麻杏石甘汤中麻黄与石膏不同剂量配比对治疗肺热喘咳证的临床效果分析
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摘要
目的:探讨麻杏石甘汤中麻黄与石膏不同剂量配比对治疗肺热喘咳证的临床效果。方法:选取2015年6月至2018年6月广东省人民医院南海医院收治的具有肺热喘咳证的肺炎患者120例作为研究对象,采用随机数字表法将患者分为A、B、C 3组,每组40例。3组患者均给予麻黄与石膏不同剂量配比的麻杏石甘汤治疗,A组:麻黄:石膏=1:3,B组:麻黄:石膏=1:5,C组:麻黄:石膏=3:8,3组均连续治疗1个月。比较3组治疗后临床症状消失时间、临床疗效及治疗前后肺功能和EOS计数、CRP水平变化。结果:治疗后B组总有效率明显高于A组和C组(P <0. 05)。治疗后B组患者咳嗽、咳痰、气喘症状及肺部罗音消失时间均明显早于A、C 2组(P <0. 05)。与治疗前比较,治疗后3组患者FEV1、FVC及PEmax均明显增加,且B组明显大于A、C 2组(P <0. 05或P <0. 01)。与治疗前比较,治疗后3组患者外周血EOS计数及血清CRP水平均明显降低,且B组明显低于A、C 2组(P <0. 01)。结论:麻杏石甘汤中麻黄:石膏为1:5的配比可更明显地改善肺热喘咳证肺炎患者临床症状,降低炎性反应状态,改善肺通气功能,提高治疗效果,建议临床推广使用。
Objective: To explore the clinical effects of different dosage ratio of Herba Ephedra and Gypsum Fibrosum in Maxing Shigan Decoction for treating lung heat with panting and cough syndrome. Methods: A total of 120 cases with pneumonia of lung heat with panting with cough syndrome admitted to our hospital from June 2015 to June 2018 were selected and randomly divided into A,B,and C groups,with 40 cases in each group. All of the 3 groups were treated with Maxing Shigan Decoction with different doses of Herba Ephedra and Gypsum Fibrosum. The group A: Herba Ephedra: Gypsum Fibrosum = 1∶ 3,the group B: Herba Ephedra: Gypsum Fibrosum = 1∶ 5,and the group C: Herba Ephedra: Gypsum Fibrosum = 3∶ 8. The 3 groups were treated continuously for1 month. The disappearance time of clinical symptoms,clinical efficacy after treatment and changes of lung function,EOS count and CRP level before and after the treatment were compared of the 3 groups. Results: After the treatment,the total effective rate of the group B was significantly higher than that of the group A and the group C( P < 0. 05). After treatment,the disappearance time of cough,expectoration,asthma symptoms and lung rale in the group B was significantly earlier than that in the group A and C( P <0. 05). Compared with before the treatment,the FEV1,FVC and PEmaxwere significantly increased of the 3 groups after the treatment,and these in the group B were significantly larger than those in the group A and C( P < 0. 05 or P < 0. 01). Compared with before the treatment,the EOS count in peripheral blood and the serum level of CRP of the 3 groups were significantly decreased after the treatment,and these in the group B was significantly lower than those in the group A and C( P < 0. 01). Conclusion: Maxing Shigan Decoction with Herba Ephedra: Gypsum Fibrosum = 1 ∶ 5 can significantly improve the clinical symptoms of pneumonia of lung heat with panting and cough syndrome,reduce the inflammatory response,improve lung ventilation function,enhance the therapeutic effect,which is recommend to use clinically.
