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中华卫生应急电子杂志 ›› 2021, Vol. 07 ›› Issue (02) : 86 -89. doi: 10.3877/cma.j.issn.2095-9133.2021.02.005

所属专题: 文献

论著

千金苇茎汤配合血必净注射液对重症肺炎患者的临床疗效
赵金荣1, 王明明1, 杨颖1,()   
  1. 1. 215129 江苏苏州,苏州高新区人民医院康复医学科
  • 收稿日期:2020-12-14 出版日期:2021-04-18
  • 通信作者: 杨颖
  • 基金资助:
    苏州市科技局项目(kjxw2015065)

Clinical effect of qianjinweizhang decoction and Xuebijing injection on patients with severe pneumonia

Jinrong Zhao1, Mingming Wang1, Ying Yang1,()   

  1. 1. Department of rehabilitation medicine, People’s Hospital of Suzhou High-tech Zone, Suzhou 215129, China
  • Received:2020-12-14 Published:2021-04-18
  • Corresponding author: Ying Yang
引用本文:

赵金荣, 王明明, 杨颖. 千金苇茎汤配合血必净注射液对重症肺炎患者的临床疗效[J/OL]. 中华卫生应急电子杂志, 2021, 07(02): 86-89.

Jinrong Zhao, Mingming Wang, Ying Yang. Clinical effect of qianjinweizhang decoction and Xuebijing injection on patients with severe pneumonia[J/OL]. Chinese Journal of Hygiene Rescue(Electronic Edition), 2021, 07(02): 86-89.

目的

观察千金苇茎汤配合血必净注射液对重症肺炎(SP)患者的质量效果。

方法

选取苏州市高新区人民医院康复医学科72例SP患者,其中男性38例,女性34例;年龄32~70岁,平均(45.74±7.79)岁。将患者分为血必净组(36例)和综合组(36例)。血必净组在常规干预的基础上采用血必净注射液治疗,综合组在血必净组基础上,进行中药千金苇茎汤加减口服。两组均干预7 d。观察两组治疗前后中医症候积分、C反应蛋白(CRP)和降钙素原(PCT)以及动脉血气分析(PaO2、PaCO2水平)的变化。

结果

两组在治疗前中医症候积分、CRP、PCT相比,差异无统计学意义(P>0.05)。治疗后血必净组中医症候积分由治疗前的(25.83±5.74)分下降到(16.82±4.37)分;CRP由治疗前的(122.75±10.12)mg/L下降到(51.46±6.42)mg/L;PCT由治疗前的(0.58±0.20)ng/mL下降到(0.27±0.12)ng/mL;PaO2水平由治疗前的(44.36±6.21)mmHg升高到(68.61±5.74)mmHg;PaCO2水平由治疗前的(67.89±5.82)mmHg下降到(48.83±4.61)mmHg。综合组中医症候积分由治疗前的(25.27±6.12)分下降到(12.38±4.16)分;CRP由治疗前的(123.74±9.75)mg/L下降到(40.48±5.38)mg/L;PCT由治疗前的(0.59±0.21)ng/mL下降到(0.17±0.09)ng/mL,PaO2水平由治疗前的(45.82±6.64)mmHg升高到(77.63±5.42)mmHg,PaCO2水平由治疗前的(66.73±6.02)mmHg下降到(38.84±4.12)mmHg。治疗后两组中医症候积分、CRP、PCT均低于治疗前(P均<0.05);同时综合组在中医症候积分、CRP、PCT均低于血必净组(P均<0.05)。在动脉血气分析方面,两组在治疗前PaO2、PaCO2水平相比,差异无统计学意义(P>0.05)。治疗后,两组PaO2、PaCO2水平均优于治疗前(P均<0.05);同时综合组在PaO2、PaCO2水平优于血必净组(P均<0.05)。

结论

千金苇茎汤配合血必净注射液治疗重症肺炎患者,能有效降低其炎症水平、提高肺功能状态,改善相关症候,值得进一步推广。

Objective

To observe the clinical effect of Qianjinweijing decoction combined with Xuebijing injection on patients with severe pneumonia (SP).

Methods

Seventy-two patients with SP were enrolled in our hospital, including 38 males and 34 females, aged from 32 to 70 years, with an average age of (45.74±7.79) years. The patients were divided into Xuebijing group (36 cases) and comprehensive group (36 cases). Xuebijing group was treated with Xuebijing Injection on the basis of routine intervention, while comprehensive group was treated with Qianjinweijing Decoction on the basis of Xuebijing group. Both groups were intervened for 7 days. The changes of TCM syndrome score, C-reactive protein (CRP), procalcitonin (PCT) and arterial blood gas(PaO2, PaCO2 levels) were observed before and after treatment.

