清金化痰汤加减治疗痰热郁肺型细菌性肺炎临床有效性及安全性评价

摘要/Abstract

摘要： 目的探究与分析清金化痰汤加减治疗痰热郁肺型细菌性肺炎临床有效性及安全性。方法选取2022年1月—2022年12月无锡市惠山区中医医院呼吸内科收治的60例痰热郁肺型细菌性肺炎患者作为研究对象,采取随机数表法将其分为对照组与观察组,每组30例。对照组采取常规西药治疗,观察组在对照组基础上加用清金化痰汤加减治疗,比较两组临床疗效、治疗后主要症状消失时间以及治疗前后实验室指标,同时观察两组不良反应发生情况。结果观察组与对照组相比临床总有效率更高,差异有统计学意义（P<0.05）。观察组与对照组相比,咳嗽、咳痰、发热、喘息、肺部湿啰音消失时间较短,差异有统计学意义（P<0.05）。观察组治疗后与对照组治疗后相比白细胞计数降低、血清降钙素原水平降低、C反应蛋白水平较低,差异有统计学意义（P<0.05）。两组治疗前后肝肾功能指标结果并未出现明显的症状表现及变化,观察组仅出现1例恶心症状,对照组与观察组的不良反应比较,差异无统计学意义（P>0.05）。结论清金化痰汤加减治疗痰热郁肺型细菌性肺炎的临床疗效突出,能够有效地改善相关症状及体征,改善实验室指标,缩短主要症状消失时间,且治疗期间无明显不良反应发生,安全性较高。

关键词: 清金化痰汤加减, 痰热郁肺型, 肺炎

Abstract: Objective To explore and analyze the clinical efficacy and safety of Qingjin Huatan Decoction in the treatment of phlegm-heat stagnation lung type bacterial pneumonia. Methods Sixty patients with phlegm-heat pneumonic bacterial pneumonia treated in Department of respiratory medicine, Huishan Hospital of Traditional Chinese Medicine from January 2022 to December 2022 were selected and divided into control group and observation group by random number table method, with 30 cases in each group. The control group was treated with conventional western medicine, and the observation group was treated with Qingjin Huatan Decoction on the basis of the control group. The clinical efficacy, the time for the main symptoms to disappear after treatment and the laboratory indexes before and after treatment were observed. Results The total effective rate of the observation group was higher than that of the control group, and the difference was statistically significant (P<0.05). The disappearance time of cough, sputum, fever, wheezing and pulmonary moist rales in observation group was shorter than that in control group, and the difference was statistically significant (P<0.05). After treatment, the leukocyte count, serum procalcitonin level and C-reactive protein level in the observation group were lower than those in the control group, and the differences were statistically significant (P<0.05). There were no obvious symptoms or changes in liver and kidney function indexes between the two groups before and after treatment, and there was only 1 case of nausea in the observation group. There was no statistically significant difference in adverse reactions between the control group and the observation group (P>0.05). Conclusion Qingjin Huatan Decoction has outstanding clinical efficacy in the treatment of phlegm-heat stagnation lung type bacterial pneumonia, which can effectively improve related symptoms and signs, improve laboratory indicators, shorten the time for the main symptoms to disappear, and have no obvious adverse reactions during treatment, with high safety.

Key words: Qingjin Huatan Tang decoction, Phlegm-heat stagnation lung type, pneumonia

中图分类号:

R563.1

朱佳琪. 清金化痰汤加减治疗痰热郁肺型细菌性肺炎临床有效性及安全性评价[J]. 中华养生保健, 2024, 42(12): 27-30.

ZHU Jia-qi. Clinical Efficacy and Safety Evaluation of Qingjin Huatan Decoction in Treating Bacterial Pneumonia of Phlegm-Heat Obstructing Lung Type[J]. ZHONGHUA YANGSHENG BAOJIAN, 2024, 42(12): 27-30.

