清热养阴生津法治疗外感高热(重症肺炎)的临床研究
Clinical Study on the Treatment of Exogenous High Fever (Severe Pneumonia) with the Therapeutic Method of Clearing Heat, Nourishing Yin and Promoting Fluid Production
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摘要: 目的 观察清热养阴生津法治疗外感高热(重症肺炎)患者的临床疗效。方法 选择符合外感高热(重症肺炎)诊断标准的68例患者,随机分为实验组、对照组,实验组在对照组常规抗感染基础上加用清热养阴生津法中药治疗,对比2组患者治疗前后的即刻退热时间、炎症指标、动脉血气、呼吸频率、心率、影像学变化、中医证候积分及临床有效率等,评估其临床疗效。结果 治疗后实验组即刻退热有效率与解热时间明显高于对照组(P<0.05);炎症指标如白细胞(WBC)、C反应蛋白(CRP)、降钙素原(PCT)与影像学炎症浸润吸收方面实验组具有明显优势(P<0.05);同时可更快的改善动脉血氧分压(PaO2)、动脉二氧化碳分压(PaCO2)、平均氧合指数(PaO2/FiO2)情况(P<0.05);2组肺部感染指数(CPIS)、呼吸频率(RR)、心率(HR)无明显统计学差异(P>0.05),但在中医证候积分方面,实验组具有明显优势(P<0.05),且实验组在治疗总有效率方面优于对照组(P<0.05)。结论 清热养阴生津法治疗外感高热(重症肺炎)疗效良好,值得临床进一步的深入研究及推广应用。Abstract: OBJECTIVE To observe the clinical efficacy of the therapeutic method of clearing heat, nourishing yin, and promoting fluid production in treating patients with exogenous high fever (severe pneumonia). METHODS 68 patients with exogenous fever (severe pneumonia) were selected and randomly divided into the experimental group and the control group. The experimental group was treated with Chinese medicinal for clearing heat, nourishing yin, and promoting fluid production plus conventional anti-infection treatment in the control group. The immediate antipyretic time, inflammation index, arterial blood gas, respiratory frequency, heart rate, imaging changes, traditional Chinese medicine (TCM) syndrome score and clinical effective rate of the two groups before and after treatment were compared to evaluate the efficacy. RESULTS The effective rate of immediate antipyretics and the lasting effect of antipyretics in the experimental group were significantly higher than those in the control group (P<0.05). As for the inflammation indicators such as white blood cells (WBC), C-reactive protein (CRP), procalcitonin (PCT) and imaging inflammation in terms of infiltration and absorption, the experimental group has obvious advantages (P<0.05). At the same time, it can improve the arterial blood oxygen partial pressure (PaO2), arterial carbon dioxide partial pressure (PaCO2), and average oxygenation index (PaO2/FiO2) more quickly (P<0.05). There was no significant difference in clinical pulmonary infection score (CPIS), respiratory rate (RR), and heart rate (HR) between the two groups (P>0.05). But in terms of TCM syndrome score and total effective rate, the experimental group had a significant advantage (P<0.05). CONCLUSION The method of clearing heat, nourishing yin and promoting fluid production has a notable effect in treating exogenous fever (severe pneumonia), and it is worthy of further clinical research, promotion, and application.
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