补肺活血胶囊辅助治疗对老年重症社区获得性肺炎患者康复进程、Th17/Treg失衡及RORγt、FOXP3表达的调控作用  

Regulatory effect of Bufei Huoxue Capsule adjuvant therapy on the recovery process,Th17/Treg imbalance,and RORγt and FOXP3 expression in elderly patients with severe community-acquired pneumonia

作　　者：孙玉寒[1] 陈佩莉 邵换璋[1] 秦秉玉[1] SUN Yu-han;CHEN Pei-li;SHAO Huan-zhang;QIN Bing-yu(Department of Critical Care Medicine,Henan Provincial People's Hospital,Zhengzhou 450000,Henan,CHINA)

机构地区：[1]河南省人民医院重症医学科,河南郑州450000

出　　处：《海南医学》2024年第15期2161-2166,共6页Hainan Medical Journal

基　　金：中华国际医学交流基金会ICU镇静镇痛专项研究基金项目(编号:Z-2017-14-2028-47)。

摘　　要：目的探究补肺活血胶囊辅助治疗对老年重症社区获得性肺炎(CAP)患者康复进程、Th17/Treg失衡及RORγt、FOXP3表达的调控作用。方法选取2022年5月至2023年7月河南省人民医院收治的102例老年重症CAP患者作为研究对象,按随机数表法分为对照组和观察组各51例,对照组患者予以头孢哌酮舒巴坦钠治疗,观察组患者在对照组治疗的基础上予以补肺活血胶囊治疗,疗程一周。治疗后比较两组患者的疗效、康复进程,以及治疗前后的肺功能[第1秒用力呼气容积占预计值百分比(FVE_(1)%)、FEV_(1)/用力肺活量(FEV_(1)/FVC)、FVC]、外周血Th17、Treg比例、相应细胞因子白介素-10(IL-10)、白介素-17(IL-17)、特异性转录因子RAR相关孤儿受体γt(RORγt)、叉头蛋白P3(FOXP3)表达和急性生理与慢性健康(APACHE)Ⅱ、临床肺部感染(CPIS)评分,同时比较两组患者治疗期间的不良反应情况。结果治疗一周后,观察组患者的总有效率为94.12%,高于对照组的76.47%,差异有统计学意义(P<0.05);观察组患者体温恢复、咳嗽缓解、机械通气及ICU入住时间分别为(4.86±1.32)d、(5.69±1.75)d、(8.10±1.96)d、(11.32±1.68)d,均短于对照组的(6.54±1.85)d、(7.12±1.63)d、(12.75±2.54)d、(15.47±2.10)d,差异均有统计学意义(P<0.05);治疗后,观察组FEV_(1)/FVC、FVC、FVE_1%分别为(75.24±4.63)%、(4.26±0.12)L、(80.86±3.41)%,明显高于对照组的(70.36±4.23)%、(4.12±0.10)L、(76.69±4.34)%,差异均有统计学意义(P<0.05);治疗后,观察组患者Th17、IL-17水平分别为(2.13±0.54)%、(11.85±1.78)pg/mL,明显低于对照组的(3.27±0.86)%、(15.32±2.57)pg/mL,Treg、IL-10水平分别为(7.86±1.12)%、(15.32±2.58)pg/mL,明显高于对照组的(5.33±1.27)%、(11.47±2.35)pg/mL,差异均有统计学意义(P<0.05);治疗后,观察组患者RORγt相对表达量为1.35±0.34,明显低于对照组的1.35±0.34,FOXP3相对表达量为6.33±1.05,明显高于对照组的4.76±1.18,差异均有统�Objective To investigate the regulatory effect of Bufei Huoxue Capsules adjuvant therapy on the recovery process,Th17/Treg imbalance,and RORγt and FOXP3 expression in elderly patients with severe communi-ty-acquired pneumonia(CAP).Methods A total of 102 elderly patients with severe CAP admitted to Henan Provincial People's Hospital from May 2022 to July 2023 were selected as the research objects.According to the random number ta-ble method,they were randomly divided into a control group and an observation group,with 51 patients in each group.The patients in the control group were treated with cefoperazone sulbactam sodium,while the patients in the observation group were treated with Bufei huoxue Capsule on the basis of the treatment in the control group,for 1 week.After treat-ment,the efficacy,rehabilitation process,and lung function before and after treatment[percentage of forced expiratory volume in 1 second(FVE_(1)%),FEV_(1)/forced vital capacity(FEV_(1)/FVC),FVC],the proportions of Th17 and Treg in periph-eral blood,the expression of corresponding cytokines interleukin-10(IL-10),interleukin-17(IL-17),specific transcrip-tion factor RAR-related orphan receptor gamma t(RORγt),forkhead box P3(FOXP3),and acute physiology and chron-ic health(APACHE)Ⅱ,clinical pulmonary infection(CPIS)scores were compared between the two groups.At the same time,the adverse reactions during treatment in both groups were compared.Results After one week of treatment,the total effective rate of patients in the observation group was 94.12%,which was higher than 76.47%in the control group(P<0.05).The recovery of body temperature,relief of cough,mechanical ventilation,and ICU admission time in the ob-servation group were(4.86±1.32)d,(5.69±1.75)d,(8.10±1.96)d,and(11.32±1.68)d,respectively,which were all short-er than(6.54±1.85)d,(7.12±1.63)d,(12.75±2.54)d,and(15.47±2.10)d in the control group(P<0.05).After treatment,the FEV_(1)/FVC,FVC,and FVE1%in the observation group were(75.24±4.63)%,(4.26±0.12)L,and(80.86±3.41)%,respec-ti

关 键 词：重症 老年 社区获得性肺炎 补肺活血胶囊 细胞免疫 疗效 

分 类 号：R563.1[医药卫生—呼吸系统]