扶正活血化痰法联合抗生素对老年肺炎患者肺功能的影响  

Study on the effect of Fuzhenghuoxuehuatan method combined with antibiotics on pulmonary function in the elderly patients with pneumonia

作　　者：刘泽林[1] 刘丹丹[1] 邹月[1] 姜星屹 王伟 董国岭[1] 郭琳娜[1] 陈玉[1] Liu Zelin;Liu Dandan;Zou Yue;Jiang Xingyi;Wang Wei;Dong Guoling;Guo Linna;Chen Yu(Department of Infectious Diseases,Langfang People’s Hospital,Hebei Province,Langfang, 065000, China.)

机构地区：[1]河北省廊坊市人民医院感染性疾病科,065000

出　　处：《疑难病杂志》2021年第10期1017-1021,共5页Chinese Journal of Difficult and Complicated Cases

基　　金：廊坊市科技支撑计划项目(2016013178)。

摘　　要：目的探讨扶正活血化痰法联合抗生素对老年肺炎患者肺功能的影响。方法收集2018年3月—2019年9月廊坊市人民医院感染性疾病科收治的老年肺炎患者84例,根据随机数字表法分为2组,对照组按诊疗指南标准予常规抗生素治疗,观察组在抗生素基础上联合扶正活血化痰法进行治疗,治疗2周后,观察比较2组临床疗效,记录咳嗽消失、体温恢复正常、肺部啰音消失等临床症状恢复时间和平均住院时间,检测血清C-反应蛋白(CRP)、白介素-6(IL-6)和肿瘤坏死因子-α(TNF-α)等炎性因子水平变化,检查治疗后第1秒用力呼气容积(FEV_(1))、第1秒呼气容积同肺活量(FVC)之间的比值(FEV1/FVC)等肺功能指标和动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))等血气指标变化情况,并进行生活质量评分比较。结果治疗2周后,观察组临床疗效显著高于对照组(92.82%vs.76.19%,χ^(2)/P=5.591/0.027),观察组咳嗽消失、体温恢复正常、肺部啰音消失等临床症状恢复时间及住院时间均短于对照组(P<0.05)。2组患者血清CRP、IL-6和TNF-α水平均较治疗前显著下降(P<0.01),且观察组各项指标下降较对照组更为明显(13.551/0.000、13.624/0.000、13.257/0.000)。肺功能和血气分析检查结果示,观察组FEV_(1)、FEV_(1)/FVC和PaO_(2)均升高,PaCO_(2)均降低,且观察组改善优于对照组(14.655/0.000、14.352/0.000、14.036/0.000、11.252/0.000)。生活质量评分改善观察组亦优于对照组(P<0.01)。结论扶正活血化痰法联合抗生素治疗老年肺炎患者,能提高临床疗效,改善临床症状、血清炎性因子水平、肺功能指标、血气指标,提高生活质量。Objective To investigate the effect of Fuzhenghuoxuehuatan method combined with antibiotics on pulmonary function in elderly patients with pneumonia.Methods A total of 84 elderly patients with pneumonia admitted to Langfang People's Hospital from March 2018 to September 2019 were collected and divided into 2 groups according to the random number table.The control group was given routine antibiotic treatment according to the guideline of treatment and guidance.The observation group was treated with the combination of strengthening the vital blood,activating blood and resolving phlegm on the basis of antibiotics.After 2 weeks of treatment,the clinical efficacy and cough disappeared in the 2 groups.The recovery time of clinical symptoms such as normal body temperature,disappearance of pulmonary rales and average hospitalization were measured,and the levels of serum C-reactive protein(CRP),interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)After treatment,the forced expiratory volume(FEV_(1)),the ratio of expiratory volume in the first second to vital capacity(FEV_(1)/FVC)and other pulmonary function indexes,arterial partial pressure of oxygen(PaO_(2))and arterial partial pressure of carbon dioxide(PaCO_(2))were examined.Results After 2 weeks of treatment,the clinical efficacy of the observation group was significantly higher than that of the control group(92.82%vs.76.19%,χ^(2)/P=5.591/0.027).The recovery time and hospitalization time of clinical symptoms such as disappearance of cough,recovery of body temperature and disappearance of pulmonary rales in the observation group were shorter than those in the control group(P<0.05)Serum CRP,IL-6 and TNF-αin 2 groups were edcreased significantly(P<0.01),the observation group were better than control group(13.551/0.000,13.624/0.000 and 13.257/0.000).The levels of FEV1,FEV1/FVC and PaO_(2) in the observation group increased and PaCO_(2) decreased significantly,and the improvement of the observation group was better than that in the control group(14.655/0.000,14.352/0.0

关 键 词：老年肺炎 扶正活血化痰法 抗生素 肺功能 血气指标 炎性因子 生活质量 

分 类 号：R563.1[医药卫生—呼吸系统]