本文選題：社區(qū)獲得性肺炎　切入點(diǎn)：化痰貼方　出處：《廣州中醫(yī)藥大學(xué)》2016年碩士論文

【摘要】：目的：通過觀察化痰貼方對社區(qū)獲得性肺炎(痰熱壅肺證)患者的臨床癥狀改善情況、炎癥指標(biāo)變化情況、胸部CT變化情況等,以了解其在社區(qū)獲得性肺炎痰熱壅肺證患者中的療效,以期指導(dǎo)臨床應(yīng)用及社會推廣。方法：本課題運(yùn)用前瞻性單盲隨機(jī)對照的研究方法。一共收集滿足研究標(biāo)準(zhǔn)的病人83例,隨機(jī)成兩組,其中治療組43例,對照組40例,兩組都給以相同的西醫(yī)基礎(chǔ)治療,治療組加上化痰貼方,對照組加上安慰劑,療程都為7天,觀察病人的癥狀、WBC、 CRP、PCT和胸部CT的變化。通過統(tǒng)計來比較兩組的療效,以客觀評價化痰貼方治療本病的效果。結(jié)果：1.兩組在治療第3天、第5天、第7天時與治療前的咳嗽、咯痰積分差值進(jìn)行獨(dú)立樣本t檢驗,P0.05,均有顯著性差異。2.兩組治療前后WBC經(jīng)配對t檢驗,P0.05,均有顯著性差異；兩組治療后WBC經(jīng)獨(dú)立樣本t檢驗,P0.05,無顯著性差異。3.兩組治療前后血清CRP值行配對t檢驗,P0.05,均有顯著性差異；兩組治療后血清CRP數(shù)值行獨(dú)立樣本t檢驗,P0.05,無顯著性差異。3.兩組治療前后PCT值行t配對檢驗,P0.05,均有顯著性差異；兩組治療后血PCT數(shù)值行配對t檢驗,P0.05,無顯著性差異。4.兩組治療后胸部CT的改變予秩和檢驗,P0.05,有顯著性差異。結(jié)論：1.同對照組相比,治療組的病人咯痰(包括痰色、痰量、痰質(zhì))和咳嗽(包括發(fā)作持續(xù)時間、咳嗽的劇烈程度)癥狀緩解速度較快,說明化痰貼方能較好地緩解病人的癥狀,減輕他們的痛苦。2.治療組在減輕肺熱病痰熱壅肺證患者的炎癥指標(biāo)方面無明顯優(yōu)勢。但在胸部CT滲出影的消散方面,治療組有明顯的優(yōu)勢。所以可以得出化痰貼方配合西醫(yī)治療肺炎痰熱壅肺證,同單純西醫(yī)療法相比,可以更好地緩解病患的痛苦,充分體現(xiàn)了中醫(yī)藥自身的獨(dú)特優(yōu)勢。
[Abstract]:Objective: to observe the improvement of clinical symptoms, changes of inflammatory indexes and CT changes of chest in patients with community-acquired pneumonia (syndrome of phlegm-heat obstruction of lung) treated with Huatan paste. In order to understand its curative effect in community acquired pneumonia patients with phlegm heat obstruction of lung syndrome, in order to guide clinical application and social popularization. Methods: this study used a prospective single-blind randomized control study method. A total of 83 patients who met the criteria of the study were collected. They were randomly divided into two groups: the treatment group (43 cases) and the control group (40 cases). Both groups were given the same basic western medicine treatment, the treatment group plus Huatan paste, the control group plus placebo, the course of treatment was 7 days. To compare the curative effect of the two groups by statistics, and to evaluate objectively the effect of Huatan plaster on the treatment of this disease. Results: the two groups had cough on the 3rd, 5th, 7th day after treatment. The difference of sputum integral between the two groups was significantly different (P 0.05) after the treatment. There was significant difference between the two groups before and after treatment by paired t test (P 0.05). There was no significant difference in WBC between the two groups after treatment by independent t-test (P0.05). There was no significant difference between the two groups before and after treatment. The serum CRP values of the two groups were matched with t-test (P0.05), and there was significant difference between the two groups before and after treatment. After treatment, the serum CRP values of the two groups were tested by independent sample t-test (P0.05), but there was no significant difference between the two groups. The PCT values of the two groups were tested with t-pairing test (P0.05) before and after treatment, and there was significant difference between the two groups. There was no significant difference between the two groups in PCT values after treatment. There was no significant difference between the two groups in chest CT changes after treatment (P 0.05). Conclusion: 1. Compared with the control group, the patients in the treatment group had sputum (including sputum color, sputum volume). Symptoms of cough (including duration of onset, severity of cough) were relieved faster, indicating that Huatan plaster could better relieve the symptoms of patients. 2. The treatment group has no obvious advantage in reducing the inflammatory indexes of the patients with phlegm and heat obstruction of lung fever. However, it has no obvious advantage in the dissipation of chest CT exudation. The treatment group has obvious advantages. So it can be concluded that Huatan paste prescription combined with western medicine in the treatment of pneumonia phlegm heat obstruction lung syndrome, compared with simple Western medicine therapy, can better alleviate the pain of patients, fully reflect the unique advantages of TCM itself.
【學(xué)位授予單位】：廣州中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R259

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