Objective: To explore the clinical effects of different dosage ratio of Herba Ephedra and Gypsum Fibrosum in Maxing Shigan Decoction for treating lung heat with panting and cough syndrome. Methods: A total of 120 cases with pneumonia of lung heat with panting with cough syndrome admitted to our hospital from June 2015 to June 2018 were selected and randomly divided into A,B,and C groups,with 40 cases in each group. All of the 3 groups were treated with Maxing Shigan Decoction with different doses of Herba Ephedra and Gypsum Fibrosum. The group A: Herba Ephedra: Gypsum Fibrosum = 1∶ 3,the group B: Herba Ephedra: Gypsum Fibrosum = 1∶ 5,and the group C: Herba Ephedra: Gypsum Fibrosum = 3∶ 8. The 3 groups were treated continuously for1 month. The disappearance time of clinical symptoms,clinical efficacy after treatment and changes of lung function,EOS count and CRP level before and after the treatment were compared of the 3 groups. Results: After the treatment,the total effective rate of the group B was significantly higher than that of the group A and the group C( P < 0. 05). After treatment,the disappearance time of cough,expectoration,asthma symptoms and lung rale in the group B was significantly earlier than that in the group A and C( P <0. 05). Compared with before the treatment,the FEV1,FVC and PEmaxwere significantly increased of the 3 groups after the treatment,and these in the group B were significantly larger than those in the group A and C( P < 0. 05 or P < 0. 01). Compared with before the treatment,the EOS count in peripheral blood and the serum level of CRP of the 3 groups were significantly decreased after the treatment,and these in the group B was significantly lower than those in the group A and C( P < 0. 01). Conclusion: Maxing Shigan Decoction with Herba Ephedra: Gypsum Fibrosum = 1 ∶ 5 can significantly improve the clinical symptoms of pneumonia of lung heat with panting and cough syndrome,reduce the inflammatory response,improve lung ventilation function,enhance the therapeutic effect,which is recommend to use clinically.
引文
[1]袁媛,阎妍. ICU坠积性肺炎患者经口咽通气道声门下吸痰的疗效观察[J].护士进修杂志,2014,29(4):355-357.
[2]张秀英,胡玲,赵国华,等.小儿肺热咳喘颗粒治疗儿童支气管肺炎的临床观察[J].中草药,2016,47(11):1931-1934.
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[4]申琳,潘丽,廖绪强,等.小儿肺热咳喘颗粒治疗小儿急性咽-气管炎(感冒风热夹痰证)的多中心临床试验研究[J].中草药,2016,47(12):2142-2146.
[5]李秀琼,李国华,罗敏,等.小儿支原体肺炎中西医结合治疗体会[J].深圳中西医结合杂志,2016,26(13):43-44.
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[8]张赛,程燕.中医诊疗小儿肺炎支原体肺炎概况[J].中医药学报,2016,44(1):73-76.
[9]黎石放,谢杨春,李莉.中医内外合治小儿肺炎喘嗽痰热闭肺证43例疗效观察[J].中医临床研究,2016,8(10):53-54.
[10]Chen L P,Cai Y M,Li J S. Medication rules of famous veteran traditional Chinese medicine doctor in treatment of chronic bronchitis based on implicit structure model[J]. Chin J TCM,2017,42(8):1609-1616.
[11]高佩芳,来益敏.麻杏石甘汤治疗常见肺系疾病[J].河南中医,2014,34(2):213-214.
[12]Fen Mei,Xuefeng Xing,Qingfa Tang,et al. Antipyretic and antiasthmatic activities of traditional Chinese herb-pairs,Ephedra and Gypsum[J]. Chin J Integr Med,2016,22(6):445-450.
[13]黄晓洁,魏刚,张龙,等.麻杏石甘汤的药理作用和临床应用研究进展[J].广东药学院学报,2014,30(1):110-114.
[14]胡元辉.基于麻杏石甘汤治疗小儿肺炎的疗效、不良反应及量效分析[J].中医临床研究,2016,8(20):89-89.
[15]赵彩霞.中药麻杏石甘汤治疗小儿肺炎的方药组成、功效及安全性评价[J].中西医结合心血管病(连续型电子期刊),2015,3(5):82-83.
[16]杨淑慧,蔡永敏.基于名老中医医案探讨麻杏石甘汤的证治规律[J].中国中西医结合杂志,2017,37(6):746-750.
[17]崔艳茹,屈飞,徐镜,等.配伍剂量变化对麻杏石甘汤解热作用的影响[J].中国实验方剂学杂志,2014,20(6):122-126.
