薤胆汤治疗成人肺炎支原体感染相关呼吸道疾病临床观察

Clinical Observation of Xiedan Decoction for the Treatment of Mycoplasma Pneumoniae Infection-related Respiratory Diseases in Adults

【目的】观察薤胆汤(由薤白、龙胆草、川厚朴、延胡索等中药组成)联合左氧氟沙星片治疗成人肺炎支原体感染相关呼吸道疾病的临床疗效。【方法】将86例肺炎支原体感染相关呼吸道疾病肝火郁肺、寒热错杂证患者(年龄>18周岁)随机分为观察组和对照组,每组各43例。对照组患者给予左氧氟沙星片口服治疗,观察组在对照组的基础上配合薤胆汤加减治疗,疗程为14 d,并于治疗结束后3个月随访。观察2组患者治疗前后咳嗽、口苦咽痛、乏力、脘闷纳差等各项中医证候积分的变化情况,比较2组患者各项中医证候的消失时间和肺炎支原体特异性抗体IgM(MP-IgM)转阴率,评价2组患者的临床疗效和安全性。【结果】(1)疗效方面,治疗14 d后,观察组的愈显率为90.7%(39/43),明显高于对照组的74.4%(32/43),组间比较,差异有统计学意义(P<0.05)。(2)治疗后,2组患者的咳嗽、口苦咽痛、乏力、脘闷纳差等各项中医证候积分均较治疗前下降(P<0.05),且观察组对各项中医证候积分的下降作用均明显优于对照组,差异均有统计学意义(P<0.05或P<0.01)。(3)治疗后,观察组的咳嗽、口苦咽痛、乏力、脘闷纳差等各项中医证候的消失时间均较对照组明显缩短,差异均有统计学意义(P<0.01)。(4)治疗结束后随访3个月,观察组的MP-IgM转阴率为88.4%(38/43),明显高于对照组的69.8%(30/43),组间比较,差异有统计学意义(P<0.05)。(5)治疗过程中,2组患者均未出现血常规、肝肾功能等安全性指标的异常变化。【结论】薤胆汤联合左氧氟沙星片治疗成人肺炎支原体感染相关呼吸道疾病疗效确切,能有效改善患者临床症状,缩短症状消失时间,并能改善相关血清学指标。

Objective To observe the clinical efficacy of Xiedan Decoction(mainly composed of Allii Macrostemonis Bulbus,Gentianae Radix et Rhizoma,Magnoliae Officinalis Cortex,and Corydalis Rhizoma)combined with Levofloxacin Tablets for the treatment of mycoplasma pneumoniae(MP)infection-related respiratory diseases in adults.Methods Eighty-six patients(aged over 18 years old)of MP infection-related respiratory diseases with liver-fire stagnating lung and concurrence of cold and heat syndrome were randomly divided into the observation group and the control group,with 43 patients in each group.Patients in the control group were given oral use of Levofloxacin Tablets,while patients in the observation group were treated with modified Xiedan Decoction on the basis of treatment for the control group.The treatment for both groups lasted 14 days and the patients were followed up for 3 months after the completion of treatment.Before and after treatment,we observed the changes in the scores of traditional Chinese medicine(TCM)symptoms such as cough,bitterness in the mouth and sore throat,fatigue,epigastric stuffiness and poor appetite,compared the time for the disappearance of TCM symptoms and the negative-conversion rate of MP specific antibody IgM(MP-IgM),and evaluated the clinical efficacy and safety of the patients in the two groups.Results(1)After 14 days of treatment,the cured and markedly-effective rate of the observation group was 90.7%(39/43),which was significantly higher than that of the control group[74.4%(32/43)],and the intergroup comparison showed that the difference was statistically significant(P<0.05).(2)After treatment,TCM symptoms such as cough,bitterness in the mouth and sore throat,fatigue,epigastric stuffiness and poor appetite in both groups were decreased compared with those before treatment(P<0.05),and the effect on lowering the TCM syndrome scores in the observation group was significantly superior to that in the control group,the difference being statistically significant(P<0.05 or P<0.01).(3)After treatment,the time for the disappearance of each TCM symptom such as cough,bitterness in the mouth and sore throat,fatigue,epigastric stuffiness and poor appetite in the observation group was significantly shortened compared with that in the control group,and the difference was statistically significant(P<0.01).(4)The 3-month follow-up after the completion of treatment showed that the negative-conversion rate of MP-IgM in the observation group was 88.4%(38/43),which was significantly higher than that in the control group[69.8%(30/43)],and the difference between the two groups was statistically significant(P<0.05).(5)During the treatment,no abnormal changes in blood routine test,liver and kidney function and other safety indicators in the two groups were found.Conclusion Xiedan Decoction combined with Levofloxacin Tablets exerts certain effect for the treatment of MP infection-related respiratory diseases in adults,and the combined therapy is effective on relieving the clinical symptoms,shortening the time for the disappearance of symptoms and improving serological indexes in the patients.