不同配比麻杏石甘汤对肺炎喘嗽痰热闭肺证患儿的临床疗效观察

发布时间：2018-02-26 14:47

本文关键词： 麻杏石甘汤肺炎喘嗽临床研究　出处：《广州中医药大学》2012年硕士论文　论文类型：学位论文

【摘要】：目的：本研究通过对麻杏石甘汤内各药不同剂量配伍应用,探讨其中各中药成分在肺炎喘嗽痰热闭肺证中的临床疗效,为今后临床应用麻杏石甘汤在各药物剂量上提供一定理论依据。方法：将符合标准的180例患儿按实际情况分为6组,每组按不同药物剂量配比应用麻杏石甘汤辅助西药治疗(原方配比：麻、杏、石、甘为3：2：6：2),即麻黄组(用麻、杏、石、甘比为6：2：6：2的方剂辅以西药治疗)、杏仁组(用麻、杏、石、甘比为3：4：6：2的方剂辅以西药治疗)、石膏组(用麻、杏、石、甘比为3：2：12：2的方剂辅以西药治疗)、甘草组(用麻、杏、石、甘比为3：2：6：4的方剂辅以西药治疗)、对照组(用麻、杏、石、甘比为3：2：6：2的方剂辅以西药治疗)与空白组(以纯西医西药治疗),记录每例患儿发热、咳嗽、咳痰、气喘症状的消失时间(若有反复,按最后消失时间计算),肺部Up音消失时间(干湿Up音均消失时间),治疗前后(入院时及治疗4天后)血清CRP浓度等数据为主要观察指征。成果： ①麻杏石甘汤配合西药治疗对肺炎各主要指征的观察上,消失时间均短于单纯西药治疗(P0.05)。改善实验室指标CRP的作用与单纯西药治疗相当(P0.05)。②各组在发热、咳嗽、咳痰、气喘、Up音等指征改善方面效果分布不尽相同。各组CRP治疗前后改善分布不具有统计学意义(P0.05)。结论：根据研究数据可知,麻杏石甘汤配合西药治疗对肺炎咳嗽、咳痰、气喘、Up音各指征的改善上,效果明显优于单纯西药治疗。其中麻黄平喘之效为全方之首,临床上增大其用量可用于小儿肺炎见气喘明显,气道高反应性,中高热并无汗,伴咳嗽咳痰的患儿。苦杏仁止咳作用最强,增大其用量可用于小儿肺炎见有痰咳嗽,或干咳无痰,稍有气喘或无气喘,发热不明显的患儿。石膏退热效果在各药中最强,增大其用量可用于小儿肺炎初期见高热,汗多,烦渴,或发热持续不退,咳嗽咳痰气喘不甚的患儿。甘草化痰效果强于其余药物,增大其用量可用于小儿肺炎见有痰咳嗽,无发热或低热,气喘不甚的患儿,且药味甘甜,易于小儿口服。肺炎因小儿体质差异、病原体种类不同、侵袭部位不同,而出现不同的表现。不同配比的麻杏石甘汤可因应不同症状,有所侧重地减轻各症状对患儿造成的损伤,在临床上值得推广。
[Abstract]:Objective:. In this study, the clinical effect of different doses of each drug in Maxingshigan decoction on the syndrome of pneumonia, cough, phlegm and heat blocking lung was studied. To provide some theoretical basis for the clinical application of maxing Shigan decoction in various drug doses. Methods:. 180 children who met the standard were divided into 6 groups according to the actual situation. Each group was treated with maxing Shigan decoction with different dosage ratio. (the original formula: Ma, Xing, Shi, Gan is 3: 2: 6: 2, that is, ephedra group (with Ma, Xing, Shi, The prescription of 6: 2: 6: 2 was treated with western medicine, the almond group (with hemp, apricot, stone, Gambi of 3: 4: 6: 2) was treated with western medicine, the gypsum group (with flax, apricot, stone, gumbi = 32: 12: 2) with western medicine, the group with licorice (with hemp, apricot, stone, stone, etc.) with western medicine, and the group with licorice (with hemp, apricot, stone, stone, etc. The prescription of 3: 2: 6: 4 was treated with western medicine, the control group (with the prescription of 3: 2: 6: 2) and the blank group (treated with pure western medicine) and the control group (with the prescription of 3: 2: 6: 2) and the control group (treated with pure western medicine) recorded each child's fever, cough, expectoration, The time of disappearance of asthmatic symptoms (if repeated, calculated according to the last time of disappearance, the time of disappearance of lung up sound (both dry and wet up), and the serum CRP concentration before and after treatment (admission and 4 days after treatment) were the main indications. Outcome:. 1the observation of the main indications of pneumonia treated by Maxingshigan decoction and western medicine was shorter than that of western medicine alone. The effect of improving the laboratory index CRP was similar to that of western medicine alone in fever, cough and expectoration. The effect of improving the symptoms of asthma and up was different in different groups, but there was no significant difference between the two groups before and after CRP treatment (P 0.05). Conclusion:. According to the research data, the effect of Maxingshigan decoction combined with western medicine on the improvement of the symptoms of pneumonia, cough, expectoration and asthma is obviously better than that of western medicine alone. The effect of ephedra on relieving asthma is the first of all Fang Zhi. It can be used in children with pneumonia with obvious asthma, airway hyperresponsiveness, moderate hyperthermia and no sweat, and cough and expectoration. Almond has the strongest antitussive effect, increasing the dosage of almond can be used in children pneumonia to see sputum cough. Or dry cough without phlegm, a little asthma or no asthma, fever is not obvious. The best antipyretic effect of gypsum in every medicine, increase its dosage can be used in early childhood pneumonia to see high fever, sweating more, irritating thirst, or fever continues to be, The effect of liquorice on phlegm reduction is stronger than that of other drugs. Increasing its dosage can be used in children with pneumonia with sputum cough, no fever or low fever, and mild asthma, and the medicine is sweet and sweet. Pneumonia is easy for children to take orally. Pneumonia is caused by different types of pathogens, different invasion sites, and different manifestations. Different proportions of Maxingshigan decoction can respond to different symptoms. It is worth popularizing in clinical practice to alleviate the injury caused by various symptoms in children.
【学位授予单位】：广州中医药大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R272

【引证文献】