中药穴位贴敷辅助治疗小儿肺炎痰热闭肺证的效果研究

Study on the therapeutic effect of traditional chinese medicine acupoint application on children with pneumonia of phlegm-heat obstructing lung syndrome

目的 探讨西医常规治疗联合中药穴位贴敷对小儿肺炎痰热闭肺证的治疗效果。方法 漳州市芗城区妇幼保健院2020年5月-2021年12月收治的80例肺炎患儿,均符合肺炎喘嗽的痰热闭肺证候分类标准。根据治疗方法不同分为观察组和对照组,各40例。两组均给予西医常规治疗,观察组在西医常规治疗基础上给予中药穴位贴敷,治疗时间均为10d。比较两组症状持续时间,治疗前及治疗后7、14d时的主要症状积分;治疗前后外周血中T淋巴细胞亚群变化及炎症因子水平变化。结果 重复测量方差分析显示,主症积分、T淋巴细胞亚群(CD3~+、CD3~+ CD4~+、CD3~+ CD8~+)和炎症因子(IL-6、TNF-α、IFN-γ)水平均存在显著的时间主效应、组间主效应和交互效应(P<0.001)。简单效应分析表明,治疗前两组各指标无显著差异(P>0.05)。治疗7、14d,观察组主症积分显著低于对照组(P<0.001),CD3~+、CD3~+ CD4~+显著高于对照组,CD3~+ CD8~+显著低于对照组(均P<0.001);观察组IL-6、TNF-α、IFN-γ水平显著低于对照组(均P<0.001)。两组不同时间点间的主症积分、T淋巴细胞亚群(CD3~+、CD3~+ CD4~+、CD3~+ CD8~+)及IL-6、TNF-α、IFN-γ水平差异均有显著性(均P<0.001)。观察组咳嗽消失时间、退热时间、肺部湿啰音消失时间和住院时间均显著短于对照组(均P<0.001)。结论 西医联合中药穴位贴敷治疗小儿肺炎痰热闭肺证的临床效果明显,可能与提升患儿机体免疫力,降低体内炎症因子水平有关。

Objective To investigate the therapeutic effect of conventional western medicine treatment combined with traditional Chinese medicine(TCM)acupoint application on children with pneumonia of phlegm-heat obstructing lung syndrome.Methods A total of 80 pediatric patients with pneumonia who met the diagnostic criteria of phlegm-heat obstructing lung syndrome of dyspnea due to pneumonia were recruited from the Zhangzhou Xiangcheng District Maternity and Child Health Hospital between May 2020 and December 2021.The patients were divided into an observation group and a control group,with 40 patients in each group.Both groups received conventional western medicine treatment,while the observation group additionally received TCM acupoint application for 10 days.The duration of symptoms,primary symptom scores before and 7,14 days after treatment,changes in T lymphocyte subsets in peripheral blood,and levels of inflammatory factors were compared between the two groups.Results Repeated measures analysis of variance showed significant time main effects,group main effects,and interaction effects for the primary symptom scores,T lymphocyte subsets(CD3+,CD3+CD4+,CD3+CD8+),and inflammatory factors(IL-6,TNF-α,IFN-γ)(all P<0.001).Simple effect analysis indicated no significant differences in these indicators between the two groups before treatment(P>0.05).At 7 and 14 days after treatment,the primary symptom scores in the observation group were significantly lower than those in the control group(P<0.001),while CD3+and CD3+CD4+were significantly higher,and CD3+CD8+was significantly lower in the observation group compared to the control group(all P<0.001).The levels of IL-6,TNF-α,and IFN-γin the observation group were also significantly lower than those in the control group(all P<0.001).There were significant differences in primary symptom scores,T lymphocyte subsets(CD3+,CD3+CD4+,CD3+CD8+),and IL-6,TNF-α,IFN-γlevels between the two groups at different time points(all P<0.001).The cough disappearance time,fever abatement time,lung wet rales disappearance time,and hospitalization time in the observation group were significantly shorter than those in the control group(all P<0.001).Conclusion The clinical effect of conventional western medicine combined with TCM acupoint application in treating children with pneumonia of phlegm-heat obstructing lung syndrome is significant,which may be related to enhancing the children's immune function and reducing the levels of inflammatory factors in the body.