【作者】 杨柳柳；

【导师】 孙志佳；

【作者基本信息】 广州中医药大学 ， 中医内科学， 2010， 硕士

【摘要】 目的：观察清肺化痰方治疗组治疗肺炎喘嗽痰热型(社区获得性肺炎)与单纯的西医治疗在临床症状、体征、血清C-反应蛋白、血分析及胸片的影响,提出中西医结合优化方案。探讨清肺化痰方在治疗该病的临床价值及推广意义。方法：将收集符合纳入标准的60例肺炎喘嗽痰热型(社区获得性肺炎)病例随机分成两组,即清肺化痰方组、西药对照组各30例,分别予治疗10天,观察治疗后两组对肺炎喘嗽痰热型(社区获得性肺炎)患者临床症状、体征、C-反应蛋白及实验室和影像学的影响。比较治疗组与对照组的疗效优劣,以客观评价清肺化痰方治疗肺炎喘嗽痰热型(社区获得性肺炎)的临床疗效。结果：1.治疗组和对照组治疗后发热(包括持续时间、退热时间)；咯痰(包括痰色、痰量、痰质)的改变；咳嗽(包括发作持续时间、咳嗽的剧烈程度)改变和肺部湿罗音分别与治疗前比较,经t检验,P<0.05,差异有显著性,两组治疗后发热(包括的持续时间、退热时间)；咯痰(包括痰色、痰量、痰质)改变等症状经t检验,P<0.05,差异有显著性；治疗后咳嗽(包括发作持续时间、剧烈程度)的改变、肺部湿罗音等症状经t检验,P>0.05,无显著性差异；2.治疗组治疗后血清CRP明显降低,与治疗前比较,经t检验,P<0.05,差异有显著性；对照组治疗后血清CRP与治疗前比较,经t检验,P<0.05,差异有显著性；治疗后两组血清CRP数值同时段比较经t检验,P<0.05,差异有显著性意义；3.治疗组治疗后血分析中白细胞数明显降低,与治疗前比较,经t检验,P<0.05,差异有显著性；对照组治疗后血分析中白细胞数治疗前比较,经t检验,P<0.05,差异有显著性；两组治疗后白细胞数值恢复正常所需的时间经t检验,P<0.05,差异有显著性；4.治疗组治疗后胸片肺部渗出影有所消散,与治疗前比较,经秩和检验,P<0.05,差异有显著性；对照组治疗后胸片肺部渗出影亦有所消散,与治疗前比较,经秩和检验,P<0.05,差异有显著性；但两组治疗后胸片指标经秩和检验,P<0.05,差异有显著性。结论：1.治疗组治疗肺炎喘嗽痰热型(社区获得性肺炎)患者可改善其发热的持续时间、退热时间；咯痰,包括痰色、痰量、痰质；咳嗽的发作持续时间、咳嗽的剧烈程度、肺部湿啰音等症状与体征,且同对照组相比,可明显改善患者的发热、咯痰等主症及兼次症；2.治疗组治疗肺炎喘嗽痰热型(社区获得性肺炎)患者可明显降低其血清CRP水平,且C反应蛋白恢复正常所需时间优于单纯西医治疗；3.治疗组治疗肺炎喘嗽痰热型(社区获得性肺炎)患者可明显降低血分析中白细胞数水平,且白细胞数水平恢复正常所需时间优于单纯西医治疗；4.治疗组治疗肺炎喘嗽痰热型(社区获得性肺炎)患者可明显改善胸片肺部渗出影状况,两组治疗后相比,治疗组有明显优势；更多还原

【Abstract】 Objective:To observe the influence of Qingfei Huatan decoction for Pneumonia(community acquired pneumonia) patients of the type of TanRe with clinical symptoms and signs score and serum C reaction protein, hemanalysis and lung X-ray, and to suggest prioritization scheme of integration of traditional and western medicine. To explore the clinical treatment efficacy and generalization meaning that the usage of Qingfei Huatan decoction.Methods:According to the inclusion criteria,60 Pneumonia (community acquired pneumonia) patients of the type of TanRe were selected and randomly divided into the treatment group and the control group, with 30 cases in each group. The treatment group with Qingfei Huatan decoction intergrated Western medicine, while the control group with conventional Western medicine alone, the treatment consisits 7 days. And the two groups of the patients with Pneumonia (community acquired pneumonia) of the type of TanRe symptoms, signs, serum C reaction protein, hemanalysis and lung X-ray are observed. To evaluate objectively the clinical treatment efficacy to comparison with the two groups.Results:1. The treatment group and the control group after treatment those of clinical symptoms and signs such as persistence time of fever, pyretolysis time, pattern of fever modification;stethocatharsis modification-the colour, quantity, quality; cough modification-persistence time, intensity level; subjective perceptions of the patients; moist rales were significantly improved(p<0.05), and for symptoms and signs such as persistence time of fever, pyretolysis time, pattern of fever modification;stethocatharsis modification-the colour, quantity, quality; subjective perceptions of the patients,the treament group better than the control group(p<0.05), another nrales were no significant differences in the two groups(p>0.05).2. The count of serum C reaction protein in the treatment group after treatment could be declined, the difference was significant(p<0.05), and the conclusion of the control group was the same with the treament group(p<0.05), and the level of CRP of the treament group was lower than the control group(p<0.05).3. The count of WBC in the hemanalysis in the treatment group and the control group after treatment could be declined, the difference was significant(p<0.05), and the level of WBCin the hemanalysis of the treatment group lower than the control group(p<0.05).4. Qingfei Huatan decoction on the lung X-ray was significant impact. The lung X-ray indicatored effusion of two groups increased pre-treatment but significant decreased after treatment, the difference was significant(p<0.05), indicating a significant improvement in lung X-ray, and the two groups of indicators of lung X-ray after treatment showed significant difference(p<0.05).Conclusion:1.The treatment group treated Pneumonia(community acquired pneumonia) patients of the type of TanRe was more significant improvement the simple western medicine group, those of clinical symptoms and signs such as persistence time of fever, pyretolysis time, pattern of fever modification;stethocatharsis modification-the colour, quantity, quality;cough modification-persistence time, intensity level; subjective perceptions of the patients; moist rales significantly improve the control rate of clinical treatment.2. The treatment group could reduce the count of serum C reaction protein after treatment better than the control group.3. The treatment group could reduce the count of WBC in the hemanalysis better than the control group after treatment;and the time of recovery normal of the hemanalysis was shorted than the control group.4. The treatment group and the control group could be significantly improved in lung X-ray. The treatment group was better than the control group after treatment.更多还原