中医内外合治小儿肺炎喘嗽临床疗效研究

【作者】 戴志国；

【导师】 吴力群；

【作者基本信息】 北京中医药大学 ， 中医儿科学， 2012， 硕士

【摘要】 目的：通过对肺炎喘嗽风热闭肺证及痰热闭肺证患儿运用中药蒿芩麻杏石甘汤配合中医外治法拔罐及中药离子导入治疗与西药常规治疗的疗效比较,观察中医内外合治法治疗小儿肺炎的临床疗效。方法：采用随机对照的方法,将符合纳入标准的60例北京中医药大学东方医院儿科门诊就诊及住院肺炎喘嗽(风热闭肺证和痰热闭肺证)患儿,随机分为2组,对照组和治疗组各30例。其中对照组中男14例,女16例,治疗组中男16例,女14例。对照组给予常规抗感染及对症治疗,治疗组在常规抗感染及对症治疗的基础上加用蒿芩麻杏石甘汤、中医外治法拔罐及中药离子导入治疗。通过对肺炎喘嗽患儿的主要症状及体征和次要症状及体征积分的比较,观察治疗组患儿经中医内外合治法治疗的临床疗效。通过对肺炎喘嗽患儿的热退时间、咳嗽消失时间及肺部罗音消失时间等主要临床疗效指标方面及治疗时间的比较,观察治疗组和对照组患儿在热退时间、咳嗽消失时间、肺部罗音消失时间及治疗时间上的差异。结果：对照组和治疗组的总有效率均为100%,提示治疗组与对照组治疗小儿肺炎喘嗽均有效。对照组和治疗组的治愈率分别为26.7%,43.3%,治疗组的治愈率高于对照组,但经统计学比较,无显著性差异(P>0.05),未提示治疗组的治愈率明显高于对照组,说明治疗组与对照组的疗效相当。经治疗后治疗组的主要症状及体征和次要症状及体征的积分明显低于对照组,经统计学比较,均有显著性差异(P值均<0.05),提示治疗组经中医内外合治法治疗后其主要症状、次要症状及体征明显改善,其改善症状及体征的疗效好于对照组。对照组和治疗组热退时间分别为3.57±1.72天,2.63±1.59天,经统计学比较,有显著性差异(P<0.05),治疗组的热退时间明显短于对照组；咳嗽消失时间分别为8.33±2.01天,6.93±3.05天,经统计学比较,有显著性差异(P<0.05),治疗组的咳嗽消退时间明显短于对照组；罗音消退时间分别为7.23±3.51天,5.00±2.68天,经统计学比较,有显著性差异(P<0.01),治疗组的罗音消退时间明显短于对照组；治疗时间分别为8.86±2.87天,7.56±3.07天,经统计学比较,有显著性差异(P<0.05),治疗组的治疗时间明显短于对照组。结论：蒿芩麻杏石甘汤配合中医外治法拔罐及中药离子导入治疗风热闭肺证和痰热闭肺证肺炎喘嗽疗效显著,能显著改善肺炎喘嗽患儿的主要症状及体征和次要症状及体征。中医内外合治法能迅速使风热闭肺证和痰热闭肺证肺炎喘嗽患儿体温恢复正常,能改善患儿咳嗽症状,促进患儿肺部罗音吸收,缩短患儿治疗时间。尤其是在患儿肺部罗音吸收方面疗效更显著。更多还原

【Abstract】 Purpose:Through the observation decoction of TCM’haoqinmaxingshigantang’ and external treatment of TCM’cupping’and external application of Chinese herbal medicine ion-introduction therapy adds the conventional treatment and the pure convention treats pneumonia chuansou of wind-heat-closed-plumonary-syndrome and phlegm-heat-closed-plumonary-syndrome. evaluate the clinical efficacy of internal-external therapy of TCM on children pneumonia.Method:60cases of pneumonia chuansou (wind-heat-closed-plumonary-syndrome and phlegm-heat-closed-plumonary-syndrome)children outpatient and inpatient who be in the dongfang hospital of Beijing university of traditional Chinese medicine were randomly divided into two groups:treated group and control group. Control group and treatment group have30cases in each group. There are14male cases and16female cases in control group.14male cases and16female cases in treated group. Give the control group conventional anti infection and symptomatic treatment, while the treated group add with haoqinmaxinshigantang, cupping and Chinese herbal medicine ion-introduction therapy. On the basis of conventional anti-infective and Symptomatic treatment. By comparing the score of the main symptoms and signs and the minor symptoms and signs of the children with pneumonia chuansou. observe the clinical efficacy of the treated group and control group. Observing and comparing the two groups in average time of temperature regression, cough disappearance, pulmonary rales disappearance and treatment time.Result:The total effective rate of treated group and control group are the same for100. The cure rate of two groups are26.7and43.3percent. After the statistical comparison, there was no significant difference(p>0.05). Tips for Chinese medicine treated group is as effective as control group. The scores of main symptoms.minor symptoms and signs of treated group are significantly lower than control group. After the statistical comparison, there was significant difference(p<0.05). Tips for that after treatment there are Significant improvement in main symptoms, minor symptoms and signs. The efficacy is better than control group. The average time of temperature regression of the control group and treated group are3.57±1.72and2.63±1.59. There was significant difference(p<0.05)after the statistical comparison. The average time of temperature regression of the treated group is Significantly shorter than the other group. The cough disappearing time are8.33±2.01and6.93±3.05. There was significant difference(p<0.05)after the statistical comparison. The cough disappearing time of the treaed group is Significantly shorter than the other group. The pulmonary rales disappearing time are7.23±3.51and5.47±3.19. There was significant difference(p<0.05)after the statistical comparison. The pulmonary rales disappearing time of the treated group is Significantly shorter than the other group. The treatment time are8.86±2.87and7.56±3.07.There was significant difference(p<0.05)after the statistical comparison. The treatment time of the treated group is significantly shorter than the other group.Conclusion:It is significant effect to treat the pneumonia chuansou children patient of wind-heat-closed-plumonary-syndrome and phlegm-heat-closed-plumonary-syndrome with haoqinmaxingshigantang, cupping, external application of Chinese herbal medicine ion-introduction.Significantly improve both main and minor symptoms and signs of children with pneumonia chuansou. Using internal-external therapy of TCM can make the high fever body temperature of Pneumonia chuansou children patient back to normal quickly, significantly improve the cough symptom from children, promote the absorption of pulmonary rales and shorten children treatment time.Especially in the promotion of children with pulmonary rale absorption effect is more obvious.更多还原