通腑化痰方治疗痰热腑实型卒中相关性肺炎患者的疗效及对其血清炎性因子水平的影响  

Therapeutic Effect of Tongfu Huatan Formula on Stroke-Associated Pneumonia with Phlegm Heat and Fu-organ Excess and Its Impact on Serum Inflammatory Factor

作　　者：高乐 向杰 杨峰 GAO Le;XIANG Jie;YANG Feng(Emergency Department,Xi′an Hospital of Traditional Chinese Medicine,Xi′an Shaanxi 710000)

机构地区：[1]西安市中医医院急诊科,陕西西安710000

出　　处：《世界中西医结合杂志》2024年第2期311-316,共6页World Journal of Integrated Traditional and Western Medicine

基　　金：陕西省重点研发计划项目(2019SF-084)。

摘　　要：目的探讨通腑化痰方治疗痰热腑实型卒中相关性肺炎疗效及对血清炎性因子水平的影响。方法选取2020年2月—2022年2月期间西安市中医医院收治的126例卒中相关性肺炎患者,按随机数字表法将分为观察组和对照组,每组各63例。对照组采用积极治疗原发病、痰液引流、纠正低氧血症、抗炎等西医常规治疗方法,观察组在对照组治疗基础上另联合通腑化痰方治疗。连续治疗10 d后,观察比较两组患者症状缓解时间、临床疗效、不良反应情况,治疗前后中医证候积分、美国国立卫生研究院卒中量表(NIH stroke scale,NIHSS)评分、日常生活能力(Activity of daily living,ADL)评分、血清炎性指标[γ-干扰素(Interferon-γ,IFN-γ)、高敏C反应蛋白(hypersensitive C-reactive protein,hs-CRP)、肿瘤坏死因子-α(Tumor necrosis factor-α,TNF-α)、降钙素原(procalcitonin,PCT)]变化情况。结果治疗10 d后两组患者咳嗽、喘促、发热、肺部体征、痰色痰质、便秘积分均较治疗前降低,差异有统计学意义(P<0.05);且观察组咳嗽、喘促、发热、肺部体征、痰色痰质、便秘积分明显低于对照组,差异有统计学意义(P<0.05)。治疗10 d后两组患者NIHSS评分较治疗前降低,ADL评分较治疗前升高,差异有统计学意义(P<0.05);且观察组NIHSS评分明显低于对照组,ADL评分明显高于对照组,差异有统计学意义(P<0.05)。治疗10 d后观察组退热时间、肺部湿罗音消失时间及咳嗽缓解时间均明显优于对照组,差异有统计学意义(P<0.05)。治疗10 d后两组患者血清IFN-γ水平较治疗前升高,血清hs-CRP、TNF-α、PCT水平较治疗前降低,差异有统计学意义(P<0.05);且观察组血清IFN-γ水平明显高于对照组,血清hs-CRP、TNF-α、PCT水平明显低于对照组,差异有统计学意义(P<0.05)。治疗10 d后观察组总有效率93.7%(59/63)明显高于对照组81.0%(51/63),差异有统计学意义(P<0.05)。治疗期间,两组患�Objective To evaluate the effectiveness of the Tongfu Huatan Formula in treating stroke-associated pneumonia with phlegm heat and fu-organ excess and its impact on serum inflammatory factors.Methods A total of 126 patients with stroke-associated pneumonia admitted to Xi′an Hospital of Traditional Chinese Medicine Hospital from February 2020 to February 2022 were selected and divided into an observation group and a control group using a random number table,with 63 in each group.The control group received conventional Western medical treatment,including active treatment of the primary disease,sputum drainage,hypoxemia correction,and anti-inflammation.The observation group received the Tongfu Huatan Formula in addition to the conventional treatment for 10 days.The symptom relief time,overall clinical efficacy,and treatment safety were recorded,and changes in traditional Chinese medicine(TCM)syndrome scores,NIH Stroke Scale(NIHSS)scores,Activities of Daily Living(ADL)scores,and serum inflammatory markers[interferon-gamma(IFN-γ),hypersensitive C-reactive protein(hs-CRP),tumor necrosis factor-alpha(TNF-α),and procalcitonin(PCT)]before and after treatment were observed and compared between the two groups.Results After 10 days of treatment,scores for cough,shortness of breath,fever,lung signs,sputum color and quality,and constipation in both groups decreased compared with the conditions before treatment(P<0.05),and the observation group had a more significant reduction than the control group(P<0.05).Additionally,NIHSS scores decreased,and ADL scores increased in both groups(P<0.05),with the observation group outperforming the control group(P<0.05).The observation group also had a shorter duration of fever relief,lung moist rale disappearance,and cough relief compared with the control group(P<0.05).After 10 days of treatment,serum IFN-γwas up-regulated,while hs-CRP,TNF-α,and PCT were down-regulated in both groups compared with those before treatment(P<0.05),with the observation group showing more significant changes

关 键 词：卒中相关性肺炎 通腑化痰方 痰热腑实证 炎性反应 γ-干扰素 神经功能缺损 

分 类 号：R563.1[医药卫生—呼吸系统]