【摘要】：目的:通過觀察喜炎平注射液治療老年社區(qū)獲得性肺炎(痰熱壅肺證)的臨床癥狀、體征、48h退熱情況、體溫恢復(fù)正常所需時(shí)間、外周血白細(xì)胞、超敏C反應(yīng)蛋白、降鈣素原、白介素-6及肺CT炎癥吸收的改善情況,評(píng)價(jià)喜炎平注射液治療老年社區(qū)獲得性肺炎(痰熱壅肺證)臨床療效。方法:收入2016年6月至2017年2月解放軍第463醫(yī)院呼吸科病房收治的老年社區(qū)獲得性肺炎(痰熱壅肺證)患者80例,采用隨機(jī)數(shù)字表法分為治療組(喜炎平+西醫(yī)常規(guī)治療)和對(duì)照組(西醫(yī)常規(guī)治療)。療程10天,10天后觀察治療組與對(duì)照組患者的主要癥狀(咳嗽、咳痰)、次要癥狀(發(fā)熱、口渴、大便)、體征(濕Up音)、48h退熱情況及體溫恢復(fù)正常所需時(shí)間,外周血白細(xì)胞計(jì)數(shù)(White blood cell,WBC)、超敏C反應(yīng)蛋白(High-sensitivity c-reactive protein,hs-CRP)、降鈣素原(Procalcitonin,PCT)及血清白介素-6(interleukin-6,IL-6)改善情況及臨床療效。結(jié)果:1.在臨床療效方面,治療組總有效率為92.5%,對(duì)照組總有效率為82.05%。治療組優(yōu)于對(duì)照組(P0.05)。2.在中醫(yī)證候評(píng)分及退熱時(shí)間方面,治療組治療后中醫(yī)證候評(píng)分、總積分(除口渴、大便外)、48h退熱情況及體溫恢復(fù)正常所需時(shí)間均較對(duì)照組改善明顯(P0.05)。3.在抗感染方面,兩組外周血WBC、hs-CRP、IL-6及肺部CT炎癥吸收情況,治療后組間比較治療組優(yōu)于對(duì)照組,有統(tǒng)計(jì)學(xué)差異(P0.05),PCT治療后組間比較無統(tǒng)計(jì)學(xué)差異(P0.05)。結(jié)論:1.西醫(yī)常規(guī)治療基礎(chǔ)上加用喜炎平注射液治療老年社區(qū)獲得性肺炎(痰熱壅肺證)的臨床療效顯著。2.西醫(yī)常規(guī)治療基礎(chǔ)上加用喜炎平注射液治療老年社區(qū)獲得性肺炎(痰熱壅肺證),在臨床癥狀(咳嗽、咳痰、發(fā)熱)、體征(濕Up音)、總積分及48h退熱情況及體溫恢復(fù)正常所需時(shí)間方面,均優(yōu)于西醫(yī)常規(guī)治療,利于疾病轉(zhuǎn)歸且能夠縮短患者退熱時(shí)間及發(fā)熱天數(shù)。3.西醫(yī)常規(guī)治療基礎(chǔ)上加用喜炎平注射液治療老年社區(qū)獲得性肺炎(痰熱壅肺證),能進(jìn)一步改善外周血WBC、hs-CRP、IL-6,肺部CT炎癥吸收情況從而促進(jìn)炎癥吸收。
[Abstract]:Objective: to observe the clinical symptoms, signs, 48 h antipyretic condition, the time required for body temperature recovery, peripheral white blood cells, hypersensitive C-reactive protein, procalcitonin in the treatment of senile community-acquired pneumonia with Xiyanping injection. To evaluate the clinical effect of Xiyanping injection in the treatment of senile community-acquired pneumonia (syndrome of phlegm-heat obstruction of lung). Methods: from June 2016 to February 2017, 80 elderly patients with community acquired pneumonia (syndrome of phlegm and heat obstructing the lung) were admitted to the respiratory ward of the 463 Hospital of PLA. The patients were randomly divided into two groups: treatment group (routine treatment of Xiyanping western medicine) and control group (routine treatment of western medicine). After 10 days of treatment, the main symptoms (cough, expectoration), secondary symptoms (fever, thirst, stool), physical signs (wet Up sound), 48 h antipyretic condition and the time needed for body temperature to return to normal were observed in the treatment group and the control group. Peripheral blood leukocyte count (White blood cell,WBC), hypersensitive C-reactive protein (High-sensitivity c-reactive protein,hs-CRP), procalcitonin (Procalcitonin,PCT) and serum interleukin-6 (interleukin-6,IL-6) were improved and their clinical efficacy was evaluated. The result is 1: 1. The total effective rate was 92.5 in the treatment group and 82.05 in the control group. The treatment group was superior to the control group (P0.05). In TCM syndrome score and antipyretic time, the treatment group after treatment TCM syndrome score, total score (except thirst, stool), 48h antipyretic condition and temperature recovery time were significantly improved compared with the control group (P0.05). In the aspect of anti-infection, the inflammatory absorption of WBC,hs-CRP,IL-6 in peripheral blood and lung CT in the two groups was better than that in the control group after treatment. There was no statistical difference between the two groups (P0.05) after), PCT treatment (P0.05). Conclusion: 1. On the basis of routine treatment of western medicine plus Xiyanping injection in the treatment of elderly community acquired pneumonia (phlegm heat obstruction lung syndrome) the clinical efficacy is significant. 2. On the basis of routine treatment of western medicine, combined with Xiyanping injection to treat elderly community-acquired pneumonia (phlegm-heat obstruction of lung syndrome), in clinical symptoms (cough, expectoration, phlegm), Fever), physical sign (wet Up sound), total score, 48 h antipyretic condition and the time needed for body temperature to return to normal were better than that of western medicine routine treatment, which was beneficial to the outcome of the disease and could shorten the time of fever and the days of fever. On the basis of routine treatment of western medicine, the treatment of elderly community-acquired pneumonia (phlegm-heat obstruction of lung syndrome) with Xiyanping injection can further improve the inflammatory absorption of peripheral blood WBC,hs-CRP,IL-6, lung CT and thus promote inflammatory absorption.
【學(xué)位授予單位】：遼寧中醫(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)】：R563.1

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