玉屏风颗粒联合抗菌药物治疗老年社区获得性肺炎患者的临床疗效及对其淋巴细胞亚群的影响  

Effect of Yupingfeng Granules Combined with Antibiotics on Clinical Efficacy and Lymphocyte Subpopulation of Elderly Patients with Community-Acquired Pneumonia

作　　者：齐洁[1] 张清潭[1] 杨倩倩[1] 梁淑芹[2] 徐文文[3] 胡孟芬 崔建国[1] QI Jie;ZHANG Qing-tan;YANG Qian-qian;LIANG Shu-qin;XU Wen-wen;HU Meng-fen;CUI Jian-guo(Geriatrics Department of Binzhou Medical University Hospital,Binzhou Shandong 256600;Neurology Department of Binzhou Medical University Hospital,Binzhou Shandong 256600;General Medical Department of Binzhou Medical University Hospital,Binzhou Shandong 256600)

机构地区：[1]滨州医学院附属医院老年医学科,山东滨州256600 [2]滨州医学院附属医院神经内科,山东滨州256600 [3]滨州医学院附属医院全科医学科,山东滨州256600

出　　处：《世界中西医结合杂志》2023年第8期1610-1615,1619,共7页World Journal of Integrated Traditional and Western Medicine

基　　金：山东省中医药科技发展计划项目(2019-0504)。

摘　　要：目的探讨玉屏风颗粒联合抗菌药物治疗老年社区获得性肺炎患者的临床疗效及对其淋巴细胞亚群的影响。方法选取2018年10月—2020年3月期间滨州医学院附属医院老年科收治的60例的社区获得性肺炎患者,采用随机数字表法分为对照组和试验组,每组各30例。对照组进行常规治疗,试验组在对照组的基础上联合玉屏风颗粒治疗。治疗2周后,观察比较两组患者的症状消失时间(发热、咳喘和肺部啰音),治疗前后炎性指标(白细胞计数(White blood cell count,WBC)、肿瘤坏死因子-α(Tumor necrosis factor-alpha,TNF-α)、白介素-6(Interleukin-6,IL-6))水平、免疫指标(CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)、CD19^(+)B、自然杀伤细胞(Natural Killer,NK)细胞)水平、肺功能[25%潮气量时呼气流速(Tidal volume during expiratory flow 25%,TEF25%)、功能残气量(Functional residual capacity,FRC)和用力呼气最大流速(Peak expiratory flow rate,PEF)]。结果治疗期间,两组患者抗生素使用情况基本一致,差异无统计学意义(P>0.05);治疗后试验组临床总有效率96.67%(29/30)明显高于对照组80.00%(24/30),差异有统计学意义(P<0.05)。治疗后试验组发热消失时间、咳喘消失时间、肺部啰音消失时间均明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者WBC、TNF-α、IL-6水平均较治疗前明显降低,差异有统计学意义(P<0.05);且试验组TNF-α、IL-6水平较对照组明显降低,差异有统计学意义(P<0.05),WBC水平与对照组比较,差异无统计学意义(P>0.05)。治疗后两组患者CD3^(+)、CD4^(+)细胞水平及CD4^(+)/CD8^(+)均较治疗前明显升高,CD8^(+)细胞水平较治疗前明显降低,差异有统计学意义(P<0.05);试验组CD19^(+)B、NK细胞水平较治疗前明显升高,差异有统计学意义(P<0.05);对照组CD19^(+)B、NK细胞水平治疗前后比较,差异无统计学意义(P>0.05)。治疗后试验组CD3^(+)、CD4^(+)、CD19^(+)B细胞水平�Objective To explore the clinical efficacy of Yupingfeng Granules combined with antibiotics in elderly patients with community-acquired pneumonia and the effect on lymphocyte subpopulation.Methods A total of 60 elderly patients with community-acquired pneumonia enrolled in the Geriatrics Department of Binzhou Medical University Hospital from October 2018 to March 2020 were studied.They were divided into a control group and an experimental group by the random number table method.There were 30 cases in each group.Patients in the control group received conventional treatment,and those in the experimental group received Yupingfeng Granules combined on the basis of conventional treatment for two weeks.Disappearing time of fever,cough,and lung murmur in both groups was compared after treatment.The level of inflammatory indicators,including white blood cell count(WBC),tumor necrosis factor-alpha(TNF-α),and interleukin-6(IL-6),as well as immune indicators(CD3^(+),CD4^(+),CD8^(+),CD4^(+)/CD8^(+),CD19^(+)B,and natural killer(NK)cells)and lung function indicators,such as tidal volume during expiratory flow 25%(TEF25%),functional residual capacity(FRC),and peak expiratory flow rate(PEF)were compared before and after treatment in both groups.Results The antibiotic treatment in both groups was basically consistent,and the difference was not statistically significant(P>0.05).The clinical total efficacy rate in the experimental group was significantly higher than that in the control group,and the difference was statistically significant(P<0.05).Disappearing time of fever,cough,and lung murmur in the experimental group was significantly lower than that in the control group(P>0.05).After the treatment,the levels of WBC,TNF-α,and IL-6 in both groups were significantly reduced(P<0.05).The levels of TNF-αand IL-6 in the experimental group were significantly lower than those in the control group(P<0.05),while there was no significant difference in WBC level between the two groups(P>0.05).After the treatment,the levels of CD3^(+),CD

关 键 词：玉屏风颗粒 老年社区获得性肺炎 免疫衰老 肿瘤坏死因子-α 白细胞介素-6 

分 类 号：R563.1[医药卫生—呼吸系统]