加味陈平汤治疗老年社区获得性肺炎患者痰湿阻肺夹瘀证的临床观察

目的:观察加味陈平汤治疗老年社区获得性肺炎患者痰湿阻肺夹瘀证患者的临床疗效及安全性,并探讨其作用机制。方法:采用随机数字表将104例老年社区获得性肺炎痰湿阻肺夹瘀证患者随机分为治疗组、对照组,各52例。治疗组患者采用常规西医治疗联合加味陈平汤,对照组患者采用单纯西医治疗,比较两组患者的临床症状体征评分、中医证候疗效、外周血炎症指标(白细胞计数、中性粒细胞数、快速C反应蛋白、血沉及降钙素原)水平、胸部CT炎症吸收情况及不良反应。结果:治疗组患者在临床症状体征评分、中医证候疗效、外周血炎症指标水平(白细胞计数、中性粒细胞数、快速C反应蛋白、血沉及降钙素原)、胸部CT炎症吸收方面显著优于对照组(P0.01)。在试验过程中,少数患者出现轻微静脉炎、胃肠道反应和肝功能受损等药物副作用,两组不良反应率差异无统计学意义。结论:在常规西医治疗基础上,服用加味陈平汤治疗老年社区获得性肺炎痰湿阻肺夹瘀证疗效更好,值得临床推广应用。

Effect of Modified Chenping Tang for Senile Community Acquired Pneumonia with Syndrome of Phlegm Dampness Obstructing Lung and Blood Stasis

Objective: To observe the effect of modified Chenping Tang for the treatment of senile community acquired pneumonia with the syndrome of phlegm dampness obstructing lung and blood stasis.Method: A total of 104 patients were randomly divided into treatment group and control group by random number table, with 52 cases in each group. Patients in treatment group received routine western medicine combined with modified Chenping decoction, while patients in control group only received pure western medicine. Clinical symptom and sign scores, curative effect of traditional Chinese medicine (TCM) syndrome, peripheral blood inflammatory markers (white blood cell count, neutrophil count, rapid C reactive protein, erythrocyte sedimentation rate and procalcitonin), inflammatory absorption of chest CT and adverse drug reactions were evaluated and compared.Result: Compared with control group, treatment group showed better clinical symptom and sign scores, curative effect of TCM syndrome, peripheral blood inflammatory markers, and inflammatory absorption of the chest CT among patients with senile community acquired pneumonia with the syndrome of phlegm dampness obstructing lung and blood stasis (P<0.01). Mild adverse reactions, such as phlebitis, gastrointestinal reaction and liver damage occurred in a few patients in the process of trial, but the adverse reaction rates between two groups were not statistically significant.Conclusion: Modified Chenping Tang combined with routine western medicine shows a better efficacy in treating patients with senile community acquired pneumonia with the syndrome of phlegm dampness obstructing lung and blood stasis, and so is worth clinical promotion and application.