何海艳 冯淬灵

〔摘要〕 目的 觀察普济消毒饮（配方颗粒）联合抗菌素治疗急性扁桃体炎临床疗效。方法 将120例患者按随机数字表法分为中药组、西药组和联合组各40例，其中中药组失访5例，西药组失访8例，最终纳入统计的有效病例为中药组35例、西药组32例和联合组40例，中药组给予单纯加减普济消毒饮（配方颗粒）治疗，西药组给予单纯抗菌素治疗，联合组给予加减普济消毒饮（配方颗粒）联合抗菌素治疗，3组均治疗5 d，观察治疗后3组临床疗效及急性扁桃体炎症状和体征改善情况。结果 治疗后，与中药组相比，西药组显效率降低、联合组显效率升高，差异有统计学意义（P<0.05）。与西药组相比，联合组显效率、总有效率均升高，差异有统计学意义（P<0.05）。与中药组相比，西药组咽痛、扁桃体肿大、咳嗽、便秘及淋巴结肿大消失率降低，联合组咽痛、扁桃体肿大及淋巴结肿大消失率升高，差异有统计学意义（P<0.05）。与西药组相比，联合组咽痛、扁桃体肿大、扁桃体脓点、咳嗽、便秘及淋巴结肿大消失率均升高，差异有统计学意义（P<0.05）。结论 普济消毒饮（配方颗粒）联合抗菌素治疗急性扁桃体炎，可缩短疗程，优于单纯中药或抗菌素治疗。

〔关键词〕 急性扁桃体炎;普济消毒饮;抗菌素;配方颗粒

〔中图分类号〕R259;R289.3       〔文献标志码〕B       〔文章编号〕doi：10.3969/j.issn.1674-070X.2019.05.020

〔Abstract〕 Objective To observe the clinical efficacy of Puji Xiaodu Decoction （formula granule） combined with antibiotics for the treatment of acute tonsillitis. Methods A total of 120 patients were randomly divided into a Chinese medicine group， a western medicine group and a combination group according to random number table， with 40 cases in each group. Among them， 5 cases were lost in the Chinese medicine group and 8 cases were lost in the western medicine group. The effective cases that were finally included in the statistics were 35 cases of the Chinese medicine group， 32 cases of the western medicine group and 40 cases of the combination group. The Chinese medicine group was given with the treatment of modified Puji Xiaodu Decoction （formula granule）， and the western medicine group was given antibiotic treatment alone. The combination group was given modified Puji Xiaodu Decoction （formula granule） combined with antibiotics. All the 3 groups were treated for 5 days. The clinical efficacy and disappearance time of symptoms and signs of acute tonsillitis were observed in the 3 groups. Results After treatment， compared with the Chinese medicine group， the marked efficiency of the western medicine group was decreased and that of the combined group was increased （P<0.05）. Compared with the western medicine group， the obvious efficiency and total efficiency of the combination group were increased， and the difference was statistically significant （P<0.05）. Compared with the Chinese medicine group， the disappearance rates of pharyngalgia， tonsillar swelling， cough， constipation and lymphadenopathy in the western medicine group were decreased， while the disappearance rate of pharyngalgia， tonsillar swelling and lymphadenopathy in the combination group were increased， and the difference was statistically significant （P<0.05）. Compared with the western medicine group， the disappearance rates of pharyngalgia， tonsillar swelling， tonsillar abscess， cough， constipation and lymphadenopathy in the combination group were increased， and the difference was statistically significant （P<0.05）. Conclusion Puji Xiaodu Decoction （formula granule） combined with antibiotics for the treatment of acute tonsillitis can shorten the course of treatment which is better than Chinese medicine or antibiotic treatment alone.

〔Keywords〕 acute tonsillitis; Puji Xiaodu Decoction; antibiotics; formula granule

急性扁桃体炎是腭扁桃体的一种非特异性急性炎症，发病率高，易反复发作[1-2]。近年来受雾霾影响，机体气道炎症反应增加、防御能力下降，更容易发生急性扁桃体炎等呼吸系统疾病[3]。该病主要经飞沫传染，传染性强，密集人群偶见暴发性流行，若不及时有效治疗，病情进展迅速，可引起局部或全身并发症，如扁桃体周围脓肿、中耳炎、鼻窦炎、气管炎、肺炎、风湿热、关节炎、心肌炎、肾炎、脓毒血症等。该病的主要致病菌为乙型溶血性链球菌，西医首选β-内酰胺类抗菌素（青霉素类、头孢菌素类）治疗。研究发现[4]，非溶血性链球菌、金黄色葡萄球菌、肺炎链球菌、肺炎克雷伯菌、流感嗜血杆菌以及一些厌氧菌也可引起本病。……