宣白承气汤加味鼻饲辅助治疗重症肺炎痰热壅肺证临床研究

Clinical Study on Nasogastric Feeding with Modified Xuanbai Chengqi Decoction for Severe Pneumonia with Phlegm-Heat Obstructing the Lung Syndrome

目的:观察宣白承气汤加味鼻饲辅助治疗重症肺炎痰热壅肺证的治疗效果。方法:112例重症肺炎痰热壅肺证患者根据随机数字表法分为治疗组与对照组各56例。对照组给予西医常规治疗,治疗组在对照组基础上联合宣白承气汤加味鼻饲治疗。比较2组治疗前后中医证候评分、血气指标、炎症因子水平,评估2组临床疗效及不良反应发生情况。结果:研究过程中,治疗组剔除3例,对照组剔除4例,最终治疗组完成研究53例,对照组完成研究52例。治疗后,治疗组总有效率92.45%,高于对照组78.85%(P<0.05)。2组治疗后中医证候评分、二氧化碳分压(PaCO_(2))及血清白细胞介素-6(IL-6)、降钙素原(PCT)、肿瘤坏死因子-α(TNF-α)水平均较治疗前降低(P<0.05),γ-干扰素(IFN-γ)、血氧分压(PaO_(2))、血氧饱和度(SaO_(2))、血氧指数(PaO_(2)/FiO_(2))水平升高(P<0.05);治疗组治疗后中医证候评分、PaCO_(2)、IL-6、PCT、TNF-α水平低于对照组(P<0.05),IFN-γ、PaO_(2)、SaO_(2)、PaO_(2)/FiO_(2)水平均高于对照组(P<0.05)。2组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:宣白承气汤加味鼻饲辅助治疗重症肺炎痰热壅肺证,能够改善患者血气指标,减轻机体炎症反应,疗效显著,安全性较高。

Objective:To observe the curative effect of nasogastric feeding with modified Xuanbai Chengqi Decoction on severe pneumonia with phlegm-heat obstructing the lung syndrome.Methods:A total of 112 patients with severe pneumonia with phlegm-heat obstructing the lung syndrome were divided into the treatment group and the control group according to the random number table method,with 56 cases in each group.The control group was treated with conventional western medicine treatment,and the treatment group was additionally treated with nasogastric feeding with modified Xuanbai Chengqi Decoction based on the treatment of the control group.Traditional Chinese medicine(TCM)syndrome scores,levels of blood gas indicators and inflammatory factors were compared between the two groups before and after treatment.Clinical effects and the incidence of adverse reactions were evaluated in the two groups.Results:During the study,3 cases were excluded from the treatment group and 4 cases were excluded from the control group;ultimately,53 cases in the treatment group and 52 cases in the control group finished the study.After treatment,the total effective rate was 92.45%in the treatment group,higher than that of 78.85%in the control group(P<0.05).After treatment,TCM syndrome scores and the levels of partial pressure of carbo n dioxide(PaCO_(2)),interleukin-6(IL-6),procalcitonin(PCT),and tumor necrosis factor-α(TNF-α)in serum in the two groups were decreased when compared with those before treatment(P<0.05),and the levels of interferon-γ(IFN-γ),partial pressure of oxygen(PaO_(2)),oxygen saturation(SaO_(2)),and the ratio of arterial oxygen partial pressure to fractional inspired oxygen(PaO_(2)/FiO_(2))were increased(P<0.05).After treatment,TCM syndrome scores and PaCO_(2),IL-6,PCT,and TNF-αlevels in the treatment group were lower than those in the control group(P<0.05);the levels of IFN-γ,PaO_(2),SaO_(2),and PaO_(2)/FiO_(2)in the treatment group were higher than those in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Nasogastric feeding with modified Xuanbai Chengqi Decoction has a significant curative effect in the treatment of severe pneumonia with phlegm-heat obstructing the lung syndrome and can improve blood gas indicators and relieve body inflammatory reactions with high safety.