三仁汤灌肠对支气管肺炎患儿C-反应蛋白及降钙素原的影响

刘玉萍 王静 龚信强

摘要：目的 探析中药三仁汤灌肠对支气管肺炎患儿的C-反应蛋白及降钙素原的影响。方法 将104例支气管肺炎患儿作为研究对象，按入院顺序编号，被随机分为2组，每组52例。对照组采用医药治疗;治疗组在对照组的基础上给予三仁汤灌肠。观察2组患者在治疗后第4 d临床症状的变化情况以及C反应蛋白（CRP）、降钙素原（PCT）数值的变化。结果 与治疗前相比较，2组患儿治疗后CRP、PCT数值及患儿发热持续时间均明显降低，差异有统计学意义（P<0.01），组间比较（P<0.01）;治疗组临床总有效率显著优于对照组（P<0.01）。结论 运用中药三仁汤灌肠治疗小儿支气管肺炎可有效降低C-反应蛋白及降钙素原，快速改善支气管肺炎患儿的症状，减少西药不良反应的发生，显著提升患儿的生活质量，其有效性及安全性较高，具有应用与推广意义。

关键词：三仁汤;C-反应蛋白;降钙素原;支气管肺炎;儿童

中图分类号：R563.1 文献标志码：B 文章编号：1007-2349（2021）06-0028-04

【Abstract】Objective： To study the effect of TCM Sanren Decoction enema on C-reactive protein and procalcitonin in child patients with bronchial pneumonia. Methods： 104 child patients with bronchial pneumonia were taken as the research objects and numbered according to the order of hospitalization， and randomly divided into two groups， 52 cases per group. The control group was treated with routine medicine and the treatment group was given Sanren Decoction enema on the basis of the control group. The changes of clinical symptoms and the changes of C-reactive protein （CRP） and procalcitonin （PCT） values of the two groups were observed on the 4th day after treatment. Results： Compared with that of prior treatment， the values of CRP， PCT and the duration of fever of the child patients in the two groups were significantly reduced after treatment， the difference was statistically significant （P<0.01）， and comparison between groups （P<0.01）. The clinical total effective rate of the treatment group was significantly better than that of the control group （P<0.01）. Conclusion： The TCM Sanren Decoction enema to treat child patients with bronchial pneumonia can effectively reduce C-reactive protein and procalcitonin， quickly improve their symptoms， reduce the occurrence of adverse reactions of western medicine， and significantly improve the quality of life of child patients. The effectiveness and safety of the method are high， and has significance of application and promotion.

【Key words】Sanren Decoction; C-reactive Protein; Procalcitonin; Bronchopneumonia; Child Patients

支气管肺炎是儿科最常见，也是病死率最高的疾病[1]，目前小儿支气管肺炎的治疗主要针对病原菌实施抗感染、退热、化痰等治疗方案，但因现阶段抗生素的严重耐药和退热药的不良反应等，加重了临床治疗支气管肺炎的难度，影响日常生活和经济发展。目前西医临床针对降低细菌的耐药作用和减少退热药的应用呈空白状态。中药三仁汤宣畅气机，清利湿热。“芳化、苦燥、淡渗”同用，使表里之湿热内外分解;“宣上、畅中、渗下”并行，使三焦湿热上下分消;寓理气于祛湿之中，纳清热于渗利之内[8]，配伍浙贝母、桑叶、刺蒺藜组方，起到宣肺平喘，化痰止咳、抑菌、抗耐药、减轻不良反应的作用，可显著改善肺炎患者的临床症状、体征，减少重症的发生，提高疗效[9]。本研究采用中药保留灌肠的疗法，改变给药途径，促进药物的吸收利用，增强患儿依从性，通过观察治疗后对比发热、症状缓解的时间及CRP、PCT数值变化等，旨在评价中药三仁汤灌肠治療小儿支气管肺炎的临床疗效。……