研究疾病:
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小儿肺炎
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研究疾病代码:
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Target disease:
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Pediatric pneumonia
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Target disease code:
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研究类型:
Study type:
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干预性研究
Interventional study
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研究设计:
Study design:
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随机平行对照
randomized controlled trial(parallel group design)
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研究所处阶段:
Study phase:
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其它
Others
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研究目的:
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评价肺俞透药疗法治疗儿童细菌性肺炎的有效性和安全性。
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Objectives of Study:
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Evaluation of the efficacy and safety of Feishu acupoint drug penetration therapy combined with antibiotics in the treatment of bacterial pneumonia in children.
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药物成份或治疗方案详述:
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试验组
在基础治疗上给予双肺俞透药疗法。操作方法:仪器为中医定向透药治疗仪,护理人员先将治疗部位处的皮肤清洁干净,待其干燥,患儿取坐位或俯卧位,将小儿肺炎电极片固定在患儿双肺俞穴接通电源,每次治疗持续25min,结束后将电极片固定于原穴位2h,每天1次,共7天。
对照组
在基础治疗上给予模拟治疗。将肺炎电极片换成空白电极片,操作方法同试验组。
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Description for medicine or protocol of treatment in detail:
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Experimental group
In the basic treatment, the therapy of both Feishu acupoint is given. Operation method: The instrument is a TCM directional transmetry therapy instrument, the nursing staff first cleans the skin at the treatment site, waits for it to dry, the child takes the sitting position or prone position, fixes the pediatric pneumonia electrode in the child's double Feishu point to connect the power, each treatment lasts for 25min, and after the end of the electrode, the electrode is fixed at the original acupuncture point for 2h, once a day, a total of 7 days.
Control group
Simulated therapy is given on the basis of basic therapy. Replace the pneumonia electrode with a blank electrode sheet, and the operation method is the same as that of the test group.
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纳入标准:
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1.西医诊断标准
① 影像学(胸部X线或胸部CT)表现符合细菌性肺炎特点:新发或进展性的肺部浸润性炎症改变。胸部X线可见点状、斑片状肺实质浸润阴影;或见两肺中内带纹理增多、模糊或出现条状阴影,甚至聚集而成网状;或见肺门阴影增深,甚至肺门周围浸润。胸部CT可见:可见斑片状、结节状密度增高阴影;或可见肺纹理增粗及斑片样密度增高阴影。
② 急性病程(≤5天);
③ 至少有三项临床表现符合下列下呼吸道感染症状或体征:
·新发或咳嗽加重;
·有脓性痰液或痰液性质发生改变;
·腋温≥38.5℃;
·呼吸困难或呼吸急促或低氧血症(室内空气中SPO2 饱和度≤92%(海平面)或≤90%(高原));
·与肺炎听诊相一致的肺部听诊(早期可闻及呼吸音变粗或减低、后期可闻及干湿性啰音或管状呼吸音);
·白细胞计数>10×109/L,中性粒细胞百分比>50%;
·C反应蛋白>10mg/L;
·PCT>0.5μg/L。
2.中医诊断标准
符合中医肺炎喘嗽?风热郁肺证的中医辨证标准:中华中医药学会《中医儿科常见病诊疗指南》[1](2012)
风热郁肺:
主症:发热;咳嗽;气喘鼻煽;咳黄痰或闻喉间痰嘶。
次症:鼻塞流清涕或黄涕;咽红;头痛;面色红赤;口渴;便秘;小便黄少。
舌脉指纹:舌质红;苔薄黄;脉浮数,指纹浮紫。
具备主症至少2项+次症至少2项,参考舌脉指纹,即可诊断。
病例纳入标准
①符合上述西医诊断标准和中医辨证标准;
②1<年龄≤5岁,性别不限;
③可入院接受常规治疗;
④患儿的法定监护人知情并同意接受治疗。
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Inclusion criteria
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1. Diagnostic standards of Western medicine
(1) Imaging (chest X-ray or chest CT) is consistent with the characteristics of bacterial pneumonia: new or progressive invasive inflammatory changes in the lungs. Thoracic x-ray may show punctate, speckled infiltration of lung parenchyma; Or see the texture of the inner band in both lungs increases, blurs or appears striped shadows, or even gathers into a network; Or see darker hilar shadow, or even infiltrates around the hilar. CT of the chest is visible: speckle-like, nodular density increased shadows can be seen; Or thickened lung texture and speckly density-increasing shadows may be seen.
