金芪清疏方治疗肺脾气虚型社区获得性肺炎的临床疗效及对血清炎症因子和免疫功能的影响  

Efficacy of Jinqi Qingshu Decotion on inflammatory factors and immune function in community-acquired pneumonia with lung spleen-deficiency type

作　　者：许玲[1] 季思勤[1] 郑月娟[2] 陈金涛 何宗阳 王振伟[1] XU Ling;JI Siqin;ZHENG Yuejuan;CHEN Jintao;HE Zongyang;WANG Zhenwei(Department of Respiratory Medicine,Yueyang Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai University of Traditional Chinese Medicine,Shanghai 200080;School of Integrative Medicine,Shanghai University of Traditional Chinese Medicine,Shanghai 200080)

机构地区：[1]上海中医药大学附属岳阳中西医结合医院呼吸内科,上海200080 [2]上海中医药大学中西医结合学院,上海200080

出　　处：《河北中医》2025年第1期20-25,共6页Hebei Journal of Traditional Chinese Medicine

基　　金：国家重点研究与发展计划(编号:2021YFE0200900);国家自然科学基金项目(编号:82073901);上海市科技重大专项(编号:ZD2021CY001);上海市进一步加快中医药事业发展三年行动计划[编号:ZY(2021-2023)-0103];上海市医院中药制剂产业转化协同创新中心项目;上海人才发展资金项目;虹口区“国医强优”三年行动计划(编号:HKGYQYXM-2022-39);岳阳医院中医肺病专科建设项目[编号:YW(2023-2024)-03-06]。

摘　　要：目的观察社区获得性肺炎肺脾气虚型患者口服金芪清疏方的临床疗效。方法本研究共收入患者76例,按照随机数字表法分为2组,其中对照组(38例)予西医治疗,治疗组(38例)在对照组的基础上予金芪清疏方口服治疗,连续7 d。治疗前后对患者中医证候积分(包括咳嗽、气短、乏力、纳呆或食少、胃脘胀满或腹胀、自汗)、炎症指标[包括白细胞计数(WBC)、嗜中性粒细胞计数(NE)、C反应蛋白(CRP),白细胞介素6(IL-6),肿瘤坏死因子α(TNF-α),红细胞沉降率(ESR)]、免疫功能相关指标[包括免疫球蛋白A(IgA)、IgM及T淋巴细胞亚群CD4^(+)、CD4^(+)/CD8^(+)比值]、疗效进行比较。结果2组治疗后中医证候总评分及咳嗽、气短、乏力、纳呆或食少、胃脘胀满或腹胀、自汗各项评分较治疗前均比较降低(P<0.05),其中治疗组治疗后中医证候总分和咳嗽、乏力、自汗评分均低于对照组治疗后(P<0.05);治疗后,治疗组WBC、NE、CRP、TNF-α、ESR、IL-6均较治疗前降低(P<0.05),对照组仅WBC、NE、CRP、ESR、IL-6水平较治疗前降低(P<0.05),其中治疗组治疗后WBC、NE、CRP、ESR、IL-6水平均低于对照组治疗后水平(P<0.05)。治疗组治疗后IgA、IgM、CD4^(+)、CD4^(+)/CD8^(+)水平较治疗前均提高(P<0.05),且均高于对照组治疗后(P<0.05),对照组IgA、IgM、CD4^(+)、CD4^(+)/CD8^(+)水平治疗前后均无明显变化(P>0.05)。治疗组和对照组有效率分别为97.4%和81.6%,治疗组总有效率高于对照组(P<0.05)。结论金芪清疏方联合西医治疗可有效改善CAP患者临床症状,尤其是咳嗽、乏力、自汗症状,降低患者相关炎症指标,提高患者免疫功能及临床疗效。Objective To observe the clinical efficacy of oral administration of Jinqi Qingshu Decotion in community-acquired pneumonia(CAP)with lung spleen-deficiency type.Methods A total of 76 CAP patients were randomized 1:1 to Western medicine(WM,control group)or Jinqi Qingshu Decotion plus WM(treatment group)for 7 days.The traditional Chinese medicine(TCM)syndrome scores(including cough,shortness of breath,fatigue,anorexia or anorexia,epigastric fullness or abdominal distension,spontaneous perspiration),inflammation indicators(including white blood cell count[WBC],neutrophil count[NE],C-reactive protein[CRP],interleukin-6[IL-6],tumor necrosis factor-α[TNF-α],erythrocyte sedimentation rate[ESR]),immune function related indicators(including immunoglobulin A[IgA],IgM and T lymphocyte subsets CD4^(+),CD4^(+)/CD8^(+))were compared.The clinical efficacy was assessed.Results The total scores and dimension scores of TCM syndrome(including cough,shortness of breath,fatigue,anorexia or anorexia,epigastric fullness or abdominal distension,spontaneous perspiration)in the two groups were significantly lower than those before treatment(P<0.05),of which,the total scores and dimension scores of TCM syndrome(cough,fatigue and spontaneous sweating)in the treatment group were significantly decreased compared with those of the control group(P<0.05).The levels of WBC,NE,CRP,TNF-α,ESR and IL-6 of the treatment group decreased significantly compared with those before treatment(P<0.05),except for TNF-α,the remaining indexes were similar in the control group(P<0.05).The levels of WBC,NE,CRP,ESR and IL-6 of the treatment group decreased significantly compared to those of control group(P<0.05).After treatment,the levels of IgA,IgM,CD4^(+)and CD4^(+)/CD8^(+)of the treatment group increased significantly than before treatment(P<0.05),which were significantly higher relative to the control group(P<0.05),the difference in levels of IgA,IgM,CD4^(+)and CD4^(+)/CD8^(+)of the control group was not significant before and after treatment(P>0.05).The ef

关 键 词：金芪清疏方 社区获得性肺炎 肺脾气虚证 临床研究 

分 类 号：R563.1[医药卫生—呼吸系统]