清金化痰汤加减辅助抗生素治疗老年重症肺炎疗效及对患者炎症反应递质的影响  

Modified Qingjin Huatan decoction with antibiotics in the treatment of elderly severe pneumonia and its influence on inflammatory response transmitters

作　　者：陈韵 张星星[1] 高志凌[1] 聂卫群[1] 俞兴群[1] CHEN Yun;ZHANG Xingxing;GAO Zhiling;NIE Weiqun;YU Xingqun(The First Affiliated Hospital of Anhui University of Traditional Chinese Medicine,Hefei 230038,China)

机构地区：[1]安徽中医药大学第一附属医院,安徽合肥230038

出　　处：《陕西中医》2022年第5期580-583,共4页Shaanxi Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金资助项目(81804039)。

摘　　要：目的:探讨清金化痰汤加减辅助抗生素治疗老年重症肺炎的临床疗效及对炎症反应递质的影响。方法:选择82例老年重症肺炎为研究对象,依照随机数字表法分为观察组和对照组各41例。对照组采用抗生素降阶梯疗法,观察组在对照组治疗的基础上采用清金化痰汤治疗,两组均持续治疗14 d。比较两组治疗前后痰热壅肺证评分、血清中性粒细胞弹性蛋白酶(NE)、白介素-8(IL-8)、白介素-10(IL-10)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)水平,对比两组临床疗效及药物不良反应。结果:两组治疗前的痰热壅肺证评分比较差异无统计学意义(P>0.05);两组治疗后的痰热壅肺证评分均降低,且观察组更低(P<0.05);观察组总有效率(92.68%)高于对照组(75.61%);两组治疗前的血清NE、IL-8、IL-10水平比较差异均无统计学意义(P>0.05);两组治疗后的血清NE、IL-8、IL-10水平均降低(P<0.05),且观察组更低(P<0.05);两组治疗前的CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)比较差异均无统计学意义(P>0.05);两组治疗后的CD4^(+)、CD4^(+)/CD8^(+)均升高(P<0.05),且观察组更高(P<0.05);治疗后,两组CD8^(+)低于治疗前(P<0.05),且观察组低于对照组(P<0.05);两组治疗期间总不良反应发生率比较差异无统计学意义(P>0.05)。结论:清金化痰汤加减辅助抗生素降阶梯疗法治疗老年重症肺炎(痰热壅肺证)的疗效确切,可降低炎症反应递质水平,提升免疫功能。Objective:To explore the clinical efficacy of Qingjin Huatan decoction with adjuvant antibiotics in the treatment of severe pneumonia in the elderly and its influence on inflammatory response transmitters.Methods:A total of 82 elderly patients with severe pneumonia were selected as the research objects,and they were divided into observation group(41 cases)and control group(41 cases)according to the numerical table method.The control group was treated with antibiotic de-escalation therapy,and the observation group was treated with Qingjin Huatan decoction on the basis of the treatment of the control group.Both groups were treated continuously for 14 days.The phlegm-heat stagnation syndrome score,serum neutrophil elastase(NE),interleukin-8(IL-8),interleukin-10(IL-10),CD4^(+),CD8^(+),CD4^(+)/CD8^(+)levels,were compared before and after treatment.The clinical efficacy and adverse drug reactions of the two groups were compared.Results:There was no significant difference in the scores of phlegm-heat stagnation syndrome between the two groups before treatment(P>0.05).After treatment,the scores of the phlegm-heat stagnation syndrome in the two groups were reduced(P<0.05),and the observation group was even lower(P<0.05).The total effective rate of the observation group(92.68%)was higher than that of the control group(75.61%).There was no significant difference in the levels of serum NE,IL-8 and IL-10 between the two groups before treatment(P>0.05).Serum NE,IL-8 and IL-10 levels after treatment in the two groups decreased(P<0.05),and the observation group was even lower(P<0.05).There was no statistically significant difference between the two groups of CD4^(+),CD8^(+),CD4^(+)/CD8^(+)before treatment(P>0.05).CD4^(+),CD4^(+)/CD8^(+)after treatment in the two groups increased(P<0.05),and the observation group was even higher(P<0.05).After treatment,the CD8^(+)of the two groups was lower than before treatment(P<0.05),and the observation group was lower than the control group(P<0.05).There was no significant difference in the i

关 键 词：重症肺炎 老年人 清金化痰汤加减 抗生素 痰热壅肺 炎症反应递质 

分 类 号：R563.1[医药卫生—呼吸系统]