化裁麻杏石甘汤加减治疗喘息性肺炎风热闭肺证的临床效果及对炎症因子的影响

Clinical effect and effect on inflammatory factors of treatment of asthmaticwind-heat blocking lung syndrome by adding and reducing Huacai Maxing Shigan Decoction

目的 探讨化裁麻杏石甘汤加减治疗喘息性肺炎风热闭肺证的临床效果及对炎症因子的影响。方法 选择2020年5月至2020年12月汕头市中医医院儿科与汕头市潮阳区人民医院儿科收治的84例喘息性肺炎风热闭肺证住院患儿,按照随机数字表法分为研究组与对照组,各42例。对照组在对症处理基础上给予孟鲁司特钠治疗,研究组在对照组治疗基础上给予化裁麻杏石甘汤加减治疗。比较两组西医疗效、中医证候疗效及治疗前后中医证候积分、炎症因子[C反应蛋白(C-reactive protein, CRP)、白细胞计数(White blood cell count, WBC)]水平、不良反应的异同。结果 (1)研究组西医总有效率(97.62%)高于对照组(88.10%),但差异无统计学意义(P>0.05)。(2)研究组中医证候总有效率(92.86%)较对照组(76.19%)高,差异有统计学意义(P<0.05)。(3)治疗前,两组主症、次症、舌象分值差异无统计学意义(P>0.05);治疗后,两组主症、次症、舌象分值均较治疗前下降,且研究组低于对照组(P<0.05)。(4)治疗前,两组CRP、WBC差异无统计学意义(P>0.05);治疗后,两组CRP、WBC均较治疗前下降,且研究组低于对照组(P<0.05)。(5)对照组、研究组不良反应发生率分别为2.38%、7.14%,二者差异无统计学意义(P>0.05)。结论 常规基础上采取化裁麻杏石甘汤加减治疗喘息性肺炎风热闭肺证,可缓解患儿临床症状,提升治疗效果,可能与其能下调WBC及CRP水平具有一定关联性。

Objective To explore the clinical effect of Huacai Maxing Shigan Decoction in treatment of asthmaticwind-heat blocking lung syndrome and observe the effect on inflammatory factors.Methods84 hospitalized children with asthmatic pneumonia and wind-heat lung closure syndrome who were admitted to the hospitalsfrom May 2020 to December 2020 were selected and divided into study groups according to the random number table method.and control group,42 cases each.The control group was given montelukast sodium treatment on the basis of symptomatic treatment,and the research group was given modified treatment of Huazai Maxingshigan Decoction on the basis of the treatment of the control group.Compare the similarities and differences in the efficacy of Western medicine,traditional Chinese medicine(TCM)syndrome efficacy,TCM syndrome scores,inflammatory factor[C-reactive protein(CRP),white blood cell count(WBC)]levelsand adverse reactions before and after the treatment between the2 groups.Results(1)The total effective rate of Western medicine in the study group(97.62%)was higher than that in the control group(88.10%),but the difference was not statistically significant(P>0.05).(2)The total effective rate of TCM syndrome in the study group(92.86%)was higher than that in the control group(76.19%),and the difference was statistically significant(P<0.05).(3)Before the treatment,there was no statistically significant difference in the scores of primary symptoms,secondary symptomsand tongue appearance between the 2 groups(P>0.05).After the treatment,the scores of primary symptoms,secondary symptomsand tongue appearance in both groups were lower than before thetreatment.And the research group was lower than the control group(P<0.05).(4)Before the treatment,there was no statistically significant difference in CRP and WBC between the 2 groups(P>0.05).After the treatment,CRP and WBC in both groups were lower than before the treatment,and the study group was lower than the control group(P<0.05).(5)The incidence rates of adverse reactions in the control group and study group were 2.38%and 7.14%respectively,and there was no statistical significance between the two groups(P>0.05).ConclusionOn the basis of routine treatment of asthmaticwind-heat blocking lung syndrome,the addition and reduction of Huacai Maxing Shigan Decoction can alleviate the clinical symptoms of children and improve the therapeutic effect,which may have a certain correlation with its ability to reduce the levels of WBC and CRP.