疏风润肺健脾法对老年肺部感染后咳嗽患者的疗效及机制研究
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摘要
目的探讨疏风润肺健脾法对老年肺部感染后咳嗽患者的疗效及机制。方法选取2016年5月—2018年3月衢州市中医医院收治的老年肺部感染后咳嗽患者86例,采用随机数字表法将其分为2组,每组43例,对照组应用常规抗炎治疗,研究组在对照组基础上使用疏风润肺健脾汤治疗,分析2组患者的治疗效果、炎症反应改善情况、临床症状改善情况,并记录2组患者不良反应发生率。结果研究组治疗有效率为88.4%,对照组治疗有效率为69.8%,研究组疗效优于对照组(P<0.05);研究组IL-6(45.1±4.5)ng/L、hs-CRP(3.2±0.5)mg/L、TNF-α(62.1±4.5)ng/L明显低于对照组的IL-6(73.4±7.1)ng/L、hs-CRP(8.4±1.5)mg/L、TNF-α(96.1±4.6)ng/L(均P<0.05);研究组症状积分分别为咳嗽(0.3±0.3)分、咯痰(0.3±0.1)分、喉痒(0.2±0.2)分,对照组症状积分分别为咳嗽(1.7±0.8)分、咯痰(1.4±0.6)分、喉痒(1.1±0.3)分,研究组症状积分均明显低于对照组(均P<0.05);研究组不良反应发生率为4.7%,对照组为4.7%,2组差异无统计学意义(P>0.05)。结论疏风润肺健脾法中诸药合用可以清除患者体内自由基,调节肺部血运,有效缓解患者体内炎症反应,降低炎性因子浓度,降低患者临床症状积分,具有较高的安全性。
Objective To explore the efficacy observation and mechanism of the ventilation, nourishing lung and strengthening spleen method(Shufeng Runfei Jianpi Decoction) in elderly patients with pulmonary infection. Methods A total of 86 elderly patients with pulmonary infection who were treated in our hospital from May 2016 to March 2018 were selected and randomly divided into two groups according to the number table method. The control group was treated with conventional drug therapy, on the basis of which the research group was treated with ventilation, nourishing lung and strengthening spleen. The treatment effect, inflammatory response degree improvement, clinical symptoms improvement and the incidence of adverse reactions were analyzed. Results The effective rate of the study group was 88.4%, and that of the control group was 69.8%. The curative effect of the study group was better than that of the control group(P<0.05); the study group had IL-6(45.1±4.5)ng/L, Hs-CRP(3.2±0.5)mg/L, TNF-α(62.1±4.5)ng/L, the control group had IL-6(73.4±7.1)ng/L, Hs-CRP(8.4±1.5)mg/L, TNF-α(96.1±4.6)ng/L, and the study group had significantly lower curative effect(P<0.05). In the control group, symptoms score cough(0.3±0.3),expectoration(0.3±0.1), laryngeal itching(0.2±0.2), symptoms score cough(1.7±0.8), expectoration(1.4±0.6), laryngeal itching(1.1±0.3) in the study group were significantly lower than those in the control group(P<0.05). The incidence of adverse reactions was 4.7% in the study group and control group respectively. There was no significant difference between the study group and the control group(P>0.05). Conclusion Shufeng Runfei Jianpi Decoction is effective in alleviating inflammation, reducing the concentration of inflammatory factors and the score of clinical symptoms in elderly patients with cough after pulmonary infection. It is safe and should be further popularized in clinic.
Objective To explore the efficacy observation and mechanism of the ventilation, nourishing lung and strengthening spleen method(Shufeng Runfei Jianpi Decoction) in elderly patients with pulmonary infection. Methods A total of 86 elderly patients with pulmonary infection who were treated in our hospital from May 2016 to March 2018 were selected and randomly divided into two groups according to the number table method. The control group was treated with conventional drug therapy, on the basis of which the research group was treated with ventilation, nourishing lung and strengthening spleen. The treatment effect, inflammatory response degree improvement, clinical symptoms improvement and the incidence of adverse reactions were analyzed. Results The effective rate of the study group was 88.4%, and that of the control group was 69.8%. The curative effect of the study group was better than that of the control group(P<0.05); the study group had IL-6(45.1±4.5)ng/L, Hs-CRP(3.2±0.5)mg/L, TNF-α(62.1±4.5)ng/L, the control group had IL-6(73.4±7.1)ng/L, Hs-CRP(8.4±1.5)mg/L, TNF-α(96.1±4.6)ng/L, and the study group had significantly lower curative effect(P<0.05). In the control group, symptoms score cough(0.3±0.3),expectoration(0.3±0.1), laryngeal itching(0.2±0.2), symptoms score cough(1.7±0.8), expectoration(1.4±0.6), laryngeal itching(1.1±0.3) in the study group were significantly lower than those in the control group(P<0.05). The incidence of adverse reactions was 4.7% in the study group and control group respectively. There was no significant difference between the study group and the control group(P>0.05). Conclusion Shufeng Runfei Jianpi Decoction is effective in alleviating inflammation, reducing the concentration of inflammatory factors and the score of clinical symptoms in elderly patients with cough after pulmonary infection. It is safe and should be further popularized in clinic.
