基于核心病机的益气活血法治疗老年肺炎的临床疗效观察

发布时间：2018-09-13 15:27

【摘要】：目的:基于老年肺炎的核心病机,观察益气活血法治疗老年肺炎的临床疗效及其安全性,并探讨其作用机制,阐明益气活血法对老年肺炎的治疗作用。方法:将符合纳入标准的60例老年肺炎住院患者随机分为观察组和对照组,每组30例,两组均予西医常规治疗,观察组加用益气活血中药治疗,疗程均为14天。观察治疗前后两组临床症状积分,治疗前后血象(白细胞计数、中性粒细胞百分比)、C-反应蛋白等炎症指标,前白蛋白等营养学指标,纤维蛋白原等凝血指标及胸部X线或胸部CT等影像学变化,运用统计学软件SPSS17.0进行数据分析,评价两组的临床疗效;观察尿常规、大便常规、心电图及肝肾功能等指标的变化,评估益气活血中药治疗老年肺炎的安全性。结果:本研究显示采用益气活血中药加西医常规治疗的观察组与给予西医常规治疗的对照组均取得良好的临床疗效,观察组总有效率(86.67%)明显高于对照组的总有效率(70%),具有显著性差异(P0.05),观察组的临床疗效优于对照组。观察组在改善患者临床症状(咳嗽咳痰,气短乏力及汗出等)、体征(口唇紫绀,舌下络脉静脉曲张及肺部湿Up音)等方面明显均优于对照组(P0.01);在实验室检查方面,对两组的白细胞计数、中性粒细胞百分比,C-反应蛋白、前白蛋白、血浆纤维蛋白原等指标的疗效进行分析,观察组的疗效显著优于对照组(P0.01),血浆纤维蛋白原(P0.05);治疗后两组胸部影像学的疗效分析,两组疗效有差异(P0.05),观察组有效率(90%)明显高于对照组(70%)。结论:基于核心病机的益气活血法能改善患者的临床症状、体征,调节恢复部分实验室检查指标及胸部影像学,减轻患者的痛苦,提高老年人的生活生存质量,安全有效,益气活血法治疗老年肺炎值得临床运用与推广。
[Abstract]:Objective: based on the core pathogenesis of senile pneumonia, to observe the clinical efficacy and safety of Yiqi Huoxue method in the treatment of senile pneumonia, to explore its mechanism, and to clarify the therapeutic effect of Yiqi Huoxue method on senile pneumonia. Methods: sixty inpatients with senile pneumonia were randomly divided into two groups: observation group (n = 30) and control group (n = 30). The two groups were treated with routine western medicine. The observation group was treated with traditional Chinese medicine for invigorating qi and activating blood. The course of treatment was 14 days. The clinical symptom scores of the two groups before and after treatment, the inflammatory indexes such as leukocyte count, neutrophil percentage, and prealbumin before and after treatment were observed. The changes of fibrinogen isocoagulant index, chest X-ray or chest CT were analyzed by SPSS17.0 to evaluate the clinical effect of the two groups, and the changes of urine routine, stool routine, electrocardiogram, liver and kidney function were observed. To evaluate the safety of traditional Chinese medicine for supplementing qi and activating blood circulation in the treatment of senile pneumonia. Results: this study showed that both the observation group and the control group treated with traditional Chinese medicine for supplementing qi and activating blood circulation plus routine western medicine had good clinical effect. The total effective rate of the observation group (86.67%) was significantly higher than that of the control group (70%), with significant difference (P0.05). The clinical efficacy of the observation group was better than that of the control group. The observation group was superior to the control group in improving the clinical symptoms (cough and phlegm, asthenia of short breath, sweating etc.), signs (cyanosis of lips, varicose veins under tongue and wet Up sound of lung) (P0.01), and in laboratory examination, The effects of white blood cell count, neutrophil percentage and C-reactive protein, prealbumin and plasma fibrinogen in the two groups were analyzed. The curative effect of the observation group was significantly better than that of the control group (P0.01) and plasma fibrinogen (P0.05); after treatment, there was a difference between the two groups in chest imaging efficacy (P0.05). The effective rate of the observation group (90%) was significantly higher than that of the control group (70%). Conclusion: the method of supplementing qi and activating blood circulation based on the core pathogenesis can improve the clinical symptoms and signs of the patients, adjust and restore some laboratory examination indexes and chest imaging, alleviate the pain of the patients, improve the quality of life of the elderly, and be safe and effective. The therapy of supplementing qi and activating blood circulation in the treatment of senile pneumonia is worthy of clinical application and promotion.
【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】：2016
【分类号】：R259

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