摘要
目的:观察麻杏石甘汤联合千金苇茎汤治疗肺炎热邪壅肺证的临床疗效和安全性。方法:2016年3月-2017年6月,采用麻杏石甘汤联合千金苇茎汤治疗肺炎热邪壅肺证患者36例。男20例,女16例;年龄62～84岁,平均67.3岁。麻杏石甘汤合千金苇茎汤药物组成包括麻黄9 g,杏仁12 g,生石膏30 g(先煎),桃仁12 g,冬瓜仁20 g,苇茎15 g,黄芩15 g,鱼腥草30 g,知母15 g,川贝9 g,瓜蒌15 g,甘草6 g。胸闷胸痛较甚者,加郁金12 g,延胡索12 g;邪热郁久,成毒化脓而咳腥臭脓痰者,加薏苡仁20 g,金银花15 g,连翘12 g;咯血痰者,加焦山栀子12 g,赤芍15 g,仙鹤草20 g;潮热便秘、痰涎壅盛、喘促不宁者,加大黄8 g(后下),枳实10 g;下利色黄热臭、肛门灼热、腹不硬满而痛者,去冬瓜仁、生石膏、瓜蒌、知母、麻黄,加黄连12 g,黄柏15 g,葛根30 g,车前草20 g。水煎服,每日2剂,共服7～10 d。同时,加强营养支持和痰液引流。观察患者退热、止咳情况,采用《中药新药临床研究指导原则》中医证候疗效判定标准评定疗效,同时记录治疗期间的不良反应发生情况。结果:依据《中药新药临床研究指导原则》中医证候疗效判定标准评定疗效,痊愈29例,显效7例。治疗期间2例患者出现恶心、呕吐等胃肠道症状,均能耐受,未停药。34例患者肝肾功能检查均无异常;1例患者血谷丙转氨酶浓度轻度增高,1例患者血肌酐浓度轻度增高,均无临床意义,未作特殊处理。36例患者均获随访,随访时间1～2个月,均未复发,均无严重不良反应发生。结论:采用麻杏石甘汤联合千金苇茎汤治疗肺炎热邪壅肺证,疗效好,安全性高,值得临床推广应用。
Objective: To explore the clinical efficacy and safety of Maxing Shigan Decoction (麻杏石甘汤) and Qianjin Weijin Decoction (千金苇茎汤) in the treatment of pneumonia heat and evil obstructing lung syndrome. Methods: From March 2016 to June 2017, 36 cases of patients with heat and evil lung syndrome of pneumonia were treated with Maxing Shigan Decoction (麻杏石甘汤) and Qianjin Weijin Decoction (千金苇茎汤). There were 20 males and 16 females. Aged 62 to 84, with an average age of 67.3. The composition of Maxing Shigan Decoction (麻杏石甘汤) and Qianjin Weijin Decoction (千金苇茎汤) was as following: Ephedra 9 g, almond 12 g, raw gypsum 30 g (first Fried), peach kernel 12 g, winter melon seed 20 g, reed stem 15 g, Scutellaria baicalensis georgi 15 g, houttuynia 30 g, anemarrhena 15 g, Fritillary bulb 9 g, guava 15 g, liquorice 6 g. The prescription was modified according to different syndrome. Taking 2 doses per day for 7 to 10 days. At the same time, nutrition support and sputum drainage were strengthened. Observe the patient’s febrile and cough cough, evaluate the curative effect by the clinical research guideline of traditional Chinese medicine new drug, and record the occurrence of adverse reactions during the treatment. Results: According to the clinical research guideline of Chinese medicine new drug, 29 cases were cured and 7 cases were remarkably effective. During the treatment, the two patients showed gastrointestinal symptoms such as nausea and vomiting, all of which could be tolerated without stopping the drug. There were no abnormal liver and kidney function in 34 patients. There was a slight increase in the concentration of Alt in 1 patient and a slight increase in the concentration of creatinine in 1 patient. All the 36 patients were followed up for 1-2 months and there was no recurrence or serious adverse reactions. Conclusion: Maxing Shigan Decoction (麻杏石甘汤) and Qianjin Weijin Decoction (千金苇茎汤) had good curative effect and high safety in the trea
作者
赵成欣
张晓丽
Zhao Chengxin;Zhang Xiaoli
出处
《中医临床研究》
2019年第3期63-65,共3页
Clinical Journal Of Chinese Medicine
关键词
肺炎
热邪壅肺证
中药疗法
麻杏石甘汤
千金苇茎汤
Pneumonia
Syndrome of heat accumulation in lung
Chinese medicine therapy
Maxing Shigan Decoction
Qianjin Weijin Decoction
