ABSTRACT
Objective:To discuss clinical effect of addition and subtraction therapy of Wuhutang combined with Qingjin Jianghuotang to community acquired pneumonia (CAP) in children with syndrome of phlegm heat closing lung, and to study the influence to inflammatory factors. Method:One hundred and forty patients were randomly divided into control group (69 cases) and observation group (71 cases) by random number table. Patients in two group of chidren got comprehensive symptomatic treatment measures of anti-infection, antipyretic, expectorant, antiasthmatic and respiratory support of inflammatory factors. The control group was treated with Lingyang Qingfei granules.1 g/time,3 time/day. Patients in observation group added addition and subtraction therapy of Wuhutang combined with Qingjin Jianghuotang, 1 dose/day. The courses of treatment in two groups were 7 days. And temperature, time of antipyretic, time of complete antipyretic and rate of complete antipyretic at the 7th day after treatment were recorded. And release time and disappearance time of cough, expectoration, disappearance time of pulmonary rales and treatment failure were also recorded. And before and after treatment, scores of syndrome of phlegm heat closing lung were graded, and levels of serum high sensitive C-reactive protein (hs-CRP), procalcitonin (PCT), tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) were detected. Result:Analyzed by rank sum test, effect in observation group was better than that in control group (Z=2.106, P<0.05), and curative effect of traditional Chinese medicine (TCM) syndrome was also better than that in control group (Z=2.119, P<0.05). Time of antipyretic, time of complete antipyretic, release time and disappearance time of cough and expectoration and disappearance time of pulmonary rales were all shorter than those in control group (P<0.01). Rate of complete antipyretic at the 7th day after treatment in observation group was 96.92%（63/65） higher than 82.81%（53/64） in control group (χ2=7.085, P<0.05). Failure rate of treatment was 9.23%（6/65） lower than 23.44%（15/64） in control group (χ2=4.775, P<0.05). And major symptom, physical sign score, minor symptom score, the total score of syndrome of phlegm heat closing lung and levels of hs-CRP, PCT, TNF-α and IL-6 were all lower than those in control group (P<0.01). Conclusion:On the basis of comprehensive anti-infection treatment, addition and subtraction therapy of Wuhutang combined with Qingjin Jianghuotang can control the clinical symptoms, and the advantages of rapid onset, rapid symptom regression, short course of disease can be found, and it can also reduce the inflammatory reaction, control the progress of the disease. The complete antipyretic rate, disease efficacy and TCM syndrome efficacy are better.
ABSTRACT
Objective:This paper analyzed the prescriptions of traditional Chinese medicine（TCM） for all patients diagnosed with novel coronavirus pneumonia（corona virus disease-2019，COVID-19）in Wuhan third hospital，analyzed the medication rules of the prescription，summarized the characteristics and thoughts of medication，and discussed the contents of TCM pharmaceutical care. Method:Use the data analysis software Excel 2007 and SQL server 2017 to perform statistical analysis for all inpatients in Wuhan Third Hospital from January 25，2020 to March 18，2020 who were treated by the prescriptions of TCM. The usage quantity，frequency，average dosage and dosage range of TCM were counted and compared with the dosage stipulated in the 2015 edition of Chinese Pharmacopoeia. Result:In this study，a total of 875 patients were included in the treatment prescription，involving 233 TCMs，and 20 high-frequency herbs were obtained，which were mainly used to dissolve phlegm，relieve cough and asthma，and tonify body. In the analysis of the characteristics of TCM，it is mainly composed of plain drugs，followed by cold drugs and warm drugs. The main taste of medicine is bitter，followed by spicy and sweet. The main meridians were the lung meridians，followed by the spleen and stomach meridians. By using association rule analysis and complex network analysis，it was found that the correlation degree of Artemisiae Scopariae Herba，Amomi Fructus Rotundus，Akebiae Caulis，Talcum and Fritillariae Cirrhosae Bulbus was very high，which could treat symptoms such as fever，cough，sputum，thirst，chest tightness and abdominal distension after COVID-19 infection. Conclusion:In this study，it was found that the core prescription for the treatment of COVID-19 in Wuhan Third Hospital was the addition and reduction of clearing damp agent，modified Ganlu Xiaodudan，and the reduction of expectorant modified Qingjin Jianghuotang，all the drugs were excess used than pharmacopoeia prescribed dosage. As a clinical Chinese pharmacist，we should distinguish the syndrome types according to the symptoms of the patients，and medication monitoring should be conducted from the aspects of usage and dosage of specific medication，processing product selection，compatibility，patient education，etc.