经方小柴胡汤与竹叶石膏汤联合加减治疗感冒后顽固性发热的效果对比

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　　 【摘要】 目的：研究竹叶石膏汤与經方小柴胡汤联合加减治疗感冒后顽固性发热的临床效果。方法：选择2017年1月-2019年1月在笔者所在医院住院的80例感冒后顽固性发热患者作为研究对象。按随机对照方式将其分成对照组与试验组，每组40例。对照组应用常规方法治疗，试验组给予经方小柴胡汤与竹叶石膏汤联合加减治疗，对比两组疗效、不良反应发生率及治疗前后生活质量。结果：试验组治疗总有效率为97.50%，高于对照组的82.50%，差异有统计学意义（P<0.05）;试验组不良反应发生率（2.50%）低于对照组（22.50%），差异有统计学意义（P<0.05）。治疗前两组生活质量评分比较差异无统计学意义（P>0.05），治疗后两组生活质量评分均高于治疗前，且试验组高于对照组，差异均有统计学意义（P<0.05）。结论：经方小柴胡汤与竹叶石膏汤联合加减治疗感冒后顽固性发热有着较好的效果，能够有效缓解症状，减轻患者痛苦，值得临床推广应用。
　　 【关键词】 经方小柴胡汤 竹叶石膏汤 感冒后顽固性发热 疗效
　　 [Abstract] Objective： To study the clinical effect of modified Jingfang Xiaochaihu Decoction and Zhuye Shigao Decoction in treating intractable fever after cold. Method： A total of 80 patients with intractable fever after cold in our hospital from January 2017 to January 2019 were selected. They were divided into the control group and the experimental group by randomized control method， 40 cases in each group. The control group was treated by conventional methods， and the experimental group was given modified Jingfang Xiaochaihu Decoction and Zhuye Shigao Decoction， and the curative effect and adverse reaction rate were compared between the two groups. Result： The total effective rate of treatment in the experimental group was 97.50%， which was higher than 82.50% in the control group， the difference was statistically significant （P<0.05）. The incidence of adverse reactions in the experimental group （2.50%） was lower than that in the control group （22.50%）， the difference was statistically significant （P<0.05）. There was no significant difference in quality of life scores between the two groups before treatment （P>0.05）. The quality of life scores of the two groups after treatment were higher than those before treatment， and the experimental group was higher than the control group， the differences were statistically significant （P<0.05）. Conclusion： The combination of modified Jingfang Xiaochaihu Decoction and Zhuye Shigao Decoction has a good effect on treating intractable fever after cold， which can effectively relieve symptoms and alleviate the suffering of patients， and is worthy of clinical application.
　　 顽固性发热主要是指通过多种方式治疗发热，但7 d以上的时间其出现反复发热或发热不退的一种疾病[1]。经过临床各种检查顽固性发热病因不能确定，治疗措施多应用药物治疗，例如抗生素、退烧药物等，效果不理想[2]。经过实践表明经方退热有着独特的优势，经方泛指唐宋医家的传世名方及《伤寒杂病论》中的方剂，并且经方联合应用疗效显著，研究发现竹叶石膏汤联合经方小柴胡汤进行加减治疗感冒后顽固性发热的效果比较显著[3]，本文作者重点研究内容如下。
　　1 资料与方法
　　1.1 一般资料
　　 收集2017年1月-2019年1月在笔者所在医院治疗的80例感冒后顽固性发热患者作为研究对象。纳入标准：（1）均符合周仲瑛《中医内科学》外感发热诊断标准，起病急病程长，外邪入侵所致;（2）发热初期多伴有恶寒，发热体温大多数高达37.5 ℃～40.0 ℃;（3）经常规药物治疗后仍发热难以控制，且多于7 d仍发热不退，少数患者呈现退而复热的状况;（4）初期均有流涕、鼻塞、咳嗽等表证。排除标准：（1）有严重心、脑功能异常;（2）对经方过敏;（3）外伤及内分泌疾病。按随机对照的方式分为对照组和试验组，每组40例。对照组男19例，女21例，年龄36～75岁，平均（45.1±5.8）岁;试验组男24例，女16例，年龄38～77岁，平均（48.9±4.2）岁。两组一般资料比较差异无统计学意义（P>0.05），可进行组间比较。患者自愿参与本次研究，并签订同意书。
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