目的 评估清咳平喘颗粒用于成人社区获得性肺炎（痰热壅肺证）治疗时的疗效和安全性。方法 选取2023年8月—2024年8月宿迁市中医院收治的80例成人社区获得性肺炎（痰热壅肺证）患者，按照随机数字表法分为对照组与治疗组，每组各40例。对照组患者接受常规西医抗感染方案治疗，治疗组在对照组治疗基础上口服清咳平喘颗粒，每次1袋，每日3次。两组患者的治疗周期均为10 d。观察患者的临床疗效，比较两组中医证候积分、简易咳嗽程度评分表（CET）、肺炎影像学吸收评分、咳嗽和咳痰评估问卷（CASA-Q）评分、咳嗽和咳痰症状消失时间、白细胞计数（WBC）、C反应蛋白（CRP）水平。结果 治疗后，治疗组与对照组的总有效率分别为97.5%、85.0%，两组之间存在显著差异（P＜0.05）。通过治疗，两组患者中医证候积分、CET评分均明显下降（P＜0.05）；治疗后，治疗组中医证候积分、CET评分均明显低于对照组，肺炎影像吸收评分明显高于对照组（P＜0.05）。治疗后，两组患者咳嗽症状评分、咳嗽影响评分、咳痰症状评分、咳痰影响评分与治疗前比较均显著升高（P＜0.05）；且治疗组的CASA-Q评分均显著高于对照组（P＜0.05）。通过治疗，治疗组咳嗽、咳痰消失时间均显著短于对照组（P＜0.05）。治疗后，两组患者WBC均明显下降（P＜0.05）但仍处于正常水平，两组无显著性差异；两组患者CRP水平均显著低于治疗前（P＜0.05），且治疗组CRP水平恢复到正常水平，显著低于对照组（P＜0.05）。结论 清咳平喘颗粒联合西医基础治疗的联合治疗方案对痰热壅肺证成人社区获得性肺炎患者具有显著的疗效，能减轻咳嗽、咳痰症状，减少对生活、工作等的影响，促进肺部炎症吸收，值得临床推广与应用。

Objective To evaluate the efficacy and safety of Qingke Pingchuan Granules in treatment of adult community acquired pneumonia patients (phlegm heat obstructing lung syndrome). Methods From August 2023 to August 2024, 80 adult patients with adult community acquired pneumonia patients (phlegm heat obstructing lung syndrome) admitted to Suqian Traditional Chinese Medicine Hospital were selected. They were divided into control group and treatment group according to random number table method, with 40 cases in each group. Patients in control group received conventional western medicine anti-infection treatment. Patients in treatment group were given Qingke Pingchuan Granules orally on basis of control group, 1 capsule each time, 3 times daily. The treatment duration for both groups was 10 d. The clinical efficacy of patients was observed, and TCM syndrome scores, the Simple Cough Severity Score (CET), the pneumonia imaging absorption score, the cough and expectoration assessment questionnaire (CASA-Q) score, the disappearance time of cough and expectoration symptoms, white blood cell count (WBC), and C-reactive protein (CRP) level were compared between two groups. Results After treatment, the total effective rates of treatment group and control group were 97.5% and 85.0%, respectively, and there was a significant difference between two groups (P < 0.05). Through the treatment, TCM syndrome scores and CET scores of patients in both groups significantly decreased (P < 0.05). After treatment, TCM syndrome scores and CET scores of treatment group were significantly lower than those of control group, and absorption score of the pneumonia images was significantly higher than that of control group (P < 0.05). After treatment, cough symptom scores, cough impact scores, expectoration symptom scores, and expectoration impact scores of patients in both groups significantly increased compared with those before treatment (P < 0.05), and the CASA-Q scores of treatment group were significantly higher than those of control group (P < 0.05). Through the treatment, the disappearance time of cough and expectoration in treatment group was significantly shorter than that in control group (P < 0.05). After treatment, WBC of patients in both groups significantly decreased (P < 0.05), but remained within the normal range, and there was no significant difference between two groups, the CRP levels of patients in both groups were significantly lower than those before treatment (P < 0.05), and the CRP level of treatment group returned to normal level, which was significantly lower than that of control group (P < 0.05). Conclusion The combined treatment regimen of Qingke Pingchuan Granules combined with basic western medicine therapy has a significant therapeutic effect in treatment of adult community acquired pneumonia patients (phlegm heat obstructing lung syndrome), and can alleviate cough and expectoration symptoms, reduce the impact on daily life and work, promote the absorption of lung inflammation, which is worthy of clinical promotion and application.

R974

宿迁市市级指导性科技计划项目（Z2024070）