千金苇茎汤合大承气汤加味治疗脑卒中合并肺部感染临床研究

目的：观察千金苇茎汤合大承气汤加味治疗脑卒中合并肺部感染气阴两虚兼痰热蕴肺证的临床疗效。方法：选取96例脑卒中合并肺部感染气阴两虚兼痰热蕴肺证患者，采用随机数字表法分为对照组与观察组各48例。对照组行常规西医疗法治疗，观察组在对照组基础上给予千金苇茎汤合大承气汤加味治疗。2组均治疗14 d。比较2 组临床疗效、临床症状体征改善时间、临床肺部感染评分（CPIS）、炎症指标[白细胞计数（WBC）、中性粒细胞百分比（NEUT%）、降钙素原（PCT）、C-反应蛋白（CRP）、白细胞介素-6（IL-6）、肿瘤坏死因子-α （TNF-α） ]水平及不良反应发生率。结果：治疗后，观察组总有效率97.92%，高于对照组85.42% （P＜0.05）。观察组咳嗽、发热、肺部啰音消失时间及胸部影像恢复正常时间均短于对照组（P＜0.05）。2 组CPIS 评分均较治疗前降低（P＜0.05）， 观察组CPIS 评分低于对照组（P＜0.05）。2 组WBC、NEUT%、PCT、CRP、IL-6、TNF-α水平均较治疗前降低（P＜0.05），观察组上述6项炎症指标水平均低于对照组（P＜0.05）。治疗期间，观察组不良反应发生率10.42%，与对照组6.25%比较，差异无统计学意义（P＞0.05）。结论：在常规西医疗法基础上加用千金苇茎汤合大承气汤加味治疗脑卒中合并肺部感染气阴两虚兼痰热蕴肺证疗效显著，可促进临床症状改善，减轻机体炎症反应，且安全性较好。

Clinical Study on Modified “Qianjin Weijing Decoction Combined with DachengqiDecoction”for Stroke Complicated with Pulmonary Infection

Abstract： Objective： To observe the clinical effect of the therapy of modified “Qianjin WeijingDecoction combined with Dachengqi Decoction” on stroke complicated with pulmonary infection withsyndrome of dual deficiency of qi and yin and syndrome of phlegm-heat in the lung. Methods： A total of96 cases of patients with stroke complicated with pulmonary infection with syndrome of dual deficiency ofqi and yin and syndrome of phlegm-heat in the lung were selected and divided into the control group andthe observation group according to the random number table method， with 48 cases in each group. Thecontrol group was treated with routine western medicine，and the observation group was additionally givenmodified “Qianjin Weijing Decoction combined with Dachengqi Decoction” for treatment based on thetreatment of the control group. The two groups were treated for 14 days. The clinical effects，improvementtime of clinical symptoms and signs， clinical pulmonary infection scores (CPIS)， levels of inflammationindexes [white blood cell (WBC) count， percentage of neutrophil granulocytes (NEUT% )， procalcitonin(PCT)，C-reactive protein (CRP)，interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α)] and incidenceof adverse reactions were compared between the two groups. Results：After treatment，the total effectiverate was 97.92% in the observation group，higher than that of 85.42% in the control group (P＜0.05). Thedisappearance time of cough， heat and lung rales and recovery time of normal chest radiograph in theobservation group were shorter than those in the control group (P＜0.05). The CPIS scores in the two groupswere decreased when compared with those before treatment (P＜0.05)， and the CPIS score in theobservation group was lower than that in the control group (P＜0.05). The levels of WBC，NEUT%，PCT，CRP，IL-6 and TNF-α in the two groups were decreased when compared with those before treatment (P＜0.05)， and the above six levels in the observation group were lower than those in the control group (P＜0.05). During treatment， the incidence of adverse reactions was 10.42% in the observation group， and6.25% in the control group，there being no significance in the difference (P＞0.05). Conclusion：Based onthe routine western medicine，the therapy of modified“Qianjin Weijing Decoction combined with DachengqiDecoction”has a significant curative effect on stroke complicated with pulmonary infection with syndromeof dual deficiency of qi and yin and syndrome of phlegm-heat in the lung， which can promote theimprovement of clinical symptoms and reduce the inflammatory responses of the body with great safety.