| Objective: Pneumonia with dyspneic cough is one of the most common diseases in pediatric respiratory system.Its main clinical symptoms include cough,stagnation of phlegm,fever,dyspnea and flaring of nares,and the severe patients may suffer from air-logged tears and mucus,cyanosis or pallor [1].This disease is equivalent to "infantile pneumonia" in western medicine,its incidence rate is extremely high among children,especially infants and young children.Due to the toxic effect of pulmonary ventilation disorder and pathogenic microorganism,the severe patients may experience the lifethreatening complications such as heart failure,respiratory failure and toxic encephalopathy,its incidence rate and case fatality rate rank the first among all the pediatric diseases,and therefore,it is listed as one of key preventing and treating pediatric diseases by National Health and Family Planning Commission of PRC [2].The method of antibiotics combination therapy is used for infantile pneumonia with dyspneic cough in modern medicine.Although antisepsis and anti-inflammation is somewhat effective to relieve the symptoms and improve the patient's physical signs,because children's internal organs are very fragile,antibiotics can do great harm to children's internal organs such as liver and kidney as well as the micro-ecosystem of gastrointestinal tract,which may lead to impaired hepatic and renal function and antibiotics-related diarrhea and have a strong impact on children's health.Professor Wang Ru and Professor Bo Liya have devoted themselves to the research about pediatric infectious diseases for many years with joint efforts and finally summarized the empirical methodology to treat infantile pneumonia with dyspneic cough,and this research topic is based on their cipher prescription,using Tongfu Xuanfei decoction to treat infantile pneumonia with dyspneic cough.The purpose of this research is to make a compassion on the clinical effects between Tongfu Xuanfei decoction therapy combined with the conventional western medicine(observation group)and only the conventional western medicine(control group)for the treatment of infantile pneumonia with dyspneic cough,in order to provide the theoretical foundation and the clinical evidence for selecting a more reasonable therapeutic schedule.Methods: The subjects of this research are chosen from the children patients with infantile pneumonia with dyspneic cough who were hospitalized in the department of pediatrics of the Third Affiliated Hospital to Hebei Medical University during the period from May 2014 to October 2015.The criterion for entering the group is subject to the diagnostic criteria for infantile pneumonia with dyspneic cough in Guidelines for Diagnosis and Treatment of Common Pediatric Diseases in Chinese Medicine set out by China Association Of Traditional Chinese Medicine[3],according with the syndrome of heat-toxicity blocking lung.In the meanwhile,the children patients also suffering from other diseases such as congenital heart disease and rickets are excluded.60 children patients are included in this researched in total,all the subjects should be approved by the Ethics Committee in the hospital,and an informed consent form should be signed by each patient's parents(the informed consent forms are available in the Third Affiliated Hospital to Hebei Medical University).The children patients are divided into two groups randomly with the random number table,including the observation group for Tongfu Xuanfei decoction therapy(Tongfu Xuanfei decoction therapy combined with the conventional western medicine)and the control group(only treated with the conventional western medicine),there are 30 patients in each group.All the differences in terms of gender,age,weigh,disease onset time,cardinal symptoms and secondary symptoms between the two groups are not statistically significant(P>0.05).The patients in the observation group are treated with the conventional western medicine and meanwhile take the Tongfu Xuanfei decoction(a kind of water decoction made from honey-fried herba ephedrae,gypsum,bulb of thunberg fritillary,honey-fried rhubarb,lumbricus,radix stemonae,almond,fructus forsythiae,herba houttuyniae,peucedanum praeruptorum,flos farfarae,periostracum cicada,folium eriobotryae and radix platycodi and so on).The appropriate dose depends on the patient's weight(10ml/Kg).The patients in the control group are treated with the conventional western medicine only: different antibiotics are used for the treatment according to different pathogens: for example,for bacterial pneumonia,piperacillin-tazobactam(or ampicillin,or amoxicillin and clavulanate potassium)is dissolved in 0.9% sodium chloride injection for intravenous drip;for mycoplasma pneumonia,azithromycin injection 10mg/kg.d is applied,every 1mg azithromycin injection is added into 1ml 5%dextrose injection for intravenous drip;for viral pneumonia,ribavirin injection 10mg/kg.d is used,every 1mg ribavirin injection is added into 1ml 10%dextrose injection for intravenous drip;and etc.Symptomatic treatment: such as abatement of fever,relieving cough and reducing sputum,aerosol inhalation,etc.By the end of the course of treatment,the patients in these two groups are analyzed and compared in terms of symptoms,physical signs,PCT(procalcitonin),CRP(C-reactive protein),the improvement in chest radiography,the degree and time of improvement in some primary and secondary symptoms before and after the treatment.Results: The criterion of curative effect is subject to the related standard mentioned in the chapter of pneumonia with dyspneic cough in Clinical Research on Pediatrics of Chinese Medicine chiefly edited by Wang Shouchuan and Yu Jingmao [4].The total effective rate in the observation group(96.67%)is higher than that in the control group(86.67%),The results showed that the curative effect of the observation group was significantly higher than that of the control group,the difference is statistically significant(P<0.05).The disappearance of the symptoms such as fever,cough and lung rale in the patients of the observation group is earlier than that in the control group,the difference is statistically significant(P<0.05).There is no significant difference in terms of various cardinal symptoms and secondary symptoms before and after the treatment when the two groups are compared with each other,with no statistical significance(P>0.05).After the treatment,the improvement in terms of the cardinal symptoms(including fever,cough,asthma,stagnation of phlegm,lung auscultation and X-ray chest film),the secondary symptoms(tongue image and defecate)as well as the inflammatory factors PCT and CRP in the observation group is better than that in the control group,both the total score of cardinal symptoms and the total score of secondary symptoms in the observation group are lower than that in the control group,the difference is statistically significant(P<0.05).Conclusion:1 The effect of Tongfu Xuanfei decoction in observation group was significantly better than the control group.2 The Tongfu Xuanfei decoction in observation group in cooling,the promotion of pulmonary rales disappeared,and in improving constipation,tongue and significantly better than that of the control group..3 Through clinical observation,Tongfu Xuanfei decoction combined with conventional western medicine in the treatment of pediatric Penumonia toxic heat obstructing the lung syndrome with: better efficacy,the advantages of a shorter course of treatment and rapid cooling,reducing the possibility of febrile convulsion in children,also reduce the legacy cough expectoration of the characteristics. |
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