引文
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[15] 冯勤丽,姚明,张小平,等.中医护理干预慢性肾衰竭合并肺部感染患者的疗效观察[J].中华全科医学,2017,15(10):1795-1797.
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[17] 安玉英,张风林,角灿武,等.阿奇霉素联合头孢噻肟钠对肺部感染患者炎性状态的控制效果观察[J].中华医院感染学杂志,2017,27(1):95-97.
[18] CRAMER E P,DAHL S L,ROZELL B,et al.Lipocalin-2 from both myeloid cells and epithelium combats Klebsiella pneumoniae lung infection in mice[J].Blood,2017,129(20):2813-2817.
[19] 徐华燕,韩春赓,谢江文,等.氧气雾化吸入对球麻痹伴肺部感染患者的临床疗效研究[J].中华医院感染学杂志,2016,26(18):4138-4140.
[20] 刘素品,段玉龙,张军,等.肺部感染患者纤维支气管镜与常规取痰法对痰液检测结果影响的研究[J].中华医院感染学杂志,2016,26(9):1973-1975.
[2] 郑育秀,徐志新,吕淞,等.不同麻醉方法对下肢骨科手术老年患者术后肺部感染的影响研究[J].中华医院感染学杂志,2017,27(22):5186-5188.
[3] 张立芳,张爱芳,单茜,等.六西格玛管理对老年住院患者肺部感染的预防研究[J].中华医院感染学杂志,2016,26(2):455-457.
[4] ELBORN J S,VATAIRE A L,FUKUSHIMA A,et al.Comparison of inhaled antibiotics for the treatment of chronic pseudomonas aeruginosa lung infection in patients with cystic fibrosis:systematic literature review and network meta-analysis[J].Clin Ther,2016,38(10):2204-2226.
[5] 李秀萍,郑湘毅.背心式高频振动排痰与机械振动排痰对老年肺部感染患者的效果观察[J].中国呼吸与危重监护杂志,2017,16(3):241-244.
[6] 陈园桃.中医病症诊疗常规[M].南京:东南大学出版社,2008.
[7] 姜攀,万文华,孙倩,等.不同麻醉方式对老年下肢骨折患者术后肺部感染发生率的影响[J].中华医院感染学杂志,2017,27(19):4472-4475.
[8] 王巍,鹿翠香,何平,等.纤维支气管镜吸痰辅助治疗对重症肺部感染患者的疗效及炎症标志物水平的影响分析[J].中华医院感染学杂志,2017,27(22):5083-5086.
[9] 李勇,付曦,李林,等.抗菌药物联合痰热清注射液治疗肺癌患者化疗后继发肺部感染的临床疗效研究[J].中华医院感染学杂志,2017,27(24):5576-5579.
[10] 张德文,任大为,史燎原,等.不同麻醉方式对腹部手术患者效果观察及对术后肺部感染影响研究[J].中华医院感染学杂志,2017,27(23):5422-5424,5428.
[11] 马敬,岳凌峰,王宁,等.老年精神分裂症患者肺部感染游离氨基酸及一氧化氮与5羟色胺和总抗氧化能力的变化研究[J].中华医院感染学杂志,2016,26(12):2694-2696.
[12] PANG Z,JUNKINS R D,MACNEIL A J,et al.The calcineurin㎞FAT axis contributes to host defense during Pseudomonas aeruginosa lung infection[J].J Leukoc Biol,2017,102(6):1461-1469.
[13] 杨兆辉,段瑞祥,杨晶,等.纤维支气管镜与肺泡灌洗术治疗老年重症肺部感染患者的疗效分析[J].中华医院感染学杂志,2016,26(6):1300-1302.
[14] 马利中,董玲婉,朱靖,等.老年脑卒中患者肺部感染、深静脉血栓发生率及相关性研究[J].中华全科医学,2016,14(12):2034-2036.
[15] 冯勤丽,姚明,张小平,等.中医护理干预慢性肾衰竭合并肺部感染患者的疗效观察[J].中华全科医学,2017,15(10):1795-1797.
[16] ROUSSEY J A,VIGLIANTI S P,TEITZ-TENNENBAUM S,et al.Anti-PD-1 Antibody Treatment Promotes Clearance of Persistent Cryptococcal Lung Infection in Mice[J].J Immunol,2017,199(10):3535-3546.
[17] 安玉英,张风林,角灿武,等.阿奇霉素联合头孢噻肟钠对肺部感染患者炎性状态的控制效果观察[J].中华医院感染学杂志,2017,27(1):95-97.
[18] CRAMER E P,DAHL S L,ROZELL B,et al.Lipocalin-2 from both myeloid cells and epithelium combats Klebsiella pneumoniae lung infection in mice[J].Blood,2017,129(20):2813-2817.
[19] 徐华燕,韩春赓,谢江文,等.氧气雾化吸入对球麻痹伴肺部感染患者的临床疗效研究[J].中华医院感染学杂志,2016,26(18):4138-4140.
[20] 刘素品,段玉龙,张军,等.肺部感染患者纤维支气管镜与常规取痰法对痰液检测结果影响的研究[J].中华医院感染学杂志,2016,26(9):1973-1975.