摘要
目的观察芪归颗粒联合常规西药治疗重症肺炎合并呼吸衰竭的临床疗效。方法选取2018年1月—2021年1月期间北京中医医院顺义医院收治的重症肺炎合并呼吸衰竭患者100例,采用随机数字表法分为对照组和治疗组,每组各50例。对照组采用常规西医治疗,在此基础上治疗组采用芪归颗粒治疗。治疗2周后,观察比较治疗前后两组患者主要症状(发热、咳嗽、胸闷、痰量、便秘)评分、肺功能及血气分析指标[第1秒用力呼气容积(First second forced expiratory volume,FEV)、FEV占用力肺活量百分比(First second forced expiratory volume/forced vital capacity,FEV/FVC)、FEV占预计值百分比(First second forced expiratory volume%,FEV%)]。采用血气分析仪测定动脉血气指标[氧分压(Oxygen partial pressure,PaO),二氧化碳分压(Carbon dioxide partial pressure,PaCO)]、血清炎症介质[高迁移率族蛋白BI(High mobility group protein BI,HMGB-1),可溶性髓系细胞触发受体-I(soluble myeloid cell trigger receptor-I,sTREM-1)]的变化,并观察两组患者肺部炎症吸收情况。结果治疗后两组患者发热、胸闷、咳嗽、痰量、便秘的症状评分均较治疗前明显降低,差异有统计学意义(P<0.05);且治疗组发热、胸闷、咳嗽、痰量、便秘的症状评分均较对照组明显降低,差异有统计学意义(P<0.05)。治疗后两组患者FEV、FEV/FVC、FEV%及PaO指标与治疗前比较明显升高,PaCO与治疗前比较明显降低,差异有统计学意义(P<0.05);且治疗组FEV、FEV/FVC、FEV%及PaO与对照组比较明显升高,PaCO与对照组比较明显减少,差异有统计学意义(P<0.05)。治疗后两组患者sTREM-1及HMGB-1水平与治疗前比较明显降低,差异有统计学意义(P<0.05);且治疗组血清sTREM-1及HMGB-1水平与对照组比较明显降低,差异有统计学意义(P<0.05)。治疗后治疗组肺部炎症总吸收率96.00%(48/50)与对照组84.00%(42/50)比较明显升高,差异有统计学意义(P<0.05)。结论芪归颗粒能明显改善SP合并RF患者临床症状及肺功能,减轻炎症反应,缩小病灶面积,值得临床推广使用。
Objective To observe the clinical efficacy of Qigui Granules combined with conventional western medicine in the treatment of severe pneumonia complicated with respiratory failure.Methods A total of 100 patients with severe pneumonia complicated with respiratory failure treated in Shunyi Hospital of Beijing Hospital of Traditional Chinese Medicine from January 2018 to January 2021 were enrolled and randomly divided into a control group and a treatment group according to a random number table,with 50 cases in each group.All patients were treated with conventional western medicine,while those in the treatment group received additional Qigui Granules.After two weeks of treatment,the scores of main symptoms(fever,cough,chest tightness,sputum volume,and constipation),and lung function and blood gas analysis indexes[first second forced expiratory volume(FEV),FEV/forced vital capacity(FEV/FVC),and FEV/predicted value(FEV%)]were observed and compared before and after treatment.The changes in arterial blood gas indexes[oxygen partial pressure(PaO)andcarbon dioxide partial pressure(PACO)]and serum inflammatory mediators[high mobility group protein BI(HMB-1)and soluble myeloid cell trigger receptor-I(STREM-1)]were measured using a blood-gasanalyzer.The absorption of lung inflammation in two groups was observed.Results After treatment,the symptom scores of fever,chest tightness,cough,sputum volume,and constipation in the two groups decreased as compared with those before treatment(P<0.05),and the treatment group was lower than the control group(P<0.05).After treatment,FEV,FEV/FVC,FEV%,and PaOof the two groups were higher than those before treatment,while PACOwas lower than that before treatment(P<0.05).Compared with the control group,FEV,FEV/FVC,FEV%,and PaOin the treatment group increased,while PACOdecreased(P<0.05).After treatment,the levels of STREM-1 and HMGB-1 in the two groups decreased(P<0.05).Compared with the control group,the levels of serum STREM-1 and HMGB-1 in the treatment group were reduced(P<0.05).The total absorption rate of pulmonary inflammation in the treatment group was 96.00%(48/50),higher than 84.00%(42/50)in the control group(P<0.05).Conclusion Qigui Granules can significantly improve the clinical symptoms and lung function of severe pneumonia patients with respiratory failure,relieve the inflammatory reaction,and reduce the area of lesions,which is worthy of clinical application.
作者
肖加斌
肖阳春
刘媛
XIAO Jia-bin;XIAO Yang-chun;LIU Yuan(Department of Emergency,Shunyi Hospital,Beijing Hospital of Traditional Chinese Medicine,Beijing 101300;Department of Geriatrics,Shunyi Hospital,Beijing Hospital of Traditional Chinese Medicine,Beijing 101300)
出处
《世界中西医结合杂志》
2022年第7期1368-1371,1375,共5页
World Journal of Integrated Traditional and Western Medicine
基金
北京市科技计划课题(Z181100001718146)。
关键词
芪归颗粒
重症肺炎
呼吸衰竭
炎症
肺功能
Qigui Granules
Severe Pneumonia
Respiratory Failure
Inflammation
Lung Function
