黄龙合剂加减方联合穴位贴敷辅助治疗小儿肺炎支原体大叶性肺炎风热闭肺证30例临床观察

Clinical observation on the adjuvant therapy of modified Huanglong Heji(黄龙合剂)combined with acupoint application in 30 cases of mycoplasma pneumoniae lobar pneumonia of wind heat blocking the lung pattern in children

目的观察黄龙合剂加减方联合穴位贴敷辅助治疗小儿肺炎支原体大叶性肺炎风热闭肺证的临床疗效。方法选取2023年1—6月宜兴市中医医院儿科收治的60例肺炎支原体大叶性肺炎风热闭肺证患儿,按照随机数字表法分为对照组和治疗组,各30例。对照组予阿奇霉素+头孢菌素治疗,并根据情况予退热、平喘、化痰、补液等对症治疗,治疗组在对照组治疗方法的基础上加黄龙合剂加减方联合穴位贴敷,2组均治疗14 d后,比较2组的临床疗效、症状体征消失时间、炎症指标水平及不良反应发生率。结果治疗组总有效率为93.33%(28/30),明显高于对照组的80.00%(24/30),2组比较,差异有统计学意义(P<0.05)。治疗组热退时间、咳嗽消失时间及肺部阴影吸收时间均短于对照组,2组比较,差异有统计学意义(P<0.05)。治疗前2组血清C反应蛋白(CRP)、降钙素原(PCT)、肝素结合蛋白(HBP)水平比较,差异无统计学意义(P>0.05),具有可比性;治疗后2组上述指标均显著下降,与同组治疗前比较,差异有统计学意义(P<0.05),且治疗组下降更显著(P<0.05)。治疗期间,对照组不良反应发生率为6.67%(2/30)(恶心呕吐1例,轻微腹痛1例),治疗组为6.67%(2/30)(腹泻1例,皮疹1例),2组不良反应发生率比较,差异无统计学意义(P>0.05)。结论黄龙合剂加减方联合穴位贴敷辅助治疗小儿肺炎支原体大叶性肺炎风热闭肺证,能有效缓解患儿临床症状,减轻炎症反应,疗效显著,且安全性良好,值得临床推广应用。

Objective To observe the clinical efficacy of modified Huanglong Heji(黄龙合剂)combined with acupoint application as adjuvant therapy in children with mycoplasma pneumoniae lobar pneumonia of wind heat blocking the lung pattern.Methods Sixty children with mycoplasma pneumoniae lobar pneumonia of wind heat blocking the lung pattern admitted to the Pediatrics Department of Yixing Traditional Chinese Medicine Hospital from January 2023 to June 2023 were selected and divided into a control group and a treatment group using a random number table method,with 30 cases in each group.The control group received azithromycin plus cephalosporin therapy and symptomatic treatment such as antipyretic,antiasthmatic,expectorant,and fluid replacement as needed.The treatment group received modified Huanglong Heji combined with acupoint application on the basis of the control group's treatment methods.After 14 days of treatment,the clinical efficacy,disappearance time of symptoms and signs,levels of inflammatory indicators,and incidence of adverse reactions were compared between the two groups.Results The total effective rate was 93.33%(28/30)in the treatment group and significantly higher at 80.00%(24/30)in the control group,with a statistically significant difference between the two groups(P<0.05).The time to fever resolution,cough disappearance,and lung shadow absorption were shorter in the treatment group than in the control group,with statistically significant differences between the two groups(P<0.05).Before treatment,there were no statistically significant differences in the levels of serum C-reactive protein(CRP),procalcitonin(PCT),and heparin-binding protein(HBP)between the two groups(P>0.05),indicating comparability.After treatment,all the above indicators significantly decreased in both groups compared with before treatment in the same group(P<0.05),and the decrease was more significant in the treatment group(P<0.05).During treatment,adverse reactions occurred in 2 cases in the control group(1 case of nausea and vomiting,1 case of mild abdominal pain)and 2 cases in the treatment group(1 case of diarrhea,1 case of rash).There was no statistically significant difference in the incidence of adverse reactions between the two groups(both 6.67%)(P>0.05).Conclusion Modified Huanglong Heji combined with acupoint application as adjuvant therapy in children with mycoplasma pneumoniae lobar pneumonia of wind heat blocking the lung pattern can effectively alleviate clinical symptoms,reduce inflammatory responses,and exhibit significant efficacy with good safety,warranting clinical promotion and application.