凉膈白虎汤加减治疗重症肺炎的临床疗效及HMGB1、sTREM-1、IFN-γ表达变化  

Clinical effect of Liangge Baihu decoction add and subtract on treatment of severe pneumonia and changes of expressions of HMGB1,sTREM-1 and IFN-γ

作　　者：车启富 何丽杰 CHE Qi-fu;HE Li-jie(Jiamusi Traditional Chinese Medicine Hospital,Jiamusi,Heilongjiang 154002,China)

机构地区：[1]佳木斯市中医医院心肺病科,黑龙江佳木斯154002 [2]佳木斯市中医医院消化科,黑龙江佳木斯154002

出　　处：《中华医院感染学杂志》2024年第2期177-181,共5页Chinese Journal of Nosocomiology

基　　金：黑龙江省卫生计生委科研课题(2018203)。

摘　　要：目的分析凉膈白虎汤加减治疗重症肺炎的疗效及高迁移率族蛋白B1(HMGB1)、溶性髓样细胞触发受体-1(sTREM-1)、干扰素-γ(IFN-γ)水平变化。方法选取2021年1月—2023年1月佳木斯市中医医院收治的重症肺炎患者80例,随机数字表法分为对照组与试验组,每组各40例,对照组在西医常规对症支持治疗基础上,给予盐酸氨溴索注射液静脉滴注进行祛痰;试验组予以凉膈白虎汤加减治疗祛痰,两组均治疗14 d,比较两组治疗疗效及HMGB1、sTREM-1、IFN-γ水平。结果治疗14 d后,试验组和对照组治疗有效率分别为92.50%和72.50%,比较有统计学差异(χ~2=5.541,P=0.019);试验组中医证候积分(发热、咳嗽、气促、痰壅)评分均低于对照组(P<0.05),呼吸功能指标[用力肺活量(FVC)、呼气中段流量(MMF)、呼吸峰流速(PEF)]优于对照组(P<0.05),CD_3~+、CD_4~+、CD_8~+免疫功能指标水平优于对照组(P<0.05),炎症指标HMGB1、sTREM-1、IFN-γ水平低于对照组(P<0.05)。结论凉膈白虎汤加减治疗重症肺炎的疗效确切,可改善中医证候积分,降低血清HMGB1、sTREM-1、IFN-γ水平,改善患者呼吸功能,调节机体免疫功能水平。OBJECTIVE To observe the effect of Liangge Baihu decoction add and subtract on treatment of severe pneumonia and analyze the changes of expression levels of high mobility group protein B1(HMGB1),soluble trig-gering receptor expressed on myeloid cells(sTREM-1)and interferon-γ(IFN-γ).METHODS A total of 80 pa-tients with severe pneumonia who were treated in Jianmusi Traditional Chinese Medicine Hospital from Jan 2021 to Jan 2023 were enrolled in the study and randomly divided into the control group and the experimental group,with 40 cases in each group.The control group was given intravenous drip of ambroxol hydrochloride injection for expectoration on basis of routine symptomatic and supportive western medicine treatment,while the experimental group was treated with Liangge Baihu decoction add and subtract for expectoration.Both groups were treated for 14 days.The curative effect and the levels of HMGB1,sTREM-1 and IFN-γwere observed and compared between the two groups.RESULTS After the treatment for 14 days,the effective rate of treatment was 92.50%in the ex-perimental group,72.50%in the control group,and there was significant difference(x2=5.541,P=0.019).The scores of TCM syndromes(fever,cough,shortness of breath,phlegm obstruction)of the experimental group were lower than those of the control group(P<0.05).The respiratory function indexes[forced vital capacity(FVC),maximal mid-expiratory flow(MMF),peak expiratory flow(PEF)]of the experimental group were su-perior to those of the control group(P<0.05).The levels of immune function indexes CD3+,CD4+and CD8+of the experimental group were superior to those of the control group(P<0.05).The levels of inflammatory indexes HMGB1,sTREM-1 and IFN-y of the experimental group were lower than those of the control group(P<0.05).CONCLUSION Liangge Baihu decoction add and subtract can achieve exact effect on treatment of severe pneumoni-a,improve the score of TCM syndrome,reduce the levels of serum HMGB1,sTREM-1 and IFN-y,improve the respiratory function,and regulate the imm

关 键 词：凉膈白虎汤加减 重症肺炎 呼吸功能 高迁移率族蛋白B1 溶性髓样细胞触发受体-1 干扰素-γ 中医证候积分 

分 类 号：R243[医药卫生—中医临床基础]