参考文献

[1] 费进军. 布地奈德联合复方异丙托溴铵治疗小儿肺炎支原体感染后咳嗽临床效果评估[J].药品评价,2019,16(6):42-44.
[2] Bai X R, Liu J M, Jiang D C, et al.Efficacy and safety of tigecycline monotherapy versus combination therapy for the treatment of hospital-acquired pneumonia (HAP): a meta-analysis of cohort studies[J]. J Chemother,2018,30(3):172-178.
[3] 许碧霞,钟晓红,王小琳,等.异丙托溴铵和布地奈德雾化吸入联合阿奇霉素治疗小儿支原体肺炎的效果探讨[J].医药前沿,2020, 10(14):52-53.
[4] 王志彦,王敏红.麻杏化瘀汤联合西医常规疗法治疗痰热闭肺型小儿肺炎喘嗽[J].吉林中医药,2018,38(11):40-41.
[5] 中华医学会,中华医学会临床药物分会,中华医学生全科医学分会,等.成人社区获得性肺炎基层合理用药指南[J].中华全科医师杂志,2020,19(9):783-791.
[6] 国家药品监督管理局.中药新药临床研究指导原则:试行[S].北京:中国医药科技出版社,2002:89-91.
[7] 王晶晶. 阿奇霉素序贯疗法联合布地奈德、可必特雾化吸入对小儿支原体肺炎的疗效及其对NO呼吸试验指标的影响[J].中国实用医药,2020,15(6):126-128.
[8] 张学燕 .清金化痰汤加减方治疗痰热郁肺型慢性支气管炎急性发作期的临床疗效[J].内蒙古中医药,2020,39(6):52-53.
[9] 徐炎,崔圣涛,白丽颖,等.拔罐联合抗生素治疗儿童细菌性肺炎:随机对照研究[J].中国针灸,2021,41(3):283-287.
[10] Mendelson F,Griesel R,Tiffin N,et al.C-reactive protein and procalcitonin to discriminate between tuberculosis,Pneumocystis jirovecii pneumonia,and bacterial pneumonia in HIV-infected inpatients meeting WHO criteria for seriously ill: a prospective cohort study[J]. BMC Infect Dis,2018,18(1) : 399.
[11] 姜桂美,袁旺贵,林谋德,等.《内经》放血疗法的应用探讨[J].河北中医,2014(6):903-906.
[12] 金瑞凡 .清金化痰汤加减治疗痰热郁肺型慢性支气管炎急性发作期的临床效果观察[J]. 中外医学研究,2019,17(8): 31-32.
[13] 王晓 .清金化痰汤加减治疗痰热郁肺型慢性支气管炎急性发作期的临床效果观察[J].智慧健康,2020,6(4):124-125.
[14] 陈文英 .清金化痰汤加减治疗痰热郁肺型慢性支气管炎急性发作期的临床效果观察[J]. 基层医学论坛,2019,23(29): 4250-4251.
[15] 赵小鹏 .清金化痰汤加减对痰热郁肺型慢性支气管炎免疫功能及血清炎性细胞因子的影响[J].现代中西医结合杂志,2018,27( 20): 2232-2235.
[16] Wang Q,Mi G, Hickey D, et al.Azithromycinloaded respirable microparticles for targeted pulmonary delivery for the treatment of pneumonia[J]. Biomaterials,2018,160(1):107-123.
[17] 李宏贵,张莹,黄蓓,等.硝黄散外敷联合加味五虎汤口服治疗痰热闭肺型肺炎支原体肺炎患儿对肺功能和血清TNF-α、IFN-γ、IL-4水平的影响[J].现代生物医学进展,2022,22(1):159-163.
[18] 李云,张洪春,刘剑,等.清金化痰方治疗社区获得性肺炎随机对照试验的系统评价[J].中医杂志,2021,62(1):37-43.
[19] 刘洁静,冯京帅,李霞,等.桑白皮汤加减治疗慢阻肺急性加重期(痰热壅肺型)的疗效观察[J].世界中医药,2021,16(12):1884-1889.
[20] 王鑫,赵雷,顾雯艳,等.升降散灌肠辅助治疗痰热蕴肺型呼吸机相关性肺炎的疗效及机制[J].实用临床医药杂志,2021,25(15):22-26.