1.国家儿童医学中心 首都医科大学附属北京儿童医院中医科,北京 100045
扫 描 看 全 文
曹童童,李亚男,胡艳,等.宣闭解毒化瘀法治疗重症支原体肺炎毒热闭肺证临床对照研究[J].北京中医药,2023,42(3):243-247.
CAO Tong-tong,LI Ya-nan,HU Yan,et al.Clinically study on treatment of severe mycoplasma pneumonia with syndrome of toxic heat obstructing lung by removing obstruction and clearing away toxin and removing blood stasis[J]. Beijing Journal of Traditional Chinese Medicine,2023,42(03):243-247.
曹童童,李亚男,胡艳,等.宣闭解毒化瘀法治疗重症支原体肺炎毒热闭肺证临床对照研究[J].北京中医药,2023,42(3):243-247. DOI: 10.16025/j.1674-1307.2023.03.003.
CAO Tong-tong,LI Ya-nan,HU Yan,et al.Clinically study on treatment of severe mycoplasma pneumonia with syndrome of toxic heat obstructing lung by removing obstruction and clearing away toxin and removing blood stasis[J]. Beijing Journal of Traditional Chinese Medicine,2023,42(03):243-247. DOI: 10.16025/j.1674-1307.2023.03.003.
目的,2,探讨以宣闭解毒化瘀法治疗重症支原体肺炎毒热闭肺证的临床疗效。,方法,2,收集2019年1月—2021年12月于北京儿童医院住院治疗的重症支原体肺炎患者200例,按随机数字表法分为2组,治疗组、对照组各100例。对照组予以西医常规治疗,总疗程10~14 d;治疗组在西医治疗基础上联合宣闭解毒化瘀法治疗,西医治疗用药和疗程同对照组,中药治疗总疗程为6周。比较2组疗效,热退、咳嗽、喘息以及肺部啰音消失时间,治疗前后D-二聚体、乳酸脱氢酶(LDH),病灶吸收情况,肺不张、闭塞性支气管炎、胃肠功能紊乱的发生率。,结果,2,治疗1周,治疗组的临床显效率高于对照组(,P,=0.029);治疗4周,治疗组临床治愈率、显效率均高于对照组,但差异无统计学意义(,P,>,0.05);12周时治疗组临床治愈率高于对照组(,P,=0.009)。治疗组热退时间、咳嗽消失时间和肺部啰音消失时间短于对照组(,P,<,0.05),2组喘息消失时间比较差异无统计学意义(,P,>,0.05);治疗1周,2组D-二聚体、LDH水平均较治疗前降低(,P,<,0.05),且治疗组D-二聚体水平低于对照组(,P,<,0.05),2组LDH水平比较差异无统计学意义(,P,>,0.05);治疗组病灶完全吸收率较对照组高(,P,<,0.05);治疗组肺不张、闭塞性支气管炎、胃肠功能紊乱发生率低于对照组(,P,<,0.05)。,结论,2,中西医结合治疗重症支原体肺炎,可显著改善患儿临床症状,效果优于单纯西医治疗。
Objective,2,To explore the clinical efficacy of the method of removing obstruction,clearing away toxin and removing blood stasis in the treatment of severe mycoplasma pneumonia with the syndrome of toxic heat obstructing the lung.,Methods,2,A total of 200 patients with severe mycoplasma pneumonia who were hospitalized in Beijing Children's Hospital from January 2019 to December 2021 were enrolled and divided into treatment group and control group of 100 cases in each one according to random number table method. The control group was treated with conventional western medicine for 10-14 days as total courses,and the treatment group was treated with traditional Chinese medicine by stages on the basis of western medicine. The curative effect,time of fever,cough, wheezing and lung rales disappearing,D-dimer,lactate dehydrogenase(LDH),lesion absorption,incidence of atelectasis, obstructive bronchitis and gastrointestinal dysfunction before and after treatment were compared between the two groups.,Results,2,After one week of treatment, the clinical effective rate in the treatment group was higher than that in the control group(,P,=0.029).After 4 weeks of treatment, the clinical cure rate and effective rate of the treatment group were higher than those of the control group, but the difference was not statistically significant(,P,>,0.05);during the 12-week follow-up, the clinical cure rate of the treatment group was higher than that of the control group(,P,=0.009). Compared with the control group, the disappearance time of fever,cough and pulmonary rales in the treatment group was significantly shortened(,P,<,0.05). There was no significant difference in disappearance time of wheezing between the two groups(,P,>,0.05). After one week of treatment, the level of D-dimer and LDH was significantly decreased(,P,<,0.05),and the level of D- dimer in the treatment group was lower than that in the control group(,P,<,0.05),and there was no significant difference in LDH level between the two groups(,P,>,0.05). The complete absorption rate of lesions in the treatment group was higher than that in the control group(,P,<,0.05).The incidence of atelectasis,obliterative bronchitis, and gastrointestinal dysfunction was significantly reduced(,P,<,0.05).,Conclusion,2,The treatment of severe mycoplasma pneumonia with integrated traditional Chinese and western medicine has obvious advantages in promoting the relief of clinical symptoms with better effect than western medicine only.
