摘要
目的探讨清肺汤联合乌司他丁治疗重症肺炎患者疗效及对血清肿瘤坏死因子-α(TNF-α)和降钙素原(PCT)的影响。方法选取2016年1月—2017年12月收治的重症肺炎痰热蕴肺证患者182例,按照随机数字表法分为观察组和对照组各91例,对照组在常规治疗基础上予注射用乌司他丁,观察组在对照组基础上予清肺汤,比较两组患者治疗前后基本生命体征、血清炎性因子指标、不良反应、中医证候评分及治疗有效率。结果经治疗,两组患者体温、呼吸、心率、动脉血二氧化碳分压(PaCO2)均较前下降,氧合指数(PaCO2/FiO2)则明显上升,且观察组体温、呼吸、心率、PaCO2均明显低于对照组,PaCO2/FiO2则高于对照组,差异具有统计学意义(P<0.05);两组患者PCT、C-反应蛋白(CRP)、白介素-6(IL-6)、TNF-α均较前下降,且观察组均明显低于对照组,差异具有统计学意义(P<0.05);治疗期间观察组[4.4(4/91)]不良事件总发生率明显低于对照组[13.2(12/91)],差异具有统计学意义(χ^2=4.390,P=0.036);两组患者主症、次症及总分均较前下降且观察组均明显低于对照组,差异具有统计学意义(P<0.05);治疗后观察组[93.4(85/91)]治疗有效率明显高于对照组[83.5(76/91)],差异具有统计学意义(χ^2=4.360,P=0.037)。结论自拟清肺汤联合乌司他丁治疗重症肺炎患者临床效果显著,可降低患者血清TNF-α和PCT表达水平。
Objective To investigate the effect of Qingfei Decoction combined with ulinastatin in the treatment of severe pneumonia and its effects on serum tumor necrosis factor-α(TNF-α)and procalcitonin(PCT).Methods 182 patients admitted to our hospital from January,2016 to December,2017 with severe pneumonia differentiated by the syndrome of phlegm-heat obstructing lung were randomly divided into the observation group and the control group by using random number table,with 91 patients in each group.Both groups were given ulinastatin based on conventional treatment,while the observation group was additionally given Qingfei Decoction.Basic vital signs,serum inflammatory factor index,adverse reactions,TCM syndrome score and treatment efficiency of the two groups were compared after treatment.Results After treatment,both groups had reductions in body temperature,respiration,heart rate,and arterial blood carbon dioxide partial pressure(PaCO2)and a significant increase in oxygenation index PaCO2/FiO2,however,the reductions and the increase in the observation group were more significant than in the control group(P<0.05).Both groups had reductions in PCT,C-reactive protein(CRP),interleukin-6(IL-6),and TNF-αand the observation group were significantly lower than the control group with significance(P<0.05).During treatment,the adverse event rate in the observation group[4.4(4/91)]were significantly lower than in the control group[13.2(12/91)],with significance(χ^2=4.390,P=0.036).After treatment,the total score,and the scores of main syndrome and secondary syndrome in both groups decreased and the observation group was significantly lower than the control group,with significance(P<0.05).The effective rate in the observation group[93.4(85/91)]was significantly higher than that in the control group[83.5(76/91)],with significance(χ^2=4.360,P=0.037).Conclusion Modified Qingfei Decoction combined with ulinastatin is effective in the treatment of severe pneumonia,which can increase serum TNF-αlevel and PCT expression.
作者
孟祥睿
冀希炜
赵丹
李春
杨志旭
MENG Xiang-rui;JI Xi-wei;ZHAO Dan;LI Chun;YANG Zhi-xu(ICU of Xiyuan Hospital,CACMS,Beijing 100091;Institute of Pharmacology,Peking University First Hospital,Beijing 100034)
出处
《世界中西医结合杂志》
2020年第1期151-155,159,共6页
World Journal of Integrated Traditional and Western Medicine
基金
北京中医药科技发展项目(QM2016-04)
