加减麻杏石甘汤联合阿奇霉素治疗儿童支原体肺炎的临床研究

发布时间：2018-07-13 15:29

【摘要】：目的运用前瞻性、对照的临床研究方法,从临床症状改善、疾病疗程、抗生素使用疗程等方面,观察加减麻杏石甘汤联合阿奇霉素的治疗方法对比单纯的西医治疗,在支原体肺炎风热闭肺证患儿的临床疗效比较,探讨优化中西医结合治疗小儿支原体肺炎方案。方法于2013年8月至2014年1月在广州中医药大学第一附属医院儿科门诊、住院部就诊的肺炎支原体肺炎患儿,筛选60例合格的病例,采用前瞻性、对照的临床研究方法,分为治疗组和对照组,每组30例。治疗组第1-3天口服阿奇霉素,配合每日一剂中药,第4-14天仅每天服用一剂中药,共治疗2周,对照组：第1-3天及第8-10天口服阿奇霉素,共治疗2周,对其临床症候积分、症状改善情况、治疗结束后有无咳嗽迁延等方面进行评价,并运用统计方法进行分析。采用spss19.0统计软件分析评价结果。结果 1.治疗组在治疗第7天、第14天,症候积分与对照组对比差异均具有统计学意义(P0.01),认为治疗组改善症候积分上明显优于对照组。 2.通过对比两组的咳嗽、发热起效时间,差异具有统计学意义(P0.01),认为治疗组在改善咳嗽、发热症状方面疗效优于对照组。 3.通过对比两组治疗第7天、第14天的疗效,差异具有统计学意义(P0.01),认为治疗组在疗效上显著优于对照组。 4.通过随访期观察,治疗组的咳嗽迁延的发生率要显著小于对照组(P=0.02),而两组在治疗结束后一个月内新发呼吸道感染的发生率无明显差异(P=0.347)。结论 1.加减麻杏石甘汤联合阿奇霉素治疗能明显改善支原体肺炎风热闭肺证患儿的症候积分。 2.运用中西医结合的治疗方法对比单纯西医治疗,能更明显改善支原体肺炎患儿的症状、体征,且能缩短病程,达到较高的治愈率。 3.在中医疗法的介入下,缩短阿奇霉素的使用疗程,并不会增加肺炎的复发、新发呼吸道感染的发生,同时能减少咳嗽迁延发生的概率。
[Abstract]:Objective to observe the therapeutic effects of maxingshigan decoction combined with azithromycin on clinical symptoms improvement, course of treatment and antibiotic use. To compare the clinical efficacy of mycoplasma pneumoniae in children with wind-heat blockage of lung syndrome, to explore the optimization of integrated traditional Chinese and western medicine in the treatment of mycoplasma pneumonia in children. Methods from August 2013 to January 2014, 60 cases of mycoplasma pneumoniae pneumonia were selected from the pediatric outpatient department of the first affiliated Hospital of Guangzhou University of traditional Chinese Medicine. The control group was divided into treatment group and control group with 30 cases in each group. In the treatment group, azithromycin was taken orally on the 1-3 days, combined with one dose of Chinese medicine daily, and only one dose of Chinese medicine was taken daily on the 4-14 days for a total of 2 weeks. In the control group, azithromycin was given orally for 2 weeks on the 1-3 and 8-10 days. Symptoms were improved, cough was delayed after treatment, and statistical methods were used to analyze the symptoms. Spss19.0 statistical software was used to analyze the evaluation results. Result 1. On the 7th and 14th day after treatment, the symptom score of the treatment group was significantly different from that of the control group (P0.01), and it was considered that the improvement symptom score of the treatment group was obviously better than that of the control group (2. 01). By comparing the onset time of cough and fever between the two groups, the difference was statistically significant (P0.01). It was concluded that the curative effect of the treatment group was better than that of the control group in improving cough and fever symptoms. By comparing the therapeutic effect of the two groups on the 7th and 14th day, the difference was statistically significant (P0.01), and it was concluded that the therapeutic effect of the treatment group was significantly better than that of the control group. 4. The incidence of cough prolongation in the treatment group was significantly lower than that in the control group (P0. 02), but there was no significant difference between the two groups in the incidence of new respiratory tract infection within one month after treatment (P0. 347). Conclusion 1. Add and reduce Ma Xing Shi Gan Tang combined with azithromycin treatment can obviously improve the syndrome score of mycoplasma pneumoniae pneumonia in children with wind-heat blocking lung syndrome. 2. 2. The treatment of mycoplasma pneumonia in children with mycoplasma pneumonia can be more obviously improved by the method of integrated traditional Chinese and western medicine than by western medicine alone, and can shorten the course of disease and reach a higher cure rate of 3. 3%. Under the intervention of TCM therapy, shortening the course of using azithromycin does not increase the recurrence of pneumonia and the occurrence of new respiratory tract infection, and at the same time can reduce the probability of prolonged cough.
【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】：2014
【分类号】：R272

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