清肺化痰解毒汤联合头孢哌酮/舒巴坦治疗支气管扩张症伴感染(痰热壅肺证)的临床研究  

Efficacy of Qingfei Huatan Jiudu Decoction Combined with Cefoperazone/Sulbactam in the Treatment of Bronchiectasis with Infection(Phlegm-heat Obstructing Lung Syndrome)

作　　者：周亮亮 任宏伟 曹国芸 李梦云 李芳[1] 刘宁 王玉彬 Zhou Liangliang;Ren Hongwei;Cao Guoyun;Li Mengyun;Li Fang;Liu Ning;Wang Yubin(The Second Affiliated Hospital of Hebei University of Traditional Chinese Medicine,Hebei Province Seventh People′s Hospital,Hebei,Dingzhou 073000,China)

机构地区：[1]河北中医学院第二附属医院河北省第七人民医院,河北定州073000

出　　处：《中国中医急症》2022年第11期1941-1944,共4页Journal of Emergency in Traditional Chinese Medicine

基　　金：河北省中医药类科研计划项目(2022134)。

摘　　要：目的 观察清肺化痰解毒汤联合头孢哌酮/舒巴坦治疗支气管扩张症伴感染的临床疗效及对患者肺功能、血清及免疫功能的影响。方法 选择100例支扩伴感染(痰热壅肺证)患者作为研究对象,按随机数字表法平均分为两组。观察组采用清肺化痰解毒汤联合头孢哌酮/舒巴坦治疗,对照组单用头孢哌酮/舒巴坦治疗,连续治疗14 d。疗程结束后对两组疗效进行评价,并汇总不良反应情况。治疗前后对两组患者主要症状进行评分,检测两组患者肺功能指标、炎性标志物、外周血Th17、Treg比例及其比值。结果 观察组总有效率为92.00%,明显高于对照组的76.00%(P<0.05)。两组治疗后咳嗽、咯痰、胸闷气急、发热积分均较治疗前显著降低(P<0.05),且观察组下降更显著(P<0.05)。两组治疗后FEV1、FVC和PEF均较治疗前显著增加(P<0.05),且观察组改善更显著(P<0.05)。两组治疗后血清白细胞细胞素-8(IL-8)、肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)水平及白细胞计数(WBC)、NEUT%均较治疗前显著降低(P<0.05),且观察组下降更显著(P<0.05)。两组治疗后外周血Treg比例均较治疗前显著升高(P<0.05),外周血Th17比例、Th17/Treg比值均较治疗前显著降低(P<0.05);治疗后观察组外周血Treg比例显著高于对照组(P<0.05),外周血Th17比例、Th17/Treg比值均显著低于对照组(P<0.05)。观察组不良反应发生率为8.00%,对照组为14.00%,差异无统计学意义(P>0.05)。结论 清肺化痰解毒汤联合头孢哌酮/舒巴坦治疗支扩伴感染(痰热壅肺证)能安全有效地缓解患者症状体征,纠正外周血Th17/Treg免疫失衡,提高临床疗效。Objective:To investigate the clinical efficacy of Qingfei Huatan Jiedu Decoction combined with cefoperazone/sulbactam in the treatment of bronchiectasis with infection and its effects on lung function,serum and immune function. Methods:A total of 100 patients with bronchiectasis complicated with infection of phlegm-heat obstructing lung syndrome were divided into two groups according to random number table method. The observation group was treated with Qingfei Huatan Jiedu Decoction combined with cefoperazone/sulbactam,while the control group was treated with cefoperazone/sulbactam alone for 14 days. After treatment,the efficacy of the two groups was evaluated,and the adverse reactions were summarized. Before and after treatment,scores of main symptoms were performed in both groups. Lung function indexes,inflammatory markers,the proportion and ratio of Th17 and Treg in peripheral blood of the two groups were detected. Results:The total effective rate of observation group was 92.00%,which was significantly higher than that of control group 76.00%(P< 0.05). After treatment,scores of cough,expectoration,chest tightness and fever in the two groups were significantly decreased compared with those before treatment(P< 0.05),and the decrease in observation group was more significant(P<0.05). After treatment,FEV1,FVC and PEF in 2 groups were significantly increased compared with before treatment(P< 0.05),and the improvement in observation group was more significant(P< 0.05). After treatment,the levels of IL-8,TNF-α,CRP,WBC and NEUT% in the two groups were significantly decreased compared with those before treatment(P< 0.05),and the decrease in the observation group was more significant(P< 0.05). After treatment,the proportion of Treg in peripheral blood of the two groups was significantly increased compared with beforetreatment(P< 0.05),and the proportion of Th17 and Th17/Treg in peripheral blood were significantly decreasedcompared with before treatment(P< 0.05). After treatment,the proportion of Treg in peripheral bloo

关 键 词：支气管扩张症 清肺化痰解毒汤 头孢哌酮/舒巴坦 痰热壅肺证 炎症反应 Th17/Treg免疫失衡 

分 类 号：R562.22[医药卫生—呼吸系统]