(2) Acute course (≤ 5 days);
(3) At least three clinical manifestations are consistent with the following signs or symptoms of lower respiratory tract infection:
New onset or worsening cough;
Purulent sputum or a change in the nature of sputum;
Axillary temperature ≥ 38.5 °C;
Dyspnea or shortness of breath or hypoxemia (SPO2 saturation in indoor air≤ 92% (sea level) or 90% ≤ (plateau));
Auscultation of the lungs consistent with auscultation of pneumonia (coarser or decreased breath sounds may be heard in the early stages, and dry and wet rales or tubular breath sounds may be heard in the later stages);
White blood cell count > 10×109/L, percentage of neutrophils > 50%;
· C-reactive protein > 10 mg/L;
· PCT>0.5μg/L
2. Diagnostic criteria of traditional Chinese medicine
Consistent with TCM pneumonia wheezing? TCM Dialectic Standards for Wind Fever Depression Lung Evidence: Guidelines for the Diagnosis and Treatment of Common Pediatric Diseases in Traditional Chinese Medicine[1] of the Chinese Association of Traditional Chinese Medicine [2012)
Wind fever depressed lungs:
Main symptoms: fever; cough; Wheezing and inciting the nose; Cough up yellow sputum or smell sputum in the throat.
Secondary symptoms: nasal congestion and runny nose or yellow nose; Pharyngeal redness; Headache; Reddish complexion; Thirst; Constipation; Less yellow urine.
Tongue vein fingerprint: tongue red; Moss thin yellow; Pulse float, fingerprint float purple.
With at least 2 main symptoms + at least 2 secondary symptoms, with reference to the tongue pulse fingerprint, you can diagnose.
Criteria for case inclusion
(1) Meet the above-mentioned diagnostic standards of Western medicine and the dialectical standards of traditional Chinese medicine;
(2) 1< age ≤5 years old, gender is not limited;
(3) Can be admitted to the hospital for routine treatment;
(4) The child's legal guardian is informed and consents to receive treatment.
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排除标准:
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①确认或怀疑肺炎由非社区获得性细菌病原体导致者;
②肺部浸润的非传染性原因,如肺栓塞、吸入引起的化学性肺炎等;
③胸膜脓胸(不包括非化脓性肺炎性胸腔积液);
④包括但不限于肺炎合并支气 管哮喘、支气管异物者,肺炎合并麻疹、百日咳、流 行性感冒者,肺炎合并肺部其他严重原发性疾病者;
⑤既往对β-内酰胺类抗生素成分过敏者;
⑥入组前72h内使用抗生素者;
⑦既往有癫痫或惊厥病史,除外有明确记录的儿童热性惊厥者;
⑧感染可能需要同时使用全身性皮质类固醇者;
⑨有立即危及生命的疾病证据,包括但不限于当前或即将发生的呼吸衰竭、 急性心力衰竭、休克、急性肝功能衰竭、活动性胃肠道出血者;
⑩合并心、肝、肾、消化及造血系统等原发病者;
?肺炎合并腹泻者;
?过敏体质,对中药穴位贴敷过敏者;
?研究人员认为会损害患儿安全或数据质量的任何情况;
?无法或不愿遵守研究指定的程序和限制者。
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Exclusion criteria:
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(1) Confirming or suspecting that pneumonia is caused by a non-community-acquired bacterial pathogen;
(2) Non-infectious causes of pulmonary infiltration, such as pulmonary embolism, chemical pneumonia caused by inhalation, etc.;
(3) Pleural empyema (excluding non-purulent pneumonic pleural effusions);
(4) including but not limited to pneumonia complicated with bronchial asthma, bronchial foreign bodies, pneumonia complicated with measles, whooping cough, circulating colds, pneumonia with other serious primary diseases of the lungs;
(5) Those who are previously allergic to β-lactam antibiotic components;
(6) Those who use antibiotics within 72 hours before enrollment;
(7) Previous history of epilepsy or convulsions, except for children with clear records of febrile seizures;
(8) Infection may require simultaneous use of systemic corticosteroids;
(9) There is evidence of an immediate life-threatening disease, including but not limited to current or imminent respiratory failure, acute heart failure, shock, acute liver failure, active gastrointestinal bleeding;
(10) Those with primary diseases such as heart, liver, kidney, digestive and hematopoietic systems;
(11) Pneumonia complicated with diarrhea;
(12) Allergic constitution, allergic to the acupuncture point patch of traditional Chinese medicine;
(13) any situation that the researcher believes would compromise the child's safety or data quality;
(14) Those who are unable or unwilling to comply with the procedures and restrictions specified in the study.
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研究实施时间:
Study execute time:
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从From
2022-09-20
至To
2023-03-01
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征募观察对象时间:
Recruiting time:
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从From
2022-09-20
至To
2023-03-01
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