热毒宁注射液联合纤维支气管肺泡灌洗吸痰对重症肺炎患者血T淋巴细胞亚群及预后的影响  

Effect of Reduning Injection Combined with Bronchoalveolar Lavage and Sputum Aspiration on T Lymphocyte Subsets and Prognosis of Patients with Severe Pneumonia

作　　者：谭志平 陈观尚 黄霞 TAN Zhi-Ping;CHEN Guan-Shang;HUANG Xia(Zhanjiang Second Hospital of Traditional Chinese Medicine, Zhanjiang 524013 Guangdong, China)

机构地区：[1]湛江市第二中医医院

出　　处：《广州中医药大学学报》2019年第10期1520-1526,共7页Journal of Guangzhou University of Traditional Chinese Medicine

摘　　要：【目的】探讨热毒宁注射液联合纤维支气管肺泡灌洗吸痰对重症肺炎(SP)患者血T淋巴细胞亚群及预后的影响。【方法】将103例SP患者按治疗方案不同分为研究组52例和对照组51例。2组患者均予以常规综合治疗,对照组加用纤维支气管肺泡灌洗吸痰治疗,研究组加用热毒宁注射液联合纤维支气管肺泡灌洗吸痰治疗,疗程7 d。观察2组患者治疗前后中医证候积分、急性生理与慢性健康问卷(APACHEⅡ)评分、肺弥散功能(DLCO)、血T淋巴细胞亚群(CD3+、CD4+、CD4+/CD8+)和炎性反应指标[血清白细胞介素4(IL-4)、白细胞介素8(IL-8)、肿瘤坏死因子α(TNF-α)]的变化情况,评价2组的疗效和安全性。【结果】(1)疗效方面:研究组的总有效率为94.23%,明显高于对照组的80.39%,差异有统计学意义(P<0.05);存活率方面:观察组和对照组分别为100.00%和98.04%,组间比较,差异无统计学意义(P>0.05)。(2)治疗后,2组患者的证候积分和APACHEⅡ评分均较治疗前降低,DLCO均较治疗前升高(P<0.01),且与对照组比较,研究组的证候积分和APACHEⅡ评分均明显降低,而DLCO明显升高(P<0.05或P<0.01)。(3)血T淋巴细胞亚群方面:治疗后,2组患者血中CD3+、CD4+、CD4+/CD8+水平均较治疗前明显升高(P<0.01),且研究组的升高作用均明显优于对照组(P<0.01)。(4)炎性反应指标方面:治疗后,2组患者血清IL-4、IL-8、TNF-α水平均较治疗前明显降低(P<0.01),且研究组的降低作用均明显优于对照组(P<0.01)。(5)不良反应方面:研究组的不良反应发生率为3.85%,对照组为2.00%,差异无统计学意义(P>0.05)。【结论】热毒宁注射液联合纤维支气管肺泡灌洗吸痰治疗SP疗效显著,能通过调节T淋巴细胞亚群,减轻炎性反应,进一步缓解症状,改善预后,且不良反应少。Objective To investigate the effect of Reduning Injection combined with bronchoalveolar lavage and sputum aspiration on T lymphocyte subsets and prognosis of patients with severe pneumonia(SP). Methods A total of 103 SP patients were divided into study group(n = 52)and control group(n = 51)according to the therapeutic schedule. All of the patients were treated with routine comprehensive treatment. And additionally, the control group was treated with bronchoalveolar lavage and sputum aspiration, while the study group was treated with Reduning Injection combined with bronchoalveolar lavage and sputum aspiration. The treatment for the two groups lasted 7 days. Before and after treatment,the scores of traditional Chinese medicine(TCM)symptoms,Acute Physiology and Chronic Health Evaluation Ⅱ(APACHEⅡ)scores,pulmonary diffusion function index of carbon monoxide diffusing capacity(DLCO), blood T lymphocyte subset CD3+,CD4+and CD4+/CD8+,inflammatory reaction indicators of serum interleukin-4(IL-4), interleukin-8(IL-8)and tumor necrosis factor-alpha(TNF-α)were compared between the two groups. Meanwhile,the clinical efficacy and safety in the two groups were also evaluated. Results(1) The total effective rate of the study group was 94.23%, higher than that of the control group(80.39%) and the difference being statistically significant(P < 0.05);the survival rate of the study group was 100.00% and that of the control group was 98.04%,there was no significant difference between the two groups(P > 0.05).(2)After treatment,TCM symptom scores and APACHEⅡ scores were decreased and DLCO was increased in the two groups(P<0.01 compared with those before treatment)and the decrease of TCM symptom scores and APACHEⅡ scores as well as the increase of DLCO in the study group was superior to that in the control group(P<0.05 or P<0.01).(3)After treatment,the levels of T lymphocyte subset CD3+,CD4+,and CD4+/CD8+were increased in the two groups(P<0.01 compared with those before treatment),and the increase in the study group was supe

关 键 词：热毒宁注射液 支气管肺泡灌洗 重症肺炎 肺弥散功能 T淋巴细胞亚群 炎性反应 

分 类 号：R259.631[医药卫生—中西医结合]