【摘要】：目的 運(yùn)用前瞻性、對(duì)照的臨床研究方法,從臨床癥狀改善、疾病療程、抗生素使用療程等方面,觀察加減麻杏石甘湯聯(lián)合阿奇霉素的治療方法對(duì)比單純的西醫(yī)治療,在支原體肺炎風(fēng)熱閉肺證患兒的臨床療效比較,探討優(yōu)化中西醫(yī)結(jié)合治療小兒支原體肺炎方案。 方法 于2013年8月至2014年1月在廣州中醫(yī)藥大學(xué)第一附屬醫(yī)院兒科門診、住院部就診的肺炎支原體肺炎患兒,篩選60例合格的病例,采用前瞻性、對(duì)照的臨床研究方法,分為治療組和對(duì)照組,每組30例。治療組第1-3天口服阿奇霉素,配合每日一劑中藥,第4-14天僅每天服用一劑中藥,共治療2周,對(duì)照組：第1-3天及第8-10天口服阿奇霉素,共治療2周,對(duì)其臨床癥候積分、癥狀改善情況、治療結(jié)束后有無(wú)咳嗽遷延等方面進(jìn)行評(píng)價(jià),并運(yùn)用統(tǒng)計(jì)方法進(jìn)行分析。采用spss19.0統(tǒng)計(jì)軟件分析評(píng)價(jià)結(jié)果。 結(jié)果 1.治療組在治療第7天、第14天,癥候積分與對(duì)照組對(duì)比差異均具有統(tǒng)計(jì)學(xué)意義(P0.01),認(rèn)為治療組改善癥候積分上明顯優(yōu)于對(duì)照組。 2.通過(guò)對(duì)比兩組的咳嗽、發(fā)熱起效時(shí)間,差異具有統(tǒng)計(jì)學(xué)意義(P0.01),認(rèn)為治療組在改善咳嗽、發(fā)熱癥狀方面療效優(yōu)于對(duì)照組。 3.通過(guò)對(duì)比兩組治療第7天、第14天的療效,差異具有統(tǒng)計(jì)學(xué)意義(P0.01),認(rèn)為治療組在療效上顯著優(yōu)于對(duì)照組。 4.通過(guò)隨訪期觀察,治療組的咳嗽遷延的發(fā)生率要顯著小于對(duì)照組(P=0.02),而兩組在治療結(jié)束后一個(gè)月內(nèi)新發(fā)呼吸道感染的發(fā)生率無(wú)明顯差異(P=0.347)。 結(jié)論 1.加減麻杏石甘湯聯(lián)合阿奇霉素治療能明顯改善支原體肺炎風(fēng)熱閉肺證患兒的癥候積分。 2.運(yùn)用中西醫(yī)結(jié)合的治療方法對(duì)比單純西醫(yī)治療,能更明顯改善支原體肺炎患兒的癥狀、體征,且能縮短病程,達(dá)到較高的治愈率。 3.在中醫(yī)療法的介入下,縮短阿奇霉素的使用療程,并不會(huì)增加肺炎的復(fù)發(fā)、新發(fā)呼吸道感染的發(fā)生,同時(shí)能減少咳嗽遷延發(fā)生的概率。
[Abstract]:Objective to observe the therapeutic effects of maxingshigan decoction combined with azithromycin on clinical symptoms improvement, course of treatment and antibiotic use. To compare the clinical efficacy of mycoplasma pneumoniae in children with wind-heat blockage of lung syndrome, to explore the optimization of integrated traditional Chinese and western medicine in the treatment of mycoplasma pneumonia in children. Methods from August 2013 to January 2014, 60 cases of mycoplasma pneumoniae pneumonia were selected from the pediatric outpatient department of the first affiliated Hospital of Guangzhou University of traditional Chinese Medicine. The control group was divided into treatment group and control group with 30 cases in each group. In the treatment group, azithromycin was taken orally on the 1-3 days, combined with one dose of Chinese medicine daily, and only one dose of Chinese medicine was taken daily on the 4-14 days for a total of 2 weeks. In the control group, azithromycin was given orally for 2 weeks on the 1-3 and 8-10 days. Symptoms were improved, cough was delayed after treatment, and statistical methods were used to analyze the symptoms. Spss19.0 statistical software was used to analyze the evaluation results. Result 1. On the 7th and 14th day after treatment, the symptom score of the treatment group was significantly different from that of the control group (P0.01), and it was considered that the improvement symptom score of the treatment group was obviously better than that of the control group (2. 01). By comparing the onset time of cough and fever between the two groups, the difference was statistically significant (P0.01). It was concluded that the curative effect of the treatment group was better than that of the control group in improving cough and fever symptoms. By comparing the therapeutic effect of the two groups on the 7th and 14th day, the difference was statistically significant (P0.01), and it was concluded that the therapeutic effect of the treatment group was significantly better than that of the control group. 4. The incidence of cough prolongation in the treatment group was significantly lower than that in the control group (P0. 02), but there was no significant difference between the two groups in the incidence of new respiratory tract infection within one month after treatment (P0. 347). Conclusion 1. Add and reduce Ma Xing Shi Gan Tang combined with azithromycin treatment can obviously improve the syndrome score of mycoplasma pneumoniae pneumonia in children with wind-heat blocking lung syndrome. 2. 2. The treatment of mycoplasma pneumonia in children with mycoplasma pneumonia can be more obviously improved by the method of integrated traditional Chinese and western medicine than by western medicine alone, and can shorten the course of disease and reach a higher cure rate of 3. 3%. Under the intervention of TCM therapy, shortening the course of using azithromycin does not increase the recurrence of pneumonia and the occurrence of new respiratory tract infection, and at the same time can reduce the probability of prolonged cough.
【學(xué)位授予單位】：廣州中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R272

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