辨证分型联合西药治疗支气管扩张症随机平行对照研究

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[目的]观察辨证分型联合西药治疗支气管扩张症疗效。[方法]使用随机平行对照方法,将52例住院患者按病志号抽签简单随机分为两组。对照组27例1加强体位引流;头孢哌酮,2.0g/次,2次/d,口服;左氧氟沙星0.6g,1次/d,静滴;根据痰培养药敏调整用药;2沐舒坦,60mg/次,3次/d,口服;加强雾化治疗;少量咯血加安络血,0.4g/次,1次/d,口服;云南白药,4.0g/次,1次/d,口服;中到大量咯血卧床休息,垂体后叶素,用生理盐水稀释至0.1单位/mL后静滴,1次/d。治疗组27例辨证治疗:1风热犯肺,化热润肺方(败酱草、鲜芦根各30g,金银花20g,黄芩、前胡各12g,连翘、枇杷叶、陈皮、茯苓、半夏制、天竺黄、苏叶、白芷、荆芥、防风各10g,薄荷6g,甘草3g);2痰热壅肺,化痰开肺方(鲜芦根、生米仁各60g,鱼腥草、败酱草各30g,火麻仁、郁李仁各15g,冬瓜仁、黄芩、天竺黄、陈皮、茯苓、半夏、扁豆炒、白术炒、枳壳各10g,甘草5g);3气阴两虚,益气养阴方(鱼腥草30g,北沙参、蛤壳各15g,麦冬、黄精制、陈皮、茯苓、乌元参、黄芪各10g,桔梗、木蝴蝶各6g,甘草5g);以上方药均1剂/d,水煎200mL,早晚口服;西药治疗同对照组。连续治疗7d为1疗程。观测临床症状、咳嗽、咳痰、肺啰音、血常规、病灶影像、不良反应。连续治疗2疗程,判定疗效。[结果]治疗组显效18例,有效8例,无效1例,总有效率96.30%。对照组显效11例,有效9例,无效5例,总有效率80.00%。治疗组疗效优于对照组(P<0.05)。[结论]辨证分型联合西药治疗支气管扩张症效果显著,值得推广。 [Objective] To observe the curative effect of syndrome differentiation and western medicine on bronchiectasis. [Methods] Using randomized parallel control method, 52 inpatients were randomly divided into two groups randomly according to the patient’s lot number. Control group, 27 cases of 1 to enhance body position drainage; cefoperazone, 2.0g / times, 2 times / d, oral; levofloxacin 0.6g, 1 times / d, intravenous infusion; / Times, 3 times / d, oral; to strengthen the treatment of atomization; a small amount of hemoptysis plus Anlu blood, 0.4g / times, 1 time / d, oral; Yunnanbaiyao, 4.0g / time, To a large number of hemoptysis bed rest, pituitary hormone, diluted with saline to 0.1 units / mL intravenous infusion, 1 / d. The treatment group of 27 cases of syndrome differentiation treatment: 1 wind heat lung, heat Runfei Fang (Patrinia grass, fresh reed rhizome each 30g, honeysuckle 20g, skullcap, Qianhu 12g, forsythia, loquat leaf, dried tangerine peel, Poria, half Summer herb, Tianzhu Huang, Su Ye, Angelica, Nepeta, the wind 10g, peppermint 6g, licorice 3g); 2 phlegm lungs, phlegm and lung side (fresh reed rhizome, raw rice kernels 60g, , Patrinia the 30g, hemp seed, Yu Li Ren the 15g, melon kernel, skullcap, Tianzhu Huang, dried tangerine peel, Poria, Pinellia, lentil fried, Atractylodes fried, Citrus aurantium 10g, licorice 5g) , Yiqi Yangyin Recipe (Houttuynia 30g, Panax ginseng, clamshell 15g, Ophiopogon, Wong refined, dried tangerine peel, Poria, Radix, Astragalus 10g, Campanulaceae, wood butterfly each 6g, licorice 5g); The above prescriptions were 1 / d, decoction 200mL, morning and evening oral; Western medicine treatment with the control group. Continuous treatment 7d for a course of treatment. Observation of clinical symptoms, cough, sputum, pulmonary rales, blood, lesions, images, adverse reactions. Continuous treatment of 2 courses to determine the efficacy. [Result] In the treatment group, 18 cases were markedly effective, 8 cases effective, 1 case ineffective, and the total effective rate was 96.30%. In the control group, 11 cases were markedly effective, 9 cases effective, 5 cases ineffective, and the total effective rate was 80.00%. The treatment group was better than the control group (P <0.05). [Conclusion] The syndrome differentiation syndrome combined with Western medicine has significant effect in treating bronchiectasis and is worth popularizing.
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