摘要
目的观察早期应用参附注射液联合注射用炎琥宁治疗老年重症社区获得性肺炎的临床疗效,以及对患者血清炎症指标与凝血状态的影响。方法将94例老年重症社区获得性肺炎患者按随机数字表法分为2组。对照组47例,在常规治疗基础上采用注射用炎琥宁治疗;治疗组47例,在对照组基础上加用参附注射液治疗。2组患者均治疗7 d后统计疗效,比较2组治疗前后炎症指标血清C反应蛋白(CRP)、降钙素原(PCT)、脑钠肽(BNP)、白细胞介素8(IL-8)、IL-10及肿瘤坏死因子-α(TNF-α)水平变化,以及凝血状态活化部分凝血活酶时间(APTT)、血浆D-二聚体(D-D)、血小板计数(PLT)水平变化,并通过观察血栓弹力图(TEG),观察2组反应时间(R值)、凝固时间(K值)、凝血形成速率(α角)及凝血最终强度(MA值)水平变化。结果治疗组总有效率91.49%,对照组总有效率80.85%,治疗组疗效优于对照组(P<0.05);2组治疗后CRP、PCT、BNP、IL-8及TNF-α水平降低,IL-10水平升高,与本组治疗前比较差异均有统计学意义(P<0.05),且治疗组治疗后CRP、PCT、BNP、IL-8、TNF-α及IL-10水平改善均优于对照组(P<0.05);2组治疗后APTT及D-D水平降低,PLT水平升高,与本组治疗前比较差异均有统计学意义(P<0.05),且治疗组治疗后APTT、D-D、PLTI水平改善均优于对照组(P<0.05);2组治疗后TEG图R值及K值水平降低,α角及MA值水平升高,与本组治疗前比较差异均有统计学意义(P<0.05),且治疗组治疗后TEG图R值、K值、α角及MA值水平改善均优于对照组(P<0.05)。结论早期应用参附注射液联合注射用炎琥宁治疗老年重症社区获得性肺炎可明显提高临床疗效,改善患者临床症状,控制感染,通过调节血清炎症指标的变化,减轻炎症反应,促进病情恢复,并且还可以改善患者凝血状态,调节凝血功能相关指标,预防弥散性血管内凝血(DIC)的发生。
Objective To observe the effects of early application of Shenfu injection combined with Yanhuning injection on elderly patients with severe community-acquired pneumonia and its effect on serum related indexes and coagulation related indexes. Methods 94 elderly patients with severe community-acquired pneumonia were divided into two groups according to random number table. 47 cases in the control group were treated by Yanhuning injection on the basis of the conventional treatment,47 cases in the treatment group were treated by Shenfu injection on the basis of the control group. The curative effects were evaluated after treatment 7 d. The level changes of serum C-reactive protein( CRP),procalcitonin( PCT),brain natriuretic peptide( BNP),interleukin8( IL-8),IL-10,and tumor necrosis factor-α( TNF-α),and the level changes of coagulation related indexes including activated partial thromboplastin time( APTT),plasma D-dimer( D-D),platelet( PLT) before and after treatment were compared in two groups. The changes of reaction time( R value),clotting time( K value),angle( α angle) and maximum amplitude( MA value) were observed by hromboelastography in two groups. Results The total effective rate in the treatment group was 91. 49%,and the control group was 80. 85%,and the curative effect in treatment group was superior to that in control group( P <0. 05). The CRP,PCT,BNP,IL-8 and TNF-α after treatment reduced in two groups,and IL-10 increased with statistical differences( P < 0. 05),and the improvements of CRP,PCT,BNP,IL-8,TNF-αand IL-10 in the treatment group were superior to those in the control group( P < 0. 05). The APTT and D-D after treatment reduced in two groups,PLT increased with statistical differences( P < 0. 05),and the improvements of APTT,D-D and PLT in the treatment group were superior to those in the control group( P < 0. 05). The R value and K value of TEG after treatment reduced in two groups,α angle and MA value increased with statistical differences( P < 0. 05),and the improvements of R value,K value,α angle and MA value in the treatment group were superior to those in the control group( P < 0. 05). Conclusion Early application of Shenfu injection combined with Yanhuning injection can significantly improve the clinical efficacy on elderly patients with severe community-acquired pneumonia,improve clinical symptoms,control infection,and it can reduce inflammation reaction and promote the recovery of the disease through regulate the changes serum related indexes,and it can also improve the coagulation status of patients,regulate the related indexes of coagulation function,and prevent the occurrence of diffuse intravascular coagulation( DIC) with the better clinical effects.
出处
《河北中医》
2017年第12期1801-1805,1811,共6页
Hebei Journal of Traditional Chinese Medicine
关键词
肺炎
老年人
中药疗法
中成药
健康状况指标
Pneumonia
Elder
Chinese herbs therapy
External therapy
Chinese patent medicine
Health status indicators
