發(fā)布時間：2018-08-08 15:44

【摘要】：目的評價清瘟敗毒飲合大承氣湯加減輔助治療肺炎膿毒癥初期(毒熱內(nèi)盛證、瘀毒內(nèi)阻證)的臨床療效并探討分析其作用機(jī)制,為臨床中西醫(yī)結(jié)合治療肺炎膿毒癥探索新途徑。方法選擇于2015年4月-2016年4月入住山東省中醫(yī)藥大學(xué)附屬醫(yī)院急診科及ICU病房的符合肺炎膿毒癥初期診斷標(biāo)準(zhǔn)的患者60例,隨機(jī)分為試驗(yàn)組(30例,采用西醫(yī)常規(guī)治療+清瘟敗毒飲合大承氣湯加減組方中藥治療),對照組(30例,采用西醫(yī)常規(guī)治療),進(jìn)行前瞻性對照研究。入院24小時內(nèi)及療程結(jié)束時分別進(jìn)行實(shí)驗(yàn)室檢查、SPACHEII評分、中醫(yī)證候總積分、各單項(xiàng)癥狀等指標(biāo)觀察比較。采用SPSS 17.0軟件進(jìn)行統(tǒng)計(jì)分析。結(jié)果經(jīng)過治療7天后,試驗(yàn)組及對照組比較存在限制性差異(P0、05)。同時,SPACHEII評分、白細(xì)胞總數(shù)(WBC)、降鈣素原(PCT)、C反應(yīng)蛋白(CRP)、中醫(yī)證候總積分明顯降低(P0、05或P0、01),各單項(xiàng)中醫(yī)臨床癥狀的改善試驗(yàn)組明顯優(yōu)于對照組,具有顯著性差異(P0.01)。結(jié)論清瘟敗毒飲合大承氣湯加減組方對肺炎膿毒癥初期有較好的干預(yù)治療作用。
[Abstract]:Objective to evaluate the clinical efficacy of Qingwen Baidu Yin combined with Dachengqi decoction in the treatment of pneumonia sepsis at the early stage of pneumonia sepsis (toxic heat and internal obstruction syndrome) and to explore the mechanism of its effect and explore a new approach for the treatment of pneumonia sepsis by integrating traditional Chinese and western medicine. Methods from April 2015 to April 2016, 60 patients admitted to the emergency department and ICU ward of the affiliated Hospital of Shandong University of traditional Chinese Medicine were selected to meet the initial diagnostic criteria for pneumonia sepsis, and were randomly divided into the experimental group (30 cases), and the control group (30 cases). Western medicine was used to treat Qingwen Baidu Yin combined with Dachengqi decoction. The control group (30 cases, treated by routine western medicine) was carried out a prospective control study. Within 24 hours of admission and at the end of the course of treatment, the scores of SPACHEII, the total score of TCM syndromes and the symptoms of each single item were observed and compared. SPSS 17.0 software was used for statistical analysis. Results after 7 days of treatment, there was a restrictive difference between the experimental group and the control group (P0. 05). At the same time, the score of SPACHEII and the total score of TCM syndromes of (WBC), procalcitonin (PCT) C reactive protein (CRP),) were significantly decreased (P00.05 or P00.01). The improvement of clinical symptoms of each single TCM in the experimental group was obviously superior to that in the control group (P0.01). Conclusion Qingwen septic decoction combined with Dachengqi decoction has better effect on the treatment of pneumonia sepsis at the initial stage.
【學(xué)位授予單位】：山東中醫(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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