Results

There was no statistical difference between the two groups in TCM syndrome score, CRP and PCT before treatment (P>0.05). After treatment, the score of TCM symptom in Xuebijing group decreased from (25.83±5.74) to (16.82±4.37), and CRP decreased from (122.75±10.12) mg/L to (51.46±6.42) mg/L, PCT decreased from (0.58±0.20) ng/mL to (0.27±0.12) ng/mL, the level of PaO2 increased from (44.36±6.21) mmHg to (68.61±5.74) mmHg, and the level of PaCO2 decreased from (67.89±5.82) to (48.83±4.61) mmHg before treatment. The scores of TCM symptom in the combined group decreased from (25.27±6.12) to (12.38±4.16) , CRP from (123.74±9.75) mg/L to (40.48±5.38) mg/L, PCT from (0.59±0.21) ng/mL to (0.17±0.09) ng/mL, the level of PaO2 increased from (45.82±6.64) mmHg to (77.63±5.42) mmHg, and the level of PaCO2 decreased from (66.73±6.02) mmHg before treatment to (38.84±4.12) mmHg before treatment. The TCM syndrome score, CRP, and PCT of the two groups were lower than those before treatment, and the differences were statistically significant (P<0.05); meanwhile, the TCM syndrome score, CRP, and PCT of the comprehensive group were lower than those of the Xuebijing group. The differences were also statistically significant (P<0.05). In terms of arterial blood gas analysis, there was no statistical difference in PaO2 and PaCO2 levels between the two groups before treatment (P>0.05). After treatment, the PaO2 and PaCO2 levels of the two groups were better than those before the treatment, and the differences were statistically significant (P<0.05). At the same time, the PaO2 and PaCO2 levels of the comprehensive group were better than those of Xuebijing group, and the differences were statistically significant (P<0.05).

Conclusion

Qianjinweijing Decoction combined with Xuebijing injection to treat severe pneumonia patients can effectively reduce the level of inflammation, improve the state of lung function and related symptoms. It is worthy of further promotion.

表1 两组在中医症候积分、CRP、PCT情况(±s)
表2 两组在动脉血气分析PaO2、PaCO2水平(±s)
1
汤铭阁,葛志军,陆俊杰.重症肺炎治疗进展[J].河北医药,2016,38(8):1247-1249.
2
王敏,闫蕾.白虎承气汤治疗重症肺炎疗效及其作用机制研究[J].陕西中医,2019,40(12):1693-1696.
3
Morgan AJ,Glossop AJ.Severe community-acquired pneumonia[J].Bja Education,2016,16(5):167-172.
4
王庆学,欧阳宇晨,卞尧尧,等.千金苇茎汤对香烟烟雾暴露模型大鼠肺组织Th17/Treg分化及其相关细胞因子表达的影响[J].中国实验方剂学杂志,2020,26(21):28-33.
5
陈建新.千金苇茎汤加减联合左氧氟沙星治疗社区获得性肺炎临床观察[J].光明中医,2020,35(17):2757-2759.
6
许馨,王草心,闫振.血必净注射液对体外循环后患者血清炎症因子水平和呼吸功能的影响[J].中国医师杂志,2020,22(10):1580-1582.
7
恒欣.血必净联合抗生素对肺癌化疗后肺部感染患者的临床疗效及其肺功能的影响[J].中国现代药物应用,2020,14(22):157-159.
8
中国医师协会急诊医师分会,中国急性感染联盟. 2015年中国急诊社区获得性肺炎临床实践指南[J].中华急诊医学杂志,2015,24(12):1324-1344.
9
国家中医药管理局.中医病证诊断疗效标准[M].南京:南京大学出版社,1994:3-4.
10
刘昶.振动排痰联合纤支镜肺泡灌洗治疗ICU重症肺炎患者的临床效果分析[J].黑龙江医药,2020,33(5):1124-1126.
11
王勤,张小方,张爱娥,等.医用磁贴联合通腑泻肺方治疗重症肺炎合并胃肠功能障碍临床研究[J].陕西中医,2019,40(2):264-266.
12
魏世雄,黄宜谋.血必净注射液在重症肺炎治疗中的作用探讨[J].中国处方药,2020,18(7):122-123.
13
丁琼蕾,李庆敏,李春阳.清肺保元汤联合血必净治疗重症肺炎疗效及对炎症反应的影响[J].现代中西医结合杂志,2020,29(25):2811-2814.
14
曹秋彩,靳楠楠.血必净佐治老年人重症肺炎伴呼吸衰竭的临床效果[J].深圳中西医结合杂志,2020,30(21):90-92.
15
孙忠华,徐驰,王越,等.血必净注射液辅助西医常规方法治疗重症社区获得性肺炎的meta分析[J].临床荟萃,2020,35(10):869-875.
16
杨蕙文,石峰,喻秋平,等.血必净对老年重症肺炎患者血清sTREM-1水平及CPIS评分的影响[J].江西医药,2020,55(8):1008-1011,1041.
17
陈亮,卓越,曾宗鼎,等.血必净注射液联合盐酸氨溴索治疗对老年重症肺炎患者免疫功能和炎性因子的影响[J].中国中医急症,2019,28(8):1411-1413.
18
吴超.加味千金苇茎汤对重症肺炎患者治疗效果的影响[J].实用中西医结合临床,2020,20(7):65-67.
19
任牧,王飞燕.千金苇茎汤联合莫西沙星及盐酸氨溴索治疗老年性肺炎的疗效及对患者IL-6、IL-10、TNF-α和生活质量的影响[J].海南医学,2020,31(3):309-312.
20
付强恒,杨洪静,谢娟,等.千金苇茎汤加减治疗重症肺炎患者的临床疗效及其部分机制[J].世界中医药,2019,14(7):1738-1742.
21
林桂仪,张莹.千金苇茎汤加味联合西医治疗对接受机械通气的重症肺炎患者呼吸力学、Th17与Treg细胞因子失衡及动脉血气分析指标的影响[J].河北中医,2018,40(4):520-526.
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