重症支原体肺炎儿童中西医结合毒热闭肺证
severe mycoplasma pneumonia in childrenintegrated traditional Chinese and western medicinetoxic heat obstructing lung syndrome
RUDAN I, BOSCHI-PINTO C, BILOGLAV Z, et al. Epidemiology and etiology of childhood pneumonia[J]. Bull World Health Organ,2008,86(5):408-416.
杜洪喆, 李新民, 晋黎,等. 甘露消毒丹辅助治疗小儿重症支原体肺炎(湿热证)临床研究[J]. 天津中医药,2015,32(8):477-480.
黄争光, 李新民, 孙丹,等. 清宣通络方治疗儿童肺炎支原体肺炎风热闭肺证临床疗效及对社区获得性呼吸窘迫综合征毒素的影响[J]. 河南中医,2021,41(9):1362-1366.
李雅莉, 张波. 双黄连氧气驱动雾化吸入联合NCPAP治疗小儿重症支原体肺炎合并呼吸衰竭的疗效及对血清Leptin、IL-17、IL-33的影响[J]. 现代中西医结合杂志,2018,27(14):1505-1508,1579.
中华医学会儿科学分会呼吸学组, 《中华实用儿科临床杂志》编辑委员会. 儿童肺炎支原体肺炎诊治专家共识(2015年版)[J]. 中华实用儿科临床杂志,2015,30(17):1304-1308.
胡亚美,江载芳.诸福棠实用儿科学[M]. 7版.北京:人民卫生出版社,2002:1280-1285.
中华中医药学会内科分会, 中华中医药学会肺系病分会, 中国民族医药学会肺病分会. 社区获得性肺炎中医诊疗指南(2018修订版)[J]. 中医杂志,2019,60(4):350-360.
郑筱萸.中药新药临床研究指导原则[M].中国医药科技出版社,2002:85-86.
阳爱梅, 宋建辉, 黄榕,等. 1026例儿童肺炎支原体感染及耐药情况分析[J]. 中国当代儿科杂志,2013,15(7):522-525.
李兴军, 吴凌燕, 张红,等. 外周血CRP及LDH对重症肺炎患儿病情及短期预后的评估效果[J]. 数理医药学杂志,2022,35(7):966-969.
袁晓旭, 贾春梅. 儿童重症肺炎支原体肺炎中D-二聚体水平的临床意义[J]. 中国中西医结合儿科学,2022,14(1):29-32.
王亚龙, 何南, 齐梦瑚. D-二聚体在儿童支原体肺炎肺不张中的临床意义探讨[J]. 中国妇幼健康研究,2017,28(11):1430-1432.
杨凯麟, 曾柳庭, 葛安琪,等. 基于网络药理学探讨桃仁-红花药对活血化瘀的分子机制[J]. 世界科学技术-中医药现代化,2018,20(12):2208-2216.
方琼杰, 郝宏文. 清肺止痉活血法治疗小儿支原体肺炎痰热闭肺证的临床疗效及其对血小板、D-二聚体的影响[J]. 北京中医药,2015,34(3):209-212.
王秀阁, 闫冠池, 金迪,等. 基于AMPK/mTOR/ULK1通路探讨解毒通络保肾方改善糖尿病肾脏疾病的作用机制[J]. 北京中医药大学学报,2022,45(12):1213-1222.
刘春雷. 活血化瘀法联合阿米卡星雾化给药治疗重症肺炎疗效及对肺功能、血清细胞因子的影响[J]. 包头医学院学报,2019,35(2):104-105.
刘知府, 钱保进, 陶贤琦. 血必净注射液联合西药治疗重症肺炎并脓毒症的临床研究[J]. 世界中西医结合杂志,2022,17(5):1038-1042.
路晨, 郝宏文, 廖欣婷,等. 活血化瘀法治疗儿童重症肺炎随机对照试验的Meta分析[J]. 实用中医内科杂志,2021,35(9):139-143,中插16,中插18.
俞珍惜,刘秀云,彭芸,等.儿童重症肺炎支原体肺炎的临床特点及预后[J].临床儿科杂志,2011,29(8):715-719.
0
Views
0
下载量
0
CSCD
Publicity Resources
Related Articles
Related Author
Related Institution