小儿病毒性肺炎痰热闭肺证临床疗效评价的RCT研究

发布时间：2019-05-06 20:25

【摘要】：目的：探讨不同方案治疗小儿病毒性肺炎痰热闭肺证的临床疗效。方法：将130例病毒性肺炎患儿随机分为三组：A组50例，予喜炎平注射液（5～10mg/kg·d）加入5%葡萄糖注射液或0.9%氯化钠溶液100ml静滴，中药五虎汤合葶苈大枣泻肺汤加减口服；B组50例，予喜炎平注射液5～10mg/（kg·d）加入5%葡萄糖注射液或0.9%氯化钠溶液100ml静滴，小儿清肺合剂(0.5～1岁10ml1+～3岁15ml3+～5岁20ml)、化痰散(0.5～1岁0.5g1+～3岁1.5g3+～5岁2.0g)口服，敷胸散（大黄：芒硝：蒜泥=4:1:4）50mg外敷背部双肺罗音明显处；C组30例，利巴韦林（10～15mg/kg·d）加入5%葡萄糖注射液或0.9%氯化钠溶液100ml静滴，愈酚甲麻那敏糖浆（0.5～1岁3ml1+～3岁5ml3+～5岁8ml）口服。结果：三组患儿治疗结束后总积分与治疗前相比均有明显减少，经统计学分析，有非常显著性差异（P=0.000）；其中，A组总有效率98%，B组总有效率96%，C组总有效率80%，A、B两组总疗效相当（P0.05），均优于C组（P0.05）。在单个症状、体征比较上，A、B组中咳嗽、咯痰、喘促、肺部罗音的平均恢复时间优于C组；治疗结束后，A、B两组在改善发热、咯痰、咳嗽、肺部罗音方面均优于C组，A组在平喘方面优于C组（P0.05）。结论：三种方案均能有效治疗小儿病毒性肺炎痰热闭肺证；其中，A、B两组疗效相当，优于C组，说明喜炎平配合中药（中成药）治疗本病较西药利巴韦林效果更好，，能有效改善临床症状、体征，具有应用价值。
[Abstract]:Objective: to explore the clinical effect of different regimens on infantile viral pneumonia with phlegm-heat closed lung syndrome. Methods: 130 children with viral pneumonia were randomly divided into three groups: group A (50 cases) received Xiyanping injection (5~10mg/ kg 路d) plus 5% glucose injection or 0.9% sodium chloride solution 100ml intravenous drip. Traditional Chinese medicine Wuhu decoction combined with Draba jujube Xiefei decoction reduced oral; Group B (50 cases) received Xiyanping injection 5~10mg/ (kg 路d) plus 5% glucose injection or 0.9% sodium chloride solution 100ml intravenous drip. Xiaoer Qingfei mixture (0. 5-1-year-old 10ml1-3-year-old 15ml3-5-year-old 20ml) was given. Huatan powder (0.5-1-year-old 0.5g1-3-year-old 1.5g3-5 years old 2.0 g) was given orally and chest powder (rhubarb: mirabilite: garlic mashed = 4:1:4) 50mg was applied on the back of both lungs. Group C (n = 30) was treated with ribavirin (10~15mg/ kg 路d) with 5% glucose injection or 0.9% sodium chloride solution (100ml). Guaifen-methylmanamine syrup (3ml1-3-year-old 5ml3-5-year-old 8ml) was given orally. Results: after treatment, the total scores of the three groups decreased significantly compared with those before treatment, and there was a significant difference between the three groups (P < 0. 000). The total effective rate was 98% in group A, 96% in group B, 80% in group C, and the total effective rate in group A and B was similar (P0.05), which was better than that in group C (P0.05). The average recovery time of cough, expectoration, wheezing and lung rales in group A and B was better than that in group C on the comparison of single symptom and physical sign. After treatment, group A and B were better than group C in improving fever, expectoration, cough and lung rales, and group A was better than group C in relieving asthma (P0.05). Conclusion: all three schemes can effectively treat the syndrome of phlegm-heat closed lung in children with viral pneumonia. The results showed that Xiyanping combined with traditional Chinese medicine (Chinese patent medicine) was more effective in treating this disease than that of western medicine ribavirin, which could effectively improve the clinical symptoms and signs, and had practical value in the treatment of this disease. The results showed that Xiyanping combined with traditional Chinese medicine was more effective than ribavirin in the treatment of this disease.
【学位授予单位】：山东中医药大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R272

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