生脉散合千金苇茎汤加减治疗痰热壅肺型老年重症肺炎临床研究

目的：观察生脉散合千金苇茎汤加减治疗痰热壅肺型老年重症肺炎的临床疗效。方法：80 例痰热壅肺型老年重症肺炎患者按随机数字表法分成对照组与观察组各40 例。对照组给予常规西医对症治疗，观察组在对照组基础上给予生脉散合千金苇茎汤加减治疗，2 组均连续治疗2 周。比较2 组治疗前后中医证候评分、临床肺部感染（CPIS） 评分、多器官功能障碍综合征（MODS） 评分、急性生理和慢性健康评分（APACHEⅡ）、肺功能指标［用力肺活量（FVC）、最大呼气流速峰值（PEF）、第1 秒用力呼气容积（FEV1）、FEV1/FVC］、白细胞计数（WBC）、降钙素原（PCT）、C-反应蛋白（CRP）、白细胞介素-6（IL-6）水平；比较2 组临床疗效及不良反应发生情况。结果：治疗后，观察组总有效率92.50%，高于对照组75.00% （P＜0.05）。2 组治疗后中医证候评分、CPIS 评分、MODS 评分、APACHEⅡ评分、WBC、PCT、CRP、IL-6 水平均较治疗前降低（P＜0.05），且观察组治疗后各项评分、炎症指标均低于对照组（P＜0.05）。2 组治疗后FVC、PEF、FEV1 水平及FEV1/FVC 均较治疗前升高（P＜0.05），且观察组治疗后肺功能指标高于对照组（P＜0.05）。2 组不良反应发生率比较，差异无统计学意义（P＞0.05）。结论：生脉散合千金苇茎汤加减治疗老年重症肺炎痰热壅肺证疗效确切，能够进一步缓解患者临床症状，抑制肺部炎症反应，改善肺功能，安全性较高。

Clinical Study on Modified Shengmai San and Qianjin Weijing Decoction for SenilePatients with Severe Pneumonia of Phlegm-Heat Obstructing the Lung Type

Abstract： Objective： To observe the clinical effect of modified Shengmai San and Qianjin WeijingDecoction for senile patients with severe pneumonia of phlegm- heat obstructing the lung type. Methods：A total of 80 cases of senile patients with severe pneumonia of phlegm-heat obstructing the lung type weredivided into the control group and the observation group according to the random number table method，with 40 cases in each group. The control group was given routine symptomatic treatment of westernmedicine， and the observation group was additionally treated with modified Shengmai San and QianjinWeijing Decoction based on the treatment of the control group. Both groups were treated for 2 weeks.Traditional Chinese medicine (TCM) syndrome scores，Clinical Pulmonary Infection Scores (CPIS)，MultipleOrgan Dysfunction Syndrome (MODS) scores， Acute Physiology and Chronic Health Evaluation (APACHEⅡ)，lung function indexes [forced vital capacity (FVC)，peak expiratory flow rate (PEF)，forced expiratory(PCT)，C- reactive protein (CRP)，interleukin- 6 (IL- 6) in the two groups were compared before and aftertreatment. The clinical effects and the incidence of adverse reactions in the two groups were compared.Results：After treatment，the total effective rate was 92.50% in the observation group，higher than that of75.00% in the control group (P＜0.05). After treatment， TCM syndrome scores， CPIS scores， MODSscores，and APACHEⅡ scores，and the levels of WBC，PCT，CRP，and IL- 6 in the two groups weredecreased when compared with those before treatment (P＜0.05)， and all the above scores and theinflammatory indexes in the observation group were lower than those in the control group (P＜0.05). Aftertreatment， the levels of FVC， PEF， FEV1， and FEV1/FVC in the two groups were increased whencompared with those before treatment (P＜0.05)，the lung function indexes in the observation group werehigher than those in the control group (P＜0.05). There was no significant difference being found in thecomparison of the incidence of adverse reactions between the two groups (P＞0.05). Conclusion：ModifiedShengmai San and Qianjin Weijing Decoction has a definite curative effect in treating senile patients withsevere pneumonia of phlegm-heat obstructing the lung type，which can further relieve clinical symptoms，inhibit lung inflammation and improve lung function，with high safety.