目的：观察宣白承气汤加减对痰热壅肺型重症肺炎的临床疗效。方法将80例痰热壅肺型重症肺炎患者随机分为2组，对照组40例予重症肺炎标准治疗，治疗组40例在对照组基础上予宣白承气汤加减。治疗10 d 后比较2组治疗前后动脉血乳酸含量、临床肺部感染评分（CPIS）及急性生理与慢性健康评分（APACHEⅡ），记录有创机械通气时间、ICU 转出率，并统计疗效。结果治疗组总有效率77.5％，优于对照组（52.5％，P ﹤0.05）。治疗组治疗后动脉血乳酸含量、CPIS 及 APACHEⅡ评分较治疗前均明显下降（P﹤0.05），且改善情况均优于对照组（P ﹤0.05）。对照组治疗后动脉血乳酸含量较治疗前下降（P ﹤0.05）。治疗组有创机械通气时间低于对照组（P ﹤0.05），ICU 转出率高于对照组（P ﹤0.05）。结论宣白承气汤加减治疗痰热壅肺型重症肺炎疗效确切，且无不良反应。%Objective To observe the clinical effect of modified Xuanbai - chengqi decoction on the treat-ment of severe pneumonia with phlegm - heat obstructing lung type. Methods 80 severe pneumonia patients with phlegm - heat obstructing lung type were randomly divided into two groups. 40 patients in control group were treated by severe pneumonia standard treatment. 40 patients in treatment group were treated by modified Xuanbai - chengqi decoction on the basis of control group treatment. The content of arterial blood lactic acid,clinical pulmonary infec-tion score(CPIS)and acute physiology and chronic health evaluation Ⅱ(APACHEⅡ)before and 10 d after treat-ment were compared in two groups. The time of invasive mechanical ventilation and ICU transfer rate were recorded, and statistics the curative effects. Results The total effective rate in treatment group(77. 5% )was superior to that in control group(52. 5% ,P ﹤ 0. 05). The arterial blood lactic acid content,CPIS and APACHEⅡ after treatment in treatment group were significantly decreased as compared with those in before treatment(P ﹤ 0. 05),and the im-provement in treatment group was superior to that in control group(P ﹤ 0. 05). The content of arterial blood lactic acid after treatment in control group was decreased as compared with that in before treatment(P ﹤ 0. 05). The time of invasive mechanical ventilation in treatment group was lower than that in control group(P ﹤ 0. 05),and the ICU transfer rate was higher(P ﹤ 0. 05). Conclusion Modified Xuanbai - chengqi decoction has exact effect on the treatment of severe pneumonia with phlegm - heat obstructing lung type,and without adverse reaction.
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