宣肺固金汤治疗痰热蕴肺型卒中相关性肺炎疗效及对炎症因子、免疫功能的影响  

Curative effect of Xuanfei Gujin decoction on stroke-associated pneumonia of pattern of phlegm-heat congesting in lung and its influence on inflammatory factors and immune function

作　　者：陈美玲 王莹 王亚楠 张金朋[2] 孙宏[2] CHEN Meiling;WANG Ying;WANG Yanan;ZHANG Jinpeng;SUN Hong(Jiamusi Hospital of Traditional Chinese Medicine,Jiamusi 154002,Heilongjiang,China;The Second Affiliated Hospital of Heilongjiang University of Chinese Medicine,Harbin 150001,Heilongjiang,China)

机构地区：[1]佳木斯市中医医院,黑龙江佳木斯154002 [2]黑龙江中医药大学附属第二医院,黑龙江哈尔滨150001

出　　处：《现代中西医结合杂志》2024年第18期2506-2510,2515,共6页Modern Journal of Integrated Traditional Chinese and Western Medicine

基　　金：黑龙江省中医药科研项目(ZHY2022-163);孙申田青年人才基金项目(2021KY-10)。

摘　　要：目的观察宣肺固金汤治疗痰热蕴肺型卒中相关性肺炎(SAP)的临床疗效及对炎症因子和免疫功能的影响。方法选取2022年6月—2024年2月在佳木斯市中医医院急诊科及黑龙江中医药大学附属第二医院康复科治疗的SAP患者91例,按随机数字表法将患者分为观察组(45例,脱落3例)和对照组(46例,脱落4例),对照组给予营养支持、肺功能训练、注射用哌拉西林钠他唑巴坦钠抗感染(根据药敏调整抗生素)等常规综合治疗,观察组在对照组治疗基础上给予宣肺固金汤治疗,2组疗程均为14 d。比较2组患者治疗前后中医证候积分、临床肺部感染评分(CPIS)及血清降钙素原(PCT)、高敏C反应蛋白(hs-CRP)、免疫球蛋白(IgA、IgM、IgG)、T淋巴细胞亚群(CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+))水平,统计2组临床疗效及不良反应发生率。结果治疗后2组患者中医证候积分、CPIS评分及血清PCT、hs-CRP、CD8^(+)水平均明显降低(P均<0.05),血清IgA、IgM、IgG、CD4^(+)、CD4^(+)/CD8^(+)均明显升高(P均<0.05),且观察组上述各项指标改善情况均明显优于对照组(P均<0.05);观察组总有效率明显高于对照组[92.86%(39/42)比80.95%(34/42),P<0.05],2组不良反应发生率比较差异无统计学意义(P>0.05)。结论西医联合宣肺固金汤治疗痰热蕴肺型SAP综合疗效优于单纯西医治疗,更有利于减轻肺部感染程度,降低炎症因子水平,增强机体免疫功能。Objective It is to observe the clinical curative effect of Xuanfei Gujin decoction on stroke-associated pneumonia(SAP)of pattern of phlegm-heat congesting in lung and its effects on inflammatory factors and immune function.Methods Ninety-one SAP patients treated in the Emergency Department of Jiamusi Hospital of Traditional Chinese Medicine and the Rehabilitation Department of the Second Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine from June 2022 to February 2024 were selected,and the patients were divided into observation group(45 cases,3 cases dropped)and control group(46 cases,4 cases dropped)according to the method of randomized numerical table,the control group was given the routine comprehensive treatments such as nutritional support,pulmonary function training,injection of piperacillin sodium tazobactam sodium for anti-infection(adjusting antibiotics according to the drug sensitivity),the observation group was given Xuanfei Gujin decoction on the basis of the treatment of the control group,both groups were treated for 14 days.The TCM syndrome score,clinical pulmonary infection score(CPIS),serum levels of procalcitonin(PCT),highly sensitive C-reactive protein(hs-CRP),immunoglobulin(IgA,IgM,IgG)and T lymphocyte subsets(CD4^(+),CD8^(+),CD4^(+)/CD8^(+))of the patients were observed and compared before and after treatment between the two groups,the clinical efficacy and incidence of adverse reactions were evaluated.Results After treatment,the TCM syndrome scores,CPIS scores and serum levels of PCT,hs-CRP,CD8^(+)of patients in the two groups were significantly reduced(all P<0.05),and serum levels of IgA,IgM,IgG,CD4^(+),CD4^(+)/CD8^(+)were significantly increased(all P<0.05),and the improvements of the above indexes in the observation group were significantly better than those in the control group(all P<0.05).The total effective rate of the observation group was significantly higher than that of the control group[92.86%(39/42)VS.80.95%(34/42),P<0.05],and the difference in the inc

关 键 词：宣肺固金汤 卒中相关性肺炎 痰热蕴肺型 炎症因子 免疫功能 

分 类 号：R743.33[医药卫生—神经病学与精神病学]