shorter than those in the control group,differences being significant(P<0.05). Before treatment,there was no significant difference being found in the comparison of FVC%,FEF50%,PEF and FEV1% between the two groups(P>0.05). After two-week treatment, the levels of FVC%, FEF50%, PEF and FEV1% in the two groups were increased when compared with those before treatment(P<0.05),and the levels of FVC%,FEF50%,PEF and FEV1% in the study group were higher than those in the control group(P<0.05). Conclusion: The application of Maxing Shigan tang combined with oxygen atomization therapy with budesonide suspension for inhalation in the treatment of pediatric pneumonia can enhance total clinical effective rate and significantly improve symptoms, signs and lung function, whose curative effect was better than that of simple western medicine.