| Background:Pneumonia is a common and serious acute lower respiratory tract infection and can be divided into community-acquired pneumonia(CAP)and hospital-acquired pneumonia(HAP).Community-acquired pneumonia can be widely spread among people of different ages and is a significant threat to children and the elderly particularly with high morbidity and mortality rate and heavy disease burden.Although antibiotics has been used as an effective treatment for most pneumonia patients,overuse of antibiotics is a very common issue,which leads to increased treatment cost and certain resistance of pathogens,posing a great threat to public health.Traditional Chinese medicine has unique clinical value in China.Modern pharmacology research found that traditional Chinese medicine has the characteristics of being multi-targeted and taking effect through multiple pathways.As one of the classic formulas derived from Treatise on Exogenous Febrile Disease by Zhang Zhongjing,Maxingshigan decoction is mainly used for treating exogenous pathogenic wind and abnormal heat in the lung syndrome as a representative prescription dispelling exogenous pathogenic wind,clearing lung heat and relieving dyspnea.Nowadays,it is widely used in the treatment of respiratory diseases and has seen outstanding effect in treating pneumonia especially.Objective:Through a retrospective analysis of the clinical data of adult CAP patients with external cold and internal heat syndrome hospitalized in our hospital,this study analyzed the characteristics of the cases and study the therapeutic effect of additional Maxingshigan decoction combined with antibiotics in the treatment of CAP patients with external cold and internal heat syndrome,so as to provide suggestions for the current clinical treatment of adult CAP patients.Method:Among the adult CAP patients hospitalized in our hospital from December 1,2019 to December 31,2020,this study screened the cases according to the established inclusion and exclusion criteria,and collect the information of qualified cases,including general demographic characteristics,clinical characteristics and treatment and so on.The observation group was treated with additional Maxingshigan decoction combined with antibiotics and other conventional western medicine,while the control group was only treated with antibiotics and other conventional western medicine.Spss23.0 was used to analyze the data.Result:1.Baseline data:of the total 174 retrieved cases,118 were in observation group and 56 in control group.The proportion of the elderly patients aged 60 and above was relatively large(67.8%).Common complications were hypertension(37.9%),cerebrovascular disease(34.5%),chronic obstructive pulmonary disease(21.0%)and pleural effusion(26.4%).The difference of PSI scores between the two groups was not statistically significant(P=0.323).2.Treatment:the commonly used course of treatment of additional Maxingshigan decoction is 3 days,the commonly used dose of ephedra is 8 grams,the commonly used dose of plaster stone is 30 grams,the dosage of semen armeniacae amarum is 10 grams,and the commonly used dose of glycyrrhiza is 10 grams.The commonly used antibiotics are fluoroquinolones(63.8%)and β-lactams(79.9%).3.Clinical efficacy evaluation:the body temperatures of observation group were significantly higher than that of the control group on admission(P=0.011),and the temperatures of observation group on D3 and before discharge were significantly lower than those on admission(P<0.001).The WBC count,NEUT%and CRP of observation group and control group were not statistically significant(P>0.05).The WBC count,NEUT%and CRP of observation group were significantly lower than those on admission(P<0.001).The effective rate of the observation group was better than that of the control group,which was statistically significant(P<0.001).4.Safety evaluation:no obvious adverse events occurred in the observation group,and 1 case of diarrhea occurred in the control group.Conclusion:1.Additional Maxingshigan decoction can improve the clinical treatment efficiency in adult CAP patients with external cold and internal heat syndrome,effectively alleviate fever,lower WBC count,NEUT%and CRP.2.Among adult CAP patients with external cold and internal heat syndrome,the elderly had higher prevalence and there were many comorbidities. |
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