通阳泄浊方对老年脑病合并肺部多重耐药菌感染患者细胞因子、血清肺表面活性蛋白、内皮功能和免疫抑制的影响  

Effect of Tongyang Xiezhuo Prescription on Cytokines,Serum Pulmonary Surfactant Protein,Endothelial Function and Immunosuppression in Elderly Patients with Encephalopathy Complicated with Pulmonary Multidrug-Resistant Bacteria Infection

作　　者：周召武 罗小星[2] ZHOU Zhaowu;LUO Xiaoxing(Guangzhou University of Chinese Medicine,Guangzhou Guangdong China 510405;The First Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou Guangdong China 510405)

机构地区：[1]广州中医药大学,广东广州510405 [2]广州中医药大学第一附属医院,广东广州510405

出　　处：《中医学报》2021年第5期1078-1083,共6页Acta Chinese Medicine

基　　金：广东省医学科学技术重点研究基金项目(2018-YS001546)。

摘　　要：目的:观察通阳泄浊方对老年脑病合并肺部多重耐药菌感染患者细胞因子、血清肺表面活性蛋白、内皮功能和免疫抑制的影响。方法:78例老年脑病合并肺部多重耐药菌感染患者按照随机数字表法平均分为对照组和中医干预组。对照组在基础治疗的基础上给予盐酸氨溴索注射液、多索茶碱注射液治疗,并根据药敏试验结果给予抗菌药物治疗;中医干预组在对照组治疗基础上给予通阳泄浊方。两组患者均治疗两周后评价临床疗效,并观察治疗前后细胞因子[白细胞介素-6(interleukin-6,IL-6)、IL-8、降钙素原(procalcitonin,PCT)、基质金属蛋白酶-9(matrix metalloproteinase,MMP-9)]、血清肺表面活性蛋白(SP-A、SP-B、SP-C、SP-D)、内皮功能指标[一氧化氮(nitric oxide,NO)、内皮素-1(endothelin-1,ET-1)、血管性血友病因子(von Willebrand factor,vWF)]、免疫功能指标(CD_(3)^(+)、CD_(4)^(+)、CD_(8)^(+)、CD_(4)^(+)/CD_(8)^(+))、中医证候积分和临床肺部感染评分(clinical pulmonary infection score,CPIS)变化。结果:中医干预组有效率为94.87%,高于对照组的82.05%,两组患者有效率比较,差异有统计学意义(P<0.05)。治疗后,两组患者身热、咳嗽、烦渴、汗出、胸闷胸痛、痰黄带血评分及总积分均低于本组治疗前(P<0.05),且中医干预组低于对照组(P<0.05)。治疗后,两组患者血清IL-6、IL-8、PCT、MMP-9水平均低于本组治疗前(P<0.05),且中医干预组低于对照组(P<0.05)。治疗后,两组患者SP-A、SP-B、SP-C、SP-D水平均低于本组治疗前(P<0.05),且中医干预组低于对照组(P<0.05)。治疗后,两组患者NO水平高于本组治疗前,ET-1、vWF水平均低于本组治疗前(P<0.05);且中医干预组NO高于对照组,中医干预组ET-1、vWF低于对照组(P<0.05)。治疗后,两组患者CD_(3)^(+)、CD_(4)^(+)、CD_(4)^(+)/CD_(8)^(+)水平高于本组治疗前,CD_(8)^(+)水平均低于本组治疗前(P<0.05);且中医干预组CD_(3)^(+)、CObjective:To observe the effects of Tongyang Xiezhuo prescription on cytokines,serum pulmonary surfactant protein,endothelial function and immunosuppression in elderly patients with encephalopathy and pulmonary multidrug-resistant bacteria infection.Methods:78 cases of elderly patients with encephalopathy complicated with pulmonary multidrug-resistant bacteria infection were divided into the control group and the Chinese medicine intervention group according to the random number table method.The control group was given ambroxol hydrochloride injection and doxofylline injection on the basis of basic treatment,and antimicrobial treatment was given according to the results of the drug sensitivity test;the Chinese medicine intervention group was given Tongyang Xiezhuo prescription on the basis of the treatment of the control group.Both groups of patients were treated for two weeks to evaluate the clinical efficacy,and the cytokines[interleukin-6(IL-6),IL-8,procalcitonin(PCT),matrix metalloproteinase-9(MMP-9)],serum pulmonary surfactant protein(SP-A,SP-B,SP-C,SP-D),endothelial function index[nitric oxide(NO),endothelin-1(ET-1),von Willebrand factor(vWF)],immune function indicators(CD_(3)^(+),CD_(4)^(+),CD_(8)^(+),CD_(4)^(+)/CD_(8)^(+)),TCM syndrome score and clinical pulmonary infection score(CPIS)changes were observed before and after treatment.Results:The effective rate of the Chinese medicine intervention group was 94.87%,which was higher than 82.05% of the control group.There was a statistically significant difference in the effective rate between the two groups(P<0.05).After treatment,the scores of body heat,cough,polydipsia,sweating,chest tightness,chest pain,sputum and yellow blood and blood scores and total scores of the two groups were lower than those before treatment(P<0.05),and the Chinese medicine intervention group was lower than the control group(P<0.05).After treatment,the serum levels of IL-6,IL-8,PCT,and MMP-9 in the two groups were lower than those before treatment(P<0.05),and the Chinese medicine i

关 键 词：通阳泄浊方 脑病 肺部多重耐药菌感染 血清肺表面活性蛋白 内皮功能 免疫功能 

分 类 号：R256.13[医药卫生—中医内科学]