麻杏化痰汤加减辅助治疗小儿肺炎痰热闭肺证78例临床观察

Clinical observation on 78 cases of modified Maxing Huatan Tang(麻杏化痰汤)in adjuvant treatment of infantile pneumonia with phlegm-heat obstructing lung syndrome

目的观察麻杏化痰汤加减辅助治疗小儿肺炎痰热闭肺证的临床疗效。方法选取2019年4月至2021年4月余姚市妇幼保健院儿科收治的肺炎痰热闭肺证患儿156例,采用随机数字表法分为对照组和治疗组,各78例。对照组予盐酸氨溴索注射液静脉滴注,细菌感染者予头孢曲松钠静脉滴注,肺炎支原体感染者予阿奇霉素静脉滴注,同时根据患儿情况给予退热、止咳、化痰、平喘、解痉等西医对症治疗。治疗组在对照组治疗方法的基础上给予麻杏化痰汤治疗。2组均以7 d为1个疗程,治疗1个疗程后统计疗效。结果对照组总有效率为88.46%(69/78),治疗组为97.44%(76/78),2组比较,差异有统计学意义(P<0.05)。治疗前2组主、次症各项积分和总积分比较,差异无统计学意义(P>0.05),具有可比性;治疗后2组主、次症各项积分和总积分均明显下降,与同组治疗前比较,差异有统计学意义(P<0.05),且治疗组下降更显著(P<0.05)。治疗组咳嗽、发热、咳痰、气促及肺部湿啰音改善或消失时间均短于对照组,2组比较,差异有统计学意义(P<0.05)。结论麻杏化痰汤加减辅助治疗小儿肺炎痰热闭肺证,能明显改善患儿的临床症状、体征和中医证候积分,疗效显著,值得临床推广应用。

Objective To observe the clinical effect of modified Maxing Huatan Tang(麻杏化痰汤)in adjuvant treatment of pneumonia in children with phlegm-heat obstructing lung syndrome.Methods 156 cases of pneumonia in children with phlegm-heat obstructing lung syndrome admitted to Pediatric Department of Yuyao Maternity and Child Health Care Hospital from April 2019 to April 2021 were divided into a control group and a treatment group in a random number table,with 78 cases in each group.The control group was given ambroxol hydrochloride injection by intravenous drip,the bacterial infected patients were given ceftriaxone sodium by intravenous drip,and the mycoplasma pneumoniae infected patients were given azithromycin by intravenous drip,and symptomatic treatment was given to reduce fever,relieve cough,phlegm,asthma and spasm according to condition of the children.The treatment group was treated with Maxing Huatan Tang on the basis of the control group.We kept statistics about the efficacy after the 2 groups were both continuously treated for 7 days.Results The total effective rate was 88.46%(69/78)in the control group and 97.44%(76/78)in the treatment group.There was statistically significant difference between the 2 groups(P<0.05).Before treatment,there was no significant difference in the scores and total scores of primary and secondary symptoms between the two groups(P>0.05),indicating that the two groups were comparable.After treatment,the scores and total scores of primary and secondary symptoms decreased significantly,and the difference was statistically significant compared with that before treatment(P<0.05),and the decrease was more significant in the treatment group(P<0.05).The improvement or disappearance time of cough,fever,sputum,shortness of breath and pulmonary moist rales in the treatment group was shorter than that in the control group,and the difference was statistically significant(P<0.05).Conclusion Modified Maxing Huatan Tang in the adjuvant treatment of pneumonia in children with phlegm-heat obstructing lung syndrome can effectively improve the clinical symptoms,signs of children,TCM syndrome score with significant curative effects,which is worthy of clinical promotion and application.