目的 观察清咳平喘颗粒治疗社区获得性肺炎(community acquired pneumonia,CAP)痰热壅肺证患者的临床疗效及安全性。方法 将2020年11月-2021年12月北京中医医院顺义医院院收治的96例痰热壅肺证CAP患者按照随机数字表法分为对照组与观察组,每组各48例,对照组采用西医常规治疗,观察组在对照组的基础上口服清咳平喘颗粒(10 g/次,3次/d),疗程10 d。比较两组患者咳嗽、咯痰、发热、肺部湿罗音等症状消失时间以及影像学结果,评价临床疗效;比较两组患者治疗前后实验室指标,并观察两组患者治疗期间不良反应的发生情况。结果 治疗后,观察组的痊愈率和总有效率明显高于对照组(P<0.05);观察组患者治疗期间咳嗽、咯痰、发热以及肺部湿罗音等主要症状消失时间显著短于对照组(P<0.05、0.01);治疗后,两组患者的白细胞计数(white blood cell count,WBC)、中性粒细胞百分比(neutrophil percentage,Neu%)以及C-反应蛋白(C-reactive protein,CRP)水平均显著下降(P<0.01),且观察组较对照组下降更明显(P<0.05、0.01);治疗后,两组动脉二氧化碳分压明显下降(P<0.01),动脉血氧分压、血氧饱和度明显上升(P<0.01),与对照组比较,观察组动脉二氧化碳分压、动脉血氧分压和血氧饱和度改善更明显(P<0.01);两组患者治疗期间均未发生明显不良反应。结论 清咳平喘颗粒治疗CAP痰热壅肺证患者的临床疗效显著,能减轻患者肺部炎症,改善患者咳嗽、咯痰、发热等症状,且无明显不良反应,值得临床推广。

Objective To explore the clinical effect and safety of Qingke Pingchuan Granule (清咳平喘颗粒) in the treatment of community acquired pneumonia (CAP) with phlegm heat obstructing lung syndrome.Methods A total of 96 patients with CAP with phlegm heat obstructing lung syndrome admitted to Shunyi Hospital of Beijing Hospital of Traditional Chinese Medicine from November 2020 to December 2021 were divided into control group and observation group according to the random number table method,48 cases in each group.The control group was given conventional western medicine treatment only,while the observation group was treated with Qingke Pingchuan Granule (10 g/time,3 times/d) orally on the basis of the control group.Both groups were treated for 10 d.The clinical efficacy and the disappearance time of cough,expectoration,fever,wet rills and other symptoms and imaging results were compared between the two groups of patients.The laboratory indicators were compared between the two groups before and after treatment,and the incidence of adverse reactions during treatment was observed.Results After treatment,the cure rate and the total effective rate of the observation group were significantly higher than that of the control group (P <0.05);The disappearance time of cough,expectoration,fever and wet rales of lungs in observation group were shorter than those in control group,the difference was statistically significant (P <0.05,0.01);The white blood cell count (WBC),neutrophil percentage (Neu%) and serum levels of C-reactive protein (CRP) in two groups were lowered (P <0.01),and the decrease was more obvious in the observation group than in the control group (P<0.05,0.01);the arterial partial pressure of carbon dioxide in two groups decreased significantly (P<0.01),and the arterial partial pressure of oxygen and oxygen saturation in two groups increased significantly (P<0.01).Compared with the control group,the arterial partial pressure of carbon dioxide,arterial partial pressure of oxygen and oxygen saturation improved more significantly in the observation group (P<0.01).There were no obvious adverse reactions in the two groups during treatment.Conclusion Qingke Pingchuan Granule has a significant clinical effect on CAP patients with phlegm heat obstructing lung syndrome,which can reduce lung inflammation,improve cough,phlegm,fever and other symptoms,and has no obvious adverse reactions,which has a certain clinical application value.

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