凉膈白虎汤加减对重症肺炎患者血清淀粉样蛋白A、高迁移率族蛋白水平的影响  

Modified Liangge Baihu Decoction Regulates Levels of Serum Amyloid A and High Mobility Group Protein in Patients with Severe Pneumonia

作　　者：谢斌[1] 邓超[1] 陈栩栩[1] 苏醒 张少明 王红梅 XIE Bin;DENG Chao;CHEN Xu-xu;SU Xing;ZHANG Shao-ming;WANG Hong-mei(Department of Critical Care Medicine,Haikou Affiliated Hospital of Central South University Xiangya School of Medicine,Haikou Hainan 570208;Department of Traditional Chinese Medicine,Haikou Affiliated Hospital of Central South University Xiangya School of Medicine,Haikou Hainan 570208;Department of Laboratory Medicine,Haikou Affiliated Hospital of Central South University Xiangya School of Medicine,Haikou Hainan 570208)

机构地区：[1]中南大学湘雅医学院附属海口医院重症医学科,海南海口570208 [2]中南大学湘雅医学院附属海口医院中医科,海南海口570208 [3]中南大学湘雅医学院附属海口医院检验科,海南海口570208

出　　处：《世界中西医结合杂志》2022年第12期2444-2449,共6页World Journal of Integrated Traditional and Western Medicine

基　　金：海南省卫生计生行业科研项目(19A200164)。

摘　　要：目的探讨凉膈白虎汤加减对重症肺炎患者血清淀粉样蛋白A(Serum amyloid A,SAA)、高迁移率族蛋白1(High mobility group protein 1,HMGB1)水平的影响。方法选取2019年1月—2020年12月期间在中南大学湘雅医学院附属海口医院就诊的重症肺炎患者100例,按随机数字表法分为对照组和研究组,每组各50例。两组患者均给予常规治疗,研究组在常规治疗的基础上给予凉膈白虎汤加减治疗。治疗1周后,观察比较两组患者临床疗效、不良反应发生率,治疗前后SAA、HMGB1水平、肺功能水平[第1秒时用力呼吸容积(Forced breathing volume in the first second,FEV_(1))、用力肺活量(Forced vital capacity,FVC)、呼气中段流量(Mid-expiratory flow,MMF)、呼吸峰流速(Peak respiratory flow,PEF)]、临床肺部感染评分(Clinical pulmonary infection score,CPIS)、序贯器官功能衰竭评分(Sequential organ failure assessment,SOFA)、急性生理与慢性健康评分Ⅱ(Acute physiology and chronic health evaluation scoring,APACHEⅡ)、中医证候积分、炎症因子[白细胞计数(White blood cell count,WBC)、白细胞介素-6(Interleukin-6,IL-6)、肿瘤坏死因子-α(Tumor necrosis factor-α,TNF-α)、降钙素原(Procalcitonin,PCT)、超敏C反应蛋白(High-sensitivity C-reactive protein,hs-CRP)]。结果治疗后研究组治疗总有效率94.00%(47/50)高于对照组76.00%(38/50)(P<0.05)。治疗后两组患者SAA、HMGB1水平低于治疗前,差异有统计学意义(P<0.05);且研究组SAA、HMGB1水平低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者肺功能FEV_(1)、FVC、MMF、PEF水平均较治疗前升高,差异有统计学意义(P<0.05);且研究组肺功能FEV1、FVC、MMF、PEF水平明显高于对照组,差异有统计学意义(P<0.05)。治疗后两组患者CPIS、SOFA、APACHEⅡ评分和中医证候积分均低于治疗前,差异有统计学意义(P<0.05);且研究组CPIS、SOFA、APACHEⅡ评分和中医证候积分明显低于对照组,差异有统�Objective To observe the effect of modified Liangge Baihu Decoction on the levels of serum amyloid A(SAA)and high mobility group protein B1(HMGB1)in the patients with severe pneumonia.Methods A total of 100 patients with severe pneumonia diagnosed in the Haikou Affiliated Hospital of Central South University Xiangya School of Medicine from January 2019 to December 2020 were selected and assigned into a control group and an observation group according to the random number table method,with 50 patients in each group.Both groups received conventional treatment,and the observation group was additionally administrated with modified Liangge Baihu Decoction.The treatment lasted for a week,and the clinical efficacy and incidence of adverse reactions were compared between the two groups.The levels of SAA and HMGB1,lung function indicators[forced breathing volume in the first second(FEV1),forced vital capacity(FVC),maximal mid-expiratory flow(MMF),and peak expiratory flow(PEF)],clinical pulmonary infection score(CPIS),sequential organ failure assessment(SOFA)score,acute physiology and chronic health evaluation(APACHE II)score,TCM syndrome score,and inflammatory cytokines[white blood cell count(WBC),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),procalcitonin(PCT),and hypersensitive C reactive protein(hs-CRP)]were measured before and after treatment in the two groups.Results The total effective rate of the observation group(47/50,94.00%)was higher than that(38/50,76.00%)of the control group(P<0.05).After treatment,the SAA and HMGB1 levels declined compared with those before treatment(P<0.05)and were lower in the observation group than in the control group(P<0.05).The treatment in both groups increased the FEV1,FVC,MMF,and PEF(P<0.05),which were higher in the observation group than in the control group(P<0.05).After treatment,the CPIS,SOFA score,APACHE II score,TCM syndrome score,and serum levels of inflammatory cytokines decreased compared with those before treatment(P<0.05),and the decreases were more significant in

关 键 词：凉膈白虎汤 重症肺炎 血清淀粉样蛋白A 迁移率族蛋白1 

分 类 号：R563.1[医药卫生—呼吸系统]