清热平喘汤联合丙种球蛋白对急性重症病毒性肺炎患者免疫功能及血清KL-6、LDH水平的影响  

Effect of Qingre Pingchuan Decoction Combined with γ-Globulin on Immune Function and Levels of KL-6 and LDH in Serum in Patients with Severe Acute Viral Pneumonia

作　　者：史晶心 闫云[1] 冯丽霞[1] 赵璟[1] SHI Jingxin;YAN Yun;FENG Lixia;ZHAO Jing(Nanyang First People's Hospital,Nanyang Henan 473004,China)

机构地区：[1]南阳市第一人民医院,河南南阳473004

出　　处：《新中医》2024年第15期61-66,共6页New Chinese Medicine

基　　金：河南省南阳市科技发展计划项目(KJGG097,KJGG098)。

摘　　要：目的:观察清热平喘汤联合丙种球蛋白对急性重症病毒性肺炎患者免疫功能及血清涎液化糖链抗原(KL-6)、乳酸脱氢酶(LDH)水平的影响。方法:选取123例急性重症病毒性肺炎患者,按治疗方式不同分为中药组、西药组、联合组各41例。中药组予以清热平喘汤治疗,西药组予以丙种球蛋白治疗,联合组予以清热平喘汤联合丙种球蛋白治疗。比较3组临床疗效及症状体征消失时间,比较3组治疗前后免疫功能、血清炎性因子[白细胞介素-2 (IL-2)、肿瘤坏死因子-α (TNF-α)]、基质金属蛋白酶-9 (MMP-9)、KL-6、LDH水平的变化。结果:联合组临床疗效总有效率为95.12%,高于中药组与西药组,差异有统计学意义。联合组体温恢复正常时间、呼吸困难消失时间、咳嗽消失时间、肺部啰音消失时间均短于中药组与西药组,差异均有统计学意义(P<0.05)。治疗后,3组IgG、IgM、IgA水平均较治疗前提升(P<0.05),联合组上述3项水平均高于中药组、西药组(P<0.05)。治疗后,3组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)指标值均较治疗前升高(P<0.05),联合组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)指标值均高于中药组、西药组(P<0.05)。治疗后,3组IL-2水平均较治疗前上升(P<0.05),TNF-α水平均较治疗前下降(P<0.05);联合组IL-2水平高于中药组、西药组(P<0.05),TNF-α水平均低于中药组、西药组(P<0.05)。治疗后,3组血清KL-6、LDH、MMP-9蛋白酶水平均较治疗前下降(P<0.05),联合组血清KL-6、LDH、MMP-9蛋白酶水平均低于中药组、西药组(P<0.05)。结论:清热平喘汤联合丙种球蛋白能调节急性重症病毒性肺炎患者免疫功能,缓解炎症反应,降低血清KL-6、LDH水平,提升疗效,促进康复。Objective:To observe the effect of Qingre Pingchuan Decoction combined withγ-globulin on immune function and levels of Krebs von den Lungen-6(KL-6)and lactate dehydrogenase(LDH)in serum in patients with severe acute viral pneumonia.Methods:A total of 123 patients with acute severe viral pneumonia were selected and divided into the Chinese medicine group,the western medicine group,and the combination group according to different treatment methods,with 41 cases in each group.The Chinese medicine group was treated with Qingre Pingchuan Decoction,the western medicine group was treated withγ-globulin,and the combination group was treated with Qingre Pingchuan Decoction combined with γ -globulin. The clinical effects and disappearance time of symptoms and signs werecompared among the three groups. The changes in immune function, serum inflammatory factors[interleukin-2 (IL-2),and tumor necrosis factor-α (TNF-α)],matrix metalloproteinase-9 (MMP-9),KL-6,and LDH were compared before and after treatment among the three groups. Results:The total effectiverate of clinical effect was 95.12% in the combination group, which was higher than that in the Chinesemedicine group and the western medicine group,and the difference was significant. The recovery time ofbody temperature, and the disappearance time of dyspnea, cough, and lung rales in the combinationgroup were all shorter than those in the Chinese medicine group and the western medicine group,and thedifferences were significant (P<0.05). After treatment, the levels of IgG, IgM, and IgA in the threegroups were all increased when compared with those before treatment (P<0.05), and the above threelevels in the combination group were higher than those in the Chinese medicine group and the westernmedicine group (P<0.05). After treatment, the values of CD3^(+) , CD4^(+) , and CD4^(+)/CD8^(+) in all the threegroups were raised when compared with those before treatment (P<0.05), and the values of CD3^(+) ,CD4^(+),and CD4^(+)/CD8^(+) in the combination group were higher than tho

关 键 词：急性重症病毒性肺炎 清热平喘汤 丙种球蛋白 免疫功能 涎液化糖链抗原 乳酸脱氢酶 

分 类 号：R563.1[医药卫生—呼吸系统]