通腑理肺汤联合西药治疗重症肺炎47例
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摘要
目的:观察通腑理肺汤联合西药治疗重症肺炎的临床效果及对其血清C反应蛋白(hs-CRP)、降钙素原(PCT)的影响。方法:将94例患者随机分为对照组与观察组,每组47例。对照组给予常规西药治疗,观察组在对照组治疗的基础上给予通腑理肺汤治疗,2组持续治疗14天。观察2组临床疗效、临床症状缓解时间、治疗前后中医证候积分及APACHEⅡ评分和血清hs-CRP、PCT水平的变化情况。结果:总有效率对照组为70.21%,观察组为91.49%,2组比较差异有统计学意义(P<0.05)。临床症状缓解时间观察组短于对照组,差异有统计学意义(P<0.05)。中医证候积分、APACHEⅡ评分及血清hs-CRP、PCT水平治疗前后2组组内比较,差异有统计学意义(P<0.05);治疗后2组组间比较差异也有统计学意义(P<0.05)。结论:通腑理肺汤联合西药治疗重症肺炎能够明显降低血清hs-CRP、PCT的水平,缩短病症缓解时间,临床疗效显著。
Objective:To observe clinical effects of TongFu Li Fei decoction combined with Western medicine in treating severe pneumonia and its influence on hs-CRP and procalcitonin(PCT). Methods: A total of 94 patients were randomized into the control group and the observation group, 47 cases each group. The control group accepted conventional therapy of Western medicine, and the observation group were treated by TongFu Li Fei decoction on the foundation of conventional therapy of Western medicine, both groups were treated for 14 days consecutively. To observe the levels of hs-CRP and PCT, APACHE Ⅱ scores, TCM syndrome scores before and after treating, the remission time of clinical symptoms and clinical effects of both groups. Results: Total effective rate of the control group was 70.21%, lower than 91.49% of the observation group, and the difference showed statistical meaning(P<0.05). The observation group was shorter than the control group in the remission time of clinical symptoms, and there was a significant difference(P<0.05). The difference was statistically significant in the comparisons of TCM syndrome scores, APACHEⅡscores and the levels of hs-CRP and PCT within two groups before and after treating(P<0.05); the difference had statistical meaning in the comparisons between both groups after treating(P<0.05).Conclusion: TongFu Li Fei decoction combined with Western medicine in treating severe pneumonia could notably decrease the levels of hs-CRP and PCT, shorten the remission time of clinical symptoms, which could obtain notable effects.
Objective:To observe clinical effects of TongFu Li Fei decoction combined with Western medicine in treating severe pneumonia and its influence on hs-CRP and procalcitonin(PCT). Methods: A total of 94 patients were randomized into the control group and the observation group, 47 cases each group. The control group accepted conventional therapy of Western medicine, and the observation group were treated by TongFu Li Fei decoction on the foundation of conventional therapy of Western medicine, both groups were treated for 14 days consecutively. To observe the levels of hs-CRP and PCT, APACHE Ⅱ scores, TCM syndrome scores before and after treating, the remission time of clinical symptoms and clinical effects of both groups. Results: Total effective rate of the control group was 70.21%, lower than 91.49% of the observation group, and the difference showed statistical meaning(P<0.05). The observation group was shorter than the control group in the remission time of clinical symptoms, and there was a significant difference(P<0.05). The difference was statistically significant in the comparisons of TCM syndrome scores, APACHEⅡscores and the levels of hs-CRP and PCT within two groups before and after treating(P<0.05); the difference had statistical meaning in the comparisons between both groups after treating(P<0.05).Conclusion: TongFu Li Fei decoction combined with Western medicine in treating severe pneumonia could notably decrease the levels of hs-CRP and PCT, shorten the remission time of clinical symptoms, which could obtain notable effects.
引文
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[13]袁荣正,王辉,韩文慧,等.痰热清注射液对重症肺炎患者CRP、PCT、WBC及细胞免疫指标的影响[J].疑难病杂志,2016,15(2):147-149.
[14]邹素昭,李兰,陈立,等.保金立甦汤对重症肺炎患者血清PCT、hs-CRP水平的影响[J].陕西中医,2016,37(6):652-654.
[15]宫成军.《伤寒论》喘证辨证研究[J].辽宁中医药大学学报,2012,14(3):101-103.
[16]李游,田伟盟,武祺,等.中西医结合治疗100例老年重症肺炎的临床疗效分析[J].中华危重病急救医学,2011,23(1):44-45.
[2]许静.关于重症肺炎治疗现状及发展探究[J].医药前沿,2017,7(4):379-380.
[3]吕波,李兰,陈立,等.通腑理肺汤结肠透析联合纤维支气管镜肺泡灌洗对肺炎合并脓毒症患者临床疗效影响[J].贵阳中医学院学报,2017,39(1):48-52.
[4]吕波,陈立,李兰,等.通腑理肺汤结肠透析对肺炎合并脓毒症患者血乳酸水平的影响[J].中国中医急症,2013,22(11):1881-1883.
[5]Mandell LA,Wunderink RG,Anzueto A,et al.Infectious diseases society of America/Ameri can thoracic society consensus guidelines on the management of community-acquired pneumo nia in adults[J].Clin Infect Dis,2007,44(2):27-72.
[6]刘清泉,张晓云,石建华,等.中医急重症学[M].北京:人民卫生出版社,2012:107-110.
[7]郑兴珍.APACHEⅡ评分在临床应用的现状及进展[J].医学综述,2011,17(21):3297-3299.
[8]谢绍华,许鹏,王小华,等.重症肺炎临床特点的初步探讨[J].江西医药,2010,45(12):1203-1205.
[9]卢幼然,丁军颖,刘清泉.重症肺炎免疫失衡机制及中医药治疗研究进展[J].解放军医药杂志,2017,29(4):45-49.
[10]徐建华.肺炎重症化机制的研究进展[J].临床肺科杂志,2012,17(8):1483-1484.
[11]Theodoratou E,Johnson S,Jhass A,et al.The effect of haemophilus influenzae type b and pneumococcal conjugate vaccines on childhood pneumonia incidence,severe morbidity and mortality[J].International Journal of Epidemiology,2010,39(1):172-185.
[12]甘斌,黄业清,罗红伟.重症肺炎患者PCT WBC CRP水平与预后的相关性分析[J].河北医学,2016,22(12):2018-2021.
[13]袁荣正,王辉,韩文慧,等.痰热清注射液对重症肺炎患者CRP、PCT、WBC及细胞免疫指标的影响[J].疑难病杂志,2016,15(2):147-149.
[14]邹素昭,李兰,陈立,等.保金立甦汤对重症肺炎患者血清PCT、hs-CRP水平的影响[J].陕西中医,2016,37(6):652-654.
[15]宫成军.《伤寒论》喘证辨证研究[J].辽宁中医药大学学报,2012,14(3):101-103.
[16]李游,田伟盟,武祺,等.中西医结合治疗100例老年重症肺炎的临床疗效分析[J].中华危重病急救医学,2011,23(1):44-45.