自制小健中汤穴位贴敷辅助治疗成人社区获得性肺炎肺脾气虚证临床研究

Clinical Study on Point Application of Self-Made Xiaojianzhong Decoction for Adult Community-Acquired Pneumonia with Syndrome of Lung-Spleen Qi Deficiency

目的:观察自制小健中汤穴位贴敷辅助治疗成人社区获得性肺炎(CAP)肺脾气虚证的临床疗效。方法:选取2021年7月—2023年7月确诊为CAP的病例,共74例,根据随机数字表法分成2组各37例。对照组参考CAP诊疗指南予常规治疗措施;治疗组在对照组治疗方案的基础上予自制小健中汤穴位贴敷治疗。2组连续观察10 d。比较2组肺功能、动脉血气指标、临床肺部感染评分(CPIS)、治疗效果以及血清降钙素原(PCT)与C-反应蛋白(CRP)水平。结果:治疗10 d后,2组肺活量(VC)、最大自主通气量(MVV)、第1秒用力呼气容积(FEV_(1))均较治疗前升高,且治疗组VC、MVV、FEV_(1)高于对照组,差异均有统计学意义(P<0.05)。治疗10 d后,2组血氧饱和度(SaO_(2))与血氧分压(PaO_(2))均较治疗前升高,二氧化碳分压(PaCO_(2))较治疗前下降,差异均有统计学意义(P<0.05);治疗组SaO_(2)及PaO_(2)均高于对照组,治疗组PaCO_(2)低于对照组,差异均有统计学意义(P<0.05)。治疗10 d后,2组CPIS评分较治疗前减少,差异有统计学意义(P<0.05),治疗组CPIS评分低于对照组,差异有统计学意义(P<0.05)。治疗10 d后,2组血清PCT及CRP水平均较治疗前下降,治疗组血清PCT及CRP水平均低于对照组,差异均有统计学意义(P<0.05)。治疗10 d后,临床疗效总有效率治疗组97.30%,对照组78.38%,差异有统计学意义(P<0.05)。结论:自制小健中汤穴位贴敷辅助治疗成人CAP肺脾气虚证临床疗效良好,能抑制炎症反应,有效改善患者的肺功能、动脉血气指标以及临床症状。

Objective:To observe the clinical effect of point application of self-made Xiaojianzhong Decoction on adult community-acquired pneumonia(CAP)with syndrome of lung-spleen qi deficiency.Methods:A total of 74 cases diagnosed with CAP from July 2021 to July 2023 were selected and divided into two groups according to random number table method,with 37 cases in each group.The control group was given conventional treatment according to CAP diagnosis and treatment guidelines,and the treatment group was treated with point application of self-made Xiaojianzhong Decoction based on the treatment of the control group.The two groups were observed for 10 days.The lung function,arterial blood gas indexes,clinical pulmonary infection score(CPIS),therapeutic effect and serum procalcitonin(PCT)and C-reactive protein(CRP)levels were compared between the two groups.Results:After 10-day treatment,the vital capacity(VC),maximum voluntary ventilation(MVV)and forced expiratory volume in one second(FEV_(1))in the two groups were increased when compared with those before treatment,and the VC,MVV and FEV_(1)in the treatment group were higher than those in the control group,the difference being significant(P<0.05).After 10-day treatment,the blood oxygen saturation(SaO_(2))and blood oxygen partial pressure(PaO_(2))in the two groups were increased when compared with those before treatment,and the partial pressure of carbon dioxide(PaCO_(2))was decreased when compared with that before treatment,differences being significance(P<0.05).SaO_(2)and PaO_(2)in the treatment group were higher than those in the control group,and PaCO_(2)in the treatment group was lower than that in the control group,differences being significance(P<0.05).After 10-day treatment,the CPIS scores in the two groups were decreased when compared with those before treatment,the difference being significance(P<0.05),and the CPIS score in the treatment group was lower than that in the control group,the difference was statistically significant(P<0.05).After 10-day treatment,the serum levels of PCT and CRP in the two groups were decreased when compared with those before treatment,and serum levels of PCT and CRP in the treatment group were decreased when compared with those in the control group,differences being significance(P<0.05).After 10-day treatment,the total effective rate was 97.30%in the treatment group,and 78.38%in the control group,differences being significance(P<0.05).Conclusion:The point application of self-made Xiaojianzhong Decoction has good clinical effect on adult CAP with syndrome of lung-spleen qi deficiency,which can inhibit inflammation,effectively improve lung function,arterial blood gas indexes and clinical symptoms of patients.