中国中西医结合杂志2024，Vol.44Issue(4)：407-413,7.DOI:10.7661/j.cjim.20240224.033
瓜蒌大黄汤治疗重症肺炎随机对照研究
Gualou Dahuang Decoction in the Treatment of Severe Pneumonia:A Randomized Controlled Trial
摘要
Abstract
Objective To observe the clinical effect of early enema with Gualou Dahuang Decoction on fever degree,inflammatory factors and epair of intestinal damaged mucosa in patients with severe pneumonia(SP).Methods Totally 80 febrile patients with SP of Qi syndrome were assigned to the observation group and the control group according to random number table,40 patients in each group.All patients received conventional Western medicine treatment,patients in the observation group additionally given Gualou Dahuang Decoction enema.The course of treatment in both groups was 5 days.The changes of the fever degree,white blood cell(WBC),neutrophil ratio(NE％),C-reactive protein(CRP),procalcitonin(PCT),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),serum diamine oxidase(DAO)and motilin(MTL),Chinese medicine(CM)syndrome score were recorded before treatment and on the 3rd and 7th day of treatment.28-day mortality,duration of mechanical ventilation,ICU stay and safety indicators were compared between the two groups.Results Compared with baseline,the levels of CRP and PCT on the 3rd day of treatment and the levels of six inflammatory factors,the serum DAO level on the 7th day reduced and the serum MTL level increased in the control group(P＜0.05).On the 7th day,the scores of fever,expectoration,wheeze and the total score of CM syndrome decreased in the control group(P＜0.05).While the levels of NE％,CRP,PCT,and TNF-α on the 3rd day of treatment,the levels of six inflammatory factors on the 7th day of treatment and the serum DAO level on the 3rd and 7th day of treatment decreased and at the same time the MTL level increased in the observation group(P＜0.05).On the 7th day,the scores of fever,cough,expectoration,wheeze,abdominal distention,constipation and the total score of CM syndrome decreased in the observation group(P＜0.05).Compared with the control group,the time of fever relief,the time of first reducation to normal temperature,the time of complete fever relief,the rate of temperature rerising and the peak temperature after rerising in the observation group were lower(P＜0.05).The reduction degree of WBC,NE％,CRP,IL-6,TNF-α and the serum DAO on the 7th day reduced,and the MTL on the 3rd and 7th day of treatment increased(P＜0.05).The reduction degree of fever,wheeze,abdominal distention,constipation and the total score of CM syndrome integral on the 7th day of treatment reduced(P＜0.05).There was no significant difference in the 28-day mortality,ICU stay and mechanical ventilation time in both groups(P＞0.05).And there was no obvious abnormalities in safety indicators.No obvious adverse reactions occurred in both groups during the treatment.Conclusion Early enema with Gualou Dahuang Decoction combined with Western medicine for the treatment of severe pneumonia can relieve fever,reduce inflammatory reaction,and promote the repair and functional recovery of gastrointestinal mucosal.关键词
重症肺炎/瓜蒌大黄汤/通腑泄热/发热/中药灌肠/随机对照试验Key words
severe pneumonia/Gualou Dahuang Decoction/purgating Fu-organs to eliminate heat/fever/Chinese medicine enema/randomized controlled trial引用本文复制引用
王田田,邓扬嘉,孙小平..瓜蒌大黄汤治疗重症肺炎随机对照研究[J].中国中西医结合杂志,2024,44(4):407-413,7.基金项目
重庆市自然科学基金面上项目(No.cstc2020 jcyj-msxmX1010) （No.cstc2020 jcyj-msxmX1010）
重庆市科卫联合中医药技术创新与应用发展项目(No.2020 ZY023689) （No.2020 ZY023689）
