【摘要】：目的:觀察自擬清肺化痰湯治療小兒肺炎支原體感染后慢性咳嗽(痰熱壅肺證)的臨床療效。方法:將60例西醫(yī)診斷為肺炎支原體感染后慢性咳嗽,中醫(yī)辨病辨證為咳嗽-痰熱壅肺證患兒隨機(jī)分成對(duì)照組30人和治療組30人。對(duì)照組予阿奇霉素口服,治療組予清肺化痰湯劑+阿奇霉素口服。觀察療程為2周,比較兩組患兒治療前后主要證候積分、次要證候積分、總證候積分及總有效率,分析其差異是否具有統(tǒng)計(jì)學(xué)意義。結(jié)果:治療前,兩組患兒的性別、舌質(zhì)、舌苔、脈象,經(jīng)卡方檢驗(yàn),P0.05,差異無(wú)統(tǒng)計(jì)學(xué)意義,兩組具有可比性;治療前兩組患兒年齡分布、咳嗽、咳痰、咯痰性質(zhì)、咳時(shí)面赤唇紅發(fā)作次數(shù)、咽部充血相關(guān)證候,經(jīng)秩和檢驗(yàn),P0.05,差異無(wú)統(tǒng)計(jì)學(xué)意義,兩組具有可比性;治療前兩組患兒主、次要證候積分及總證候積分經(jīng)兩獨(dú)立樣本t檢驗(yàn),P0.05,差異無(wú)統(tǒng)計(jì)學(xué)差異,兩組具有可比性。(1)證候積分:治療后對(duì)照組與治療組主要證候積分,經(jīng)兩獨(dú)立樣本t檢驗(yàn),P0.05,差異具有統(tǒng)計(jì)學(xué)意義;治療后對(duì)照組與治療組次要證候積分,經(jīng)兩獨(dú)立樣本t檢驗(yàn),P0.05,差異具有統(tǒng)計(jì)學(xué)意義;治療后對(duì)照組與治療組總證候積分,經(jīng)兩獨(dú)立樣本t檢驗(yàn),P0.05,差異具有統(tǒng)計(jì)學(xué)意義。治療前后,對(duì)照組內(nèi)部主、次要證候積分及總證候積分,經(jīng)配對(duì)t檢驗(yàn),P0.05,差異具有統(tǒng)計(jì)學(xué)意義;治療前后,治療組內(nèi)部主、次要證候積分及總證候積分,經(jīng)配對(duì)t檢驗(yàn),P0.05,差異具有統(tǒng)計(jì)學(xué)意義。(2)總療效:對(duì)照組30例,痊愈3例,顯效3例,有效15例,無(wú)效9例,對(duì)照組總有效率為70.0%;治療組30例,痊愈7例,顯效7例,有效14例,無(wú)效2例,治療組總有效率為93.3%,經(jīng)秩和檢驗(yàn),P0.05,兩組總有效率差異,具有統(tǒng)計(jì)學(xué)意義,可認(rèn)為治療組療效優(yōu)于對(duì)照組。結(jié)論:清肺化痰湯聯(lián)合阿奇霉素口服治療小兒肺炎支原體感染后慢性咳嗽,中醫(yī)屬咳嗽-痰熱壅肺證具有確切的臨床療效,值得臨床推廣應(yīng)用。
[Abstract]:Objective: to observe the clinical effect of self-made Qingfei Huatan decoction on chronic cough (phlegm-heat syndrome) after infection of mycoplasma pneumoniae in children. Methods: 60 cases of chronic cough diagnosed as mycoplasma pneumoniae infection by western medicine were randomly divided into two groups: control group (30 cases) and treatment group (30 cases). The control group was given azithromycin orally, and the treatment group was given azithromycin orally by Qingfei Huatan decoction. The course of treatment was 2 weeks. The main syndrome integral, secondary syndrome score, total syndrome score and total effective rate were compared between the two groups before and after treatment, and the difference between the two groups was statistically significant. Results: before treatment, there was no significant difference in sex, tongue quality, tongue coating, pulse pattern between the two groups by Chi-square test, P 0.05, and there was no significant difference between the two groups. Before treatment, there was no significant difference between the two groups in age distribution, cough, expectoration and expectoration nature, the number of red lip attacks on the face of cough, the syndrome related to pharynx hyperemia, the rank sum test, P0.05, there was no significant difference between the two groups, and the two groups were comparable. Before the treatment, the main and secondary syndrome integral and the total syndrome score of the two groups were tested by two independent samples t test, P 0.05, there was no statistical difference between the two groups. (1) the syndrome integral: after treatment, the main syndrome integral of the control group and the treatment group was the main syndrome integral, and there was no statistical difference between the two groups. By t test of two independent samples, P 0.05, the difference was statistically significant. After treatment, the scores of syndrome between the control group and the treatment group were significantly higher than those of the control group (P 0.05), by two independent samples t-test (P 0.05). After treatment, the total syndrome score between the control group and the treatment group was statistically significant by two independent sample t-test, P 0.05. Before and after treatment, the scores of the main and secondary syndromes and the total syndrome scores in the control group were statistically significant by paired t-test, P 0.05; Before and after treatment, the scores of main and secondary syndromes and total syndrome scores in the treatment group were statistically significant by paired t-test, P 0.05. (2) the total curative effect: 30 cases in the control group, 3 cases cured, 3 cases significantly effective, 15 cases effective, 3 cases in the control group, 3 cases in the control group and 15 cases in the control group. The total effective rate of the control group was 70.0%; In the treatment group, 7 cases were cured, 7 cases were markedly effective, 14 cases were effective, and 2 cases were ineffective. The total effective rate of the treatment group was 93.3%. By rank sum test, P 0.05, the total effective rate of the two groups was significantly different. The therapeutic effect of the treatment group was better than that of the control group. Conclusion: Qingfei Huatan decoction combined with azithromycin is effective in treating chronic cough after infection of Mycoplasma pneumoniae in children. Chinese medicine belongs to cough-phlegm-heat syndrome, which is worthy of clinical popularization and application.
【學(xué)位授予單位】：安徽中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R272

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