[18]李冰涛,徐国良,张启云,等.基于代谢物组麻杏石甘汤止喘量效关系的实验研究[J].中药新药与临床药理,2014,25(6):717-720.
[19]王法霞,赖克方,陈如冲,等.哮喘患者吸入表面激素减量后哮喘症状变化与诱导痰嗜酸性粒细胞比例的关系[J].中华肺部疾病杂志(连续型电子期刊),2014,7(5):9-12.
[20]沈海广,唐远平,黄东平,等.化痰清热方联合盐酸氨溴索对小儿肺炎CRP、IL-18水平及免疫功能的影响[J].中国临床研究,2016,29(11):1534-1536.
[2]张秀英,胡玲,赵国华,等.小儿肺热咳喘颗粒治疗儿童支气管肺炎的临床观察[J].中草药,2016,47(11):1931-1934.
[3]李春生,李兆合.高龄肺炎中医药治疗规律探讨[J].世界中西医结合杂志,2017,12(1):130-133.
[4]申琳,潘丽,廖绪强,等.小儿肺热咳喘颗粒治疗小儿急性咽-气管炎(感冒风热夹痰证)的多中心临床试验研究[J].中草药,2016,47(12):2142-2146.
[5]李秀琼,李国华,罗敏,等.小儿支原体肺炎中西医结合治疗体会[J].深圳中西医结合杂志,2016,26(13):43-44.
[6]王永炎,严世芸.实用中医内科学[M].上海:上海科学技术出版社,2009:181-182.
[7]国家中医药管理局.中医内科病证诊断疗效标准(试行)[J].湖北中医杂志,2002,24(4):3.
[8]张赛,程燕.中医诊疗小儿肺炎支原体肺炎概况[J].中医药学报,2016,44(1):73-76.
[9]黎石放,谢杨春,李莉.中医内外合治小儿肺炎喘嗽痰热闭肺证43例疗效观察[J].中医临床研究,2016,8(10):53-54.
[10]Chen L P,Cai Y M,Li J S. Medication rules of famous veteran traditional Chinese medicine doctor in treatment of chronic bronchitis based on implicit structure model[J]. Chin J TCM,2017,42(8):1609-1616.
[11]高佩芳,来益敏.麻杏石甘汤治疗常见肺系疾病[J].河南中医,2014,34(2):213-214.
[12]Fen Mei,Xuefeng Xing,Qingfa Tang,et al. Antipyretic and antiasthmatic activities of traditional Chinese herb-pairs,Ephedra and Gypsum[J]. Chin J Integr Med,2016,22(6):445-450.
[13]黄晓洁,魏刚,张龙,等.麻杏石甘汤的药理作用和临床应用研究进展[J].广东药学院学报,2014,30(1):110-114.
[14]胡元辉.基于麻杏石甘汤治疗小儿肺炎的疗效、不良反应及量效分析[J].中医临床研究,2016,8(20):89-89.
[15]赵彩霞.中药麻杏石甘汤治疗小儿肺炎的方药组成、功效及安全性评价[J].中西医结合心血管病(连续型电子期刊),2015,3(5):82-83.
[16]杨淑慧,蔡永敏.基于名老中医医案探讨麻杏石甘汤的证治规律[J].中国中西医结合杂志,2017,37(6):746-750.
[17]崔艳茹,屈飞,徐镜,等.配伍剂量变化对麻杏石甘汤解热作用的影响[J].中国实验方剂学杂志,2014,20(6):122-126.
[18]李冰涛,徐国良,张启云,等.基于代谢物组麻杏石甘汤止喘量效关系的实验研究[J].中药新药与临床药理,2014,25(6):717-720.
[19]王法霞,赖克方,陈如冲,等.哮喘患者吸入表面激素减量后哮喘症状变化与诱导痰嗜酸性粒细胞比例的关系[J].中华肺部疾病杂志(连续型电子期刊),2014,7(5):9-12.
[20]沈海广,唐远平,黄东平,等.化痰清热方联合盐酸氨溴索对小儿肺炎CRP、IL-18水平及免疫功能的影响[J].中国临床研究,2016,29(11):1534-1536.