张英博 李楠 王曼莉 王成 梁京 马翠翠

〔摘要〕 目的 觀察宣肺止咳方联合中药穴位贴敷治疗小儿病毒性肺炎的临床疗效。方法 将120例病毒性肺炎患儿按照随机数字表法分为对照组和观察组，每组60例。对照组予西医常规治疗，观察组在对照组基础上予宣肺止咳方联合中药穴位贴敷治疗。2组均治疗7 d后统计疗效，比较2组治疗前后患儿症状和体征（发热、咳嗽、喘憋、肺部啰音）消失时间及住院时间、比较2组治疗前后中医证候（症状、体征、舌象、脉象）、血清因子（IL-6、CRP、PCT）及肺功能（PEF、FVC、FEV1、FEV1/FEC）情况。结果 观察组总有效率95.0%（57/60），对照组总有效率73.3%（44/60），观察组疗效优于对照组（P<0.05）。2组治疗后观察组患儿症状体征（发热、咳嗽、肺部啰音、胸部正位X线）恢复正常及住院时间与对照组比较明显降低（P<0.05）。2组治疗后症状、体征、舌象、脉象评分与本组治疗前比较均明显降低（P<0.05），且观察组治疗后各项评分均低于对照组（P<0.05）。2组治疗后血清因子（IL-6、CRP、PCT）与本组治疗前比较均显著降低（P<0.05），观察组治疗后血清因子（IL-6、CRP、PCT）各项指标水平均低于对照组（P<0.05）。2组治疗后肺功能指标PEF、FVC、FEV1、FEV1/FEC与本组治疗前比较均明显升高（P<0.05），且观察组治疗后PEF、FVC、FEV1、FEV1/FEC均高于对照组（P<0.05）。结论 宣肺止咳方联合中药穴位贴敷治疗小儿病毒性肺炎较西医常规治疗疗效确切，可明显改善患儿症状、体征，缩短住院时间，下调炎症反应，改善肺功能，提高临床疗效。

〔关键词〕 小儿病毒性肺炎;痰热闭肺证;宣肺止咳方;穴位贴敷;临床疗效

〔中图分类号〕R254       〔文献标志码〕B       〔文章编号〕doi：10.3969/j.issn.1674-070X.2021.05.020

Clinical Effect of Xuanfei Zhike Decoction Combined with Acupoint Application of

Traditional Chinese Medicine on Children with Viral Pneumonia

ZHANG Yingbo， LI Nan， WANG Manli， WANG Cheng， LIANG Jing， MA Cuicui

（Maternal and Child Health Care Hospital of Shijiazhuang City， Shijiazhuang， Hebei 050000， China）

〔Abstract〕 Objective To observe the clinical efficacy of Xuanfei Zhike Decoction combined with acupoint application of traditional Chinese medicine （TCM） in the treatment of children with viral pneumonia. Methods 120 children with viral pneumonia were randomly divided into the control group and observation group， with 60 cases in each group. The control group was given routine western medicine treatment， while the observation group were given Xuanfei Zhike Decoction combined with acupoint application of TCM. After 7 days of treatment， the curative effect was statistically analyzed. The disappearance time of symptoms and signs （fever， cough， wheezing and lung rales） and hospitalization time before and after treatment in the two groups were compared. The TCM syndrome scores （symptoms， signs， tongue signs， pulse signs）， serum factors （IL-6， CRP， PCT） and lung function indexes （PEF， FVC， FEV1， FEV1/FEC） were compared between the two groups before and after treatment. Results The total effective rate of the observation group was 95.0% （57/60）， and that of the control group was 73.3% （44/60）. The curative effect of the observation group was better than that of the control group （P<0.05）. After treatment， the symptoms and signs （fever， cough， lung rales， chest X-ray） of the observation group returned to normal and the length of hospital stay was significantly reduced compared with the control group （P<0.05）. After treatment， the scores of symptoms， signs， tongue and pulse of the two groups were significantly lower than those before treatment （P<0.05）， and the scores of the observation group after treatment were lower than those of the control group （P<0.05）. Serum cytokines （IL-6， CRP， PCT） in 2 groups were significantly decreased after treatment compared with before treatment in this group （P<0.05）. The levels of serum cytokines （IL-6， CRP， PCT） in observation group were lower than those in control group after treatment （P<0.05）. After treatment， lung function indexes PEF， FVC， FEV1， FEV1/FEC of the two groups were significantly higher than those before treatment （P<0.05）， and PEF， FVC， FEV1， FEV1/FEC in the observation group were higher than those in the control group （P<0.05）. Conclusion Xuanfei Zhike Decoction combined with acupoint application of TCM has definite curative effect on children with viral pneumonia， which can significantly improve the symptoms and signs of children， shorten the hospitalization time， reduce the inflammatory reaction， improve the lung function and improve the clinical efficacy.

〔Keywords〕 infantile viral pneumonia; phlegm heat closed lung syndrome; Xuanfei Zhike Decoction; acupoint application; clinical efficacy

小儿肺炎已发展成为小儿最常见的下呼吸道感染性疾病之一，并以呼吸道合胞病毒、腺病毒、流感病毒等病毒感染致病较多见，冬春季节多发，发病年龄以学龄前期婴幼儿为主，主要表现为高热、咳嗽、咳痰、呼吸困难、肺部细湿啰音等症状体征，咽拭子病毒检测阳性，胸部X线片考虑肺部感染[1]。目前，小儿病毒性肺炎发病率正呈上升趋势，西医治疗因多采用干扰素、更昔洛韦、利巴韦林等抗病毒及抗生素、激素等对症和支持疗法为主，西药抗病毒药物不良反应大，抗生素易耐药，缺乏理想的治疗药物[2]。小儿病毒性肺炎发病急骤，病情变化多端，严重者可能会并发心、脑等多系统疾病，正严重威胁儿童的生长发育及生命安全[3-4]。……