中西医结合治疗儿童大叶性肺炎的临床研究

Clinical study on the treatment of lobar pneumonia in children with combination of traditional Chinese and western medicine

目的探讨中西医结合治疗儿童大叶性肺炎的临床效果。方法选取2021年6月至2023年7月宝鸡市妇幼保健院儿科收治的6~14岁大叶性肺炎患儿100例作为研究对象,采用随机数字表法将患儿分为对照组(50例)和治疗组(50例)。对照组男27例,女23例;年龄(9.03±1.42)岁;病程(8.75±1.76)d。治疗组男25例,女25例;年龄(9.28±1.69)岁;病程(8.46±1.63)d。对照组采用常规西医治疗,治疗组在对照组基础上采用口服麦门冬汤合六君子汤配合中医治疗。两组均治疗4周。比较两组临床疗效、症状消失时间(咳嗽持续时间、退热时间、肺部X线片影像好转时间)、实验室指标[白细胞总数(WBC)、C反应蛋白(CRP)、血沉(ESR)、降钙素原(PCT)和D-二聚体(D-dimer)]和肺功能指标[用力肺活量(FVC)、第1秒用力呼气容积(FEV1)、呼气峰值流量(PEF),用力呼出肺活量25%、50%、75%的瞬间流量(FEF25%、FEF50%、FEF75%),最大呼气中期流量(MMEF)]。采用独立样本t检验和χ^(2)检验。结果治疗组患儿治疗总有效率[96.00%(48/50)]高于对照组[84.00%(42/50)],差异有统计学意义(P<0.05)。治疗组患儿咳嗽持续时间[(7.13±1.55)d]、退热时间[(2.44±1.04)d]及肺部X线片影像好转时间[(12.34±1.83)d]均短于对照组[(10.73±1.79)d、(4.39±1.35)d、(16.68±2.46)d],差异均有统计学意义(均P<0.05)。治疗后,治疗组CRP[(8.79±3.75)mg/L]、ESR[(16.48±3.58)mm/h]、PCT[(0.48±0.27)μg/L]、D-dimer[(575.64±106.89)μg/L]水平均低于对照组[(11.37±4.97)mg/L、(19.16±3.86)mm/h、(0.69±0.23)μg/L、(798.46±113.78)μg/L],差异均有统计学意义(均P<0.05);治疗组FVC、FEV1、PEF、FEF 25%、FEF 50%、FEF 75%、MMEF均高于对照组(均P<0.05)。结论中西医结合治疗大叶性肺炎可显著提高患儿治疗总有效率,改善症状和肺功能,恢复生理指标。此方案有望为儿童大叶性肺炎的治疗提供新思路,值得在临床上推广应用。

Objective To investigate the clinical effect of combined traditional Chinese and western medicine treatment for children with lobar pneumonia.Methods A total of 100 children with lobar pneumonia aged 6-14 years admitted to the pediatric department of Baoji Maternal and Child Health Hospital from June 2021 to July 2023 were selected as the study objects,and were divided into a control group(50 cases)and a treatment group(50 cases)by the random number table method.In the control group,27 boys and 23 girls were(9.03±1.42)years old,and the course of disease was(8.75±1.76)days.In the treatment group,25 boys and 25 girls were(9.28±1.69)years old,and the course of disease was(8.46±1.63)days.The control group received conventional western medical treatment,and the treatment group was treated with oral Maimendong decoction and Liujunzi decoction combined with traditional Chinese medicine on the basis.Both groups were treated for 4 weeks.The clinical efficacy,symptom resolution time(duration of cough,fever resolution time,and improvement time of lung X-ray images),laboratory indicators[total white blood cell count(WBC),C-reactive protein(CRP),erythrocyte sedimentation rate(ESR),procalcitonin(PCT),and D-dimer],and lung function indicators[forced vital capacity(FVC),forced expiratory volume in one second(FEV1),peak expiratory flow(PEF),forced expiratory flow at 25%,50%,and 75%of FVC(FEF25%,FEF50%,and FEF75%),and maximum mid-expiratory flow rate(MMEF)]were compared between the two groups.Independent sample t test andχ^(2) test were used.Results The total effective rate of the treatment group[96.00%(48/50)]was higher than that of the control group[84.00%(42/50)],with a statistically significant difference(P<0.05).The duration of cough[(7.13±1.55)d],fever resolution time[(2.44±1.04)d],and improvement time of lung X-ray images[(12.34±1.83)d]in the treatment group were shorter than those in the control group[(10.73±1.79)d,(4.39±1.35)d,and(16.68±2.46)d],with statistically significant differences(all P<0.05).After treatment,the levels of CRP[(8.79±3.75)mg/L],ESR[(16.48±3.58)mm/h],PCT[(0.48±0.27)μg/L],and D-dimer[(575.64±106.89)μg/L]in the treatment group were lower than those in the control group[(11.37±4.97)mg/L,(19.16±3.86)mm/h,(0.69±0.23)μg/L,and(798.46±113.78)μg/L],with statistically significant differences(all P<0.05).The FVC,FEV1,PEF,FEF 25%,FEF 50%,FEF 75%,and MMEF in the treatment group were higher than those in the control group(all P<0.05).Conclusions The combination of traditional Chinese and western medicine in the treatment of lobar pneumonia can significantly improve the clinical efficacy rate in children,notably ameliorate the symptoms,significantly restore the physiological indicators,and notably improve the lung function.This approach holds promise for providing a new direction in the treatment of pediatric lobar pneumonia,and is worth further clinical application and promotion.