自拟通腑益肺汤联合喜炎平注射液对痰热壅肺型重症肺炎并Ⅱ型呼吸衰竭患者肺功能及血清炎性因子水平的影响  

Impact of Self-made Tongfu-yifei Decoction Combined with Xiyanping Injection on Pulmonary Function and Serum Inflammatory Cytokines Levels in Severe Pneumonia Patients Complicated with Type Ⅱ Respiratory Failure Differed as TCM Pathogenic Phlegm-heat Rete

作　　者：李鹏飞[1] 陈红 邢笑梅 安福成 LI Peng-fei;CHEN Hong;XING Xiao-mei;AN Fu-cheng(Department of Respiratory Medicine,Beijing Mentougou District Hospital,Beijing 100043,China;Department of Pathology,Beijing West Branch of Beijing Chaoyang Hospital,Beijing 100020,China;Department of Traditional Chinese Medicine,Beijing Mentougou District Hospital,Beijing 100043,China)

机构地区：[1]北京市门头沟区医院呼吸科,100043 [2]北京市朝阳医院京西院区病理科,100020 [3]北京市门头沟区医院中医科,100043

出　　处：《实用心脑肺血管病杂志》2018年第7期89-93,共5页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

基　　金：北京市门头沟区科技计划医疗卫生项目(10039A76)

摘　　要：目的探讨自拟通腑益肺汤联合喜炎平注射液对痰热壅肺型重症肺炎并Ⅱ型呼吸衰竭患者肺功能及血清炎性因子水平的影响。方法选取2014年1月—2016年2月北京市门头沟区医院收治的痰热壅肺型重症肺炎并Ⅱ型呼吸衰竭患者84例,采用随机数字表法分为对照组和观察组,每组42例。在常规治疗基础上,对照组患者加用喜炎平注射液治疗,观察组患者在对照组基础上联合自拟通腑益肺汤治疗;两组患者均连续治疗10 d。比较两组患者治疗前后肺功能指标、动脉血气分析指标、血清炎性因子水平、中医证候评分及临床疗效,并观察两组患者治疗期间不良反应发生情况。结果 (1)治疗前两组患者第1秒用力呼气容积(FEV_1)、肺总量(TLC)、每分钟最大通气量(MMV)和功能残气量(FRC)比较,差异无统计学意义(P>0.05);治疗后观察组患者FEV_1、TLC、MMV、FRC大于对照组(P<0.05)。(2)治疗前两组患者动脉血氧分压(Pa O2)、动脉血二氧化碳分压(PaCO_2)、氧合指数(OI)比较,差异无统计学意义(P>0.05);治疗后观察组患者Pa O2、OI高于对照组,PaCO_2低于对照组(P<0.05)。(3)治疗前两组患者血清降钙素原(PCT)、血小板激活因子(PAF)、白介素6(IL-6)、可溶性髓样细胞触发受体1(sTREM-1)水平比较,差异无统计学意义(P>0.05);治疗后观察组患者血清PCT、PAF、IL-6、sTREM-1水平低于对照组(P<0.05)。(4)治疗前两组患者中医证候评分比较,差异无统计学意义(P>0.05);治疗后观察组患者中医证候评分低于对照组(P<0.05)。(5)观察组患者临床疗效优于对照组(P<0.05)。(6)两组患者治疗期间均未发生明显不良反应。结论自拟通腑益肺汤联合喜炎平注射液能有效改善痰热壅肺型重症肺炎并Ⅱ型呼吸衰竭患者肺功能,减轻呼吸衰竭程度,降低血清炎性因子水平,临床疗效确切且安全性较高。Objective To investigate the impact of self-made Tongfu-yifei decoction combined with Xiyanping injection on pulmonary function and serum inflammatory cytokines levels in severe pneumonia patients complicated with typeⅡrespiratory failure differed as TCM pathogenic phlegm-heat retention lung syndrome.Methods From January 2014 to February 2016,a total of 84 severe pneumonia patients complicated with typeⅡrespiratory failure differed as TCM pathogenic phlegmheat retention lung syndrome were selected in Beijing Mentougou District Hospital,and they were divided into control group and observation group according to random number table,each of 42 cases.Based on conventional treatment,patients in control group received Xiyanping injection,while patients in observation group received self-made Tongfu-yifei decoction combined with Xiyanping injection;both groups continuously treated for 10 days.Index of pulmonary function,arterial blood-gas analysis results,serum inflammatory cytokines levels and TCM syndromes score before and after treatment,and clinical effect were compared between the two groups,and incidence of adverse reactions was observed during treatment.Results (1)No statistically significant differences of FEV1,TLC,MMV or FRC was found between the two groups before treatment(P>0.05),while FEV1,TLC,MMV and FRC in observation group were statistically significantly larger than those in control group after treatment(P<0.05).(2)No statistically significant differences of PaO2,PaCO2 or OI was found between the two groups before treatment(P>0.05);after treatment,PaO2 and OI in observation group were statistically significantly higher than those in control group,while PaCO2 in observation group was statistically significantly lower than that in control group(P<0.05).(3)No statistically significant differences of serum level of PCT,PAF,IL-6 or sTREM-1 was found between the two groups before treatment(P>0.05);while serum levels of PCT,PAF,IL-6 and sTREM-1 in observation group were statistically significantly lower tha

关 键 词：肺炎 呼吸功能不全 自拟通腑益肺汤 喜炎平注射液 肺功能 炎性因子 

分 类 号：R563.1[医药卫生—呼吸系统] R563.8[医药卫生—内科学]