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肺超声监测下温肺化饮法治疗1~6岁儿童支气管肺炎寒饮停肺证临床疗效评价

Evaluation of clinical efficacy of warming the lung and dissolving the decoction under the monitoring of lung ultrasound in the treatment of children aged 1~6with bronchial pneumonia with cold drink stopping the lung
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摘要 目的:通过麻杏六安煎加味口服联合中药塌渍肩胛间区的温肺化饮法治疗1~6岁儿童支气管肺炎寒饮停肺证的疗效评价,探讨中医药温法方案治疗该病寒饮停肺证有效性,并评价采用儿童肺超声监测手段动态观察该病肺部渗出的可行性及科学性。方法:采用多中心、随机、单盲、阳性平行对照原则,通过两年时间多中心观察病例240例,随机分为三组(每组80例):温肺化饮法治疗组、温肺化饮法结合西医治疗组、西医治疗组,7天为1个疗程,结合肺超声技术比较三组临床疗效及各项症状指标改变。结果:(1)在疗效方面,与治疗前相比,三组病情严重程度均下降(P<0.001)。麻杏六安煎加味口服联合中药塌渍温肺化饮法治疗支气管肺炎寒饮停肺证具有肯定的临床疗效,联合西医治疗的疗效更明显。(2)儿童肺超声应用于肺部渗出情况评估方面,重症支气管肺炎的肺超声评分的最佳临界值为19分,敏感度为90.0%,特异度为91.1%;肺超声评分和体温间不存在相关性;肺超声评分和呼吸频率之间存在正向相关性;肺超声评分与动脉血氧饱和度之间存在负向相关性;肺超声评分和肺部体征评分之间存在正向相关性。结论:(1)麻杏六安煎加味口服联合中药塌渍肩胛间区的温肺化饮法治疗儿童支气管肺炎寒饮停肺证在咳嗽次数和咳嗽程度的治疗方面,具有明显疗效。(2)肺超声检查在连续评价疾病的转归、治疗疗效的随访评估方面具有显著的优势。 Objective: To evaluate the therapeutic effect of MaXing Lu'an Decoction combined with Warm Fei Hua Yin method of Chinese medicine in the treatment of cold drink stopping lung syndrome in children aged 1~6years,and to evaluate the feasibility and scientific nature of dynamic observation of pulmonary exusion in children with pulmonary ultrasound monitoring. Methods: After two years of multi-center observation,240cases were randomly divided into three groups (80cases in each group): Wenfeihuyin treatment group,Wenfeihuyin combined with western medicine treatment group,western medicine treatment group,7days as a course,combined with pulmonary ultrasound technology to compare the clinical efficacy and symptom indicators of the three groups. Results: (1) In terms of curative effect,compared with before treatment,the severity of illness in the three groups decreased ( P <0.001). Maxing Lu'an Decoction combined with Chinese medicine Wenfeihuyin has definite clinical curative effect on bronchopneumonia cold drink stopping lung syndrome,and the curative effect of combined western medicine is more obvious. (2) In the assessment of pulmonary exudation in children,the optimal threshold value of pulmonary ultrasound score for severe bronchopneumonia was 19points,sensitivity was 90.0%,specificity was 91.1%. There was no correlation between lung ultrasound score and body temperature. There was a positive correlation between pulmonary ultrasound score and respiratory rate. There was a negative correlation between pulmonary ultrasound score and arterial oxygen saturation. There was a positive correlation between pulmonary ultrasound score and pulmonary signs score. Conclusion: (1) Maxing Lu'an Decoction supplemented by oral medicine combined with Wenfeihuyin method of traditional Chinese medicine in the treatment of cold drink stopping lung syndrome in children with bronchopneumonia has obvious curative effect in the treatment of cough frequency and cough degree. (2) Pulmonary ultrasound has significant advantages in continuous evaluation of disease outcome and follow-up evaluation of therapeutic effect.
作者 梁河 莫莉 刘艳 向红 刘翔 宋军 曾守平 张芳芳 林绍琼 刘小凡 LIANG He;MO Li;LIU Yan(Chengdu Xindu District Hospital of Traditional Chinese Medicine,Chengdu 610000,China)
出处 《四川中医》 2025年第3期163-168,共6页 Journal of Sichuan of Traditional Chinese Medicine
基金 四川省中医药管理局科学技术研究专项(编号:2020LC0053)。
关键词 肺超声 寒饮停肺证 支气管肺炎 Pulmonary ultrasound Cold drink stopping lung syndrome Bronchopneumonia
作者简介 第一作者:梁河,硕士,副主任中医师,研究方向:中医儿科学肺脾相关性研究,E-mail:181549633@qq.com。
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