摘要
目的探讨升降散保留灌肠辅助治疗痰热壅肺型呼吸机相关性肺炎对患者中医证候积分、疗效及相关炎症因子水平的影响。方法选取痰热壅肺型呼吸机相关性肺炎患者62例作为研究对象,按照随机数字表法分为对照组和治疗组,对照组采用常规治疗方法,治疗组在对照组治疗基础上加用保留灌肠中药汤剂升降散,观察并比较2组患者的降钙素原(PCT)、C反应蛋白(CRP)、白介素-1β(IL-1β)、白介素-2R(IL-2R)、肿瘤坏死因子-α(TNF-α)、白介素-8(IL-8)、白介素-6(IL-6)、白介素-10(IL-10)水平和中医证候积分、疗效。结果治疗后,2组患者CRP、PCT、IL-1β、IL-2R、TNF-α、IL-6、IL-8水平均低于治疗前,IL-10水平高于治疗前,且治疗组CRP、PCT、IL-1β、IL-2R、TNF-α、IL-6、IL-8水平低于对照组,IL-10水平高于对照组,差异均有统计学意义(P<0.05或P<0.01);治疗后,2组患者中医证候积分均低于治疗前,且治疗组患者治疗后的中医证候积分低于对照组患者,差异均有统计学意义(P<0.05);治疗组的治疗有效率高于对照组,差异有统计学意义(P<0.05);治疗组患者未出现严重不良反应。结论升降散保留灌肠法联合西医治疗能降低痰热壅肺型呼吸机相关性肺炎患者CRP、PCT、IL-1β、IL-2R、TNF-α、IL-6、IL-8水平,升高IL-10水平,并降低中医证候评分,提高疗效。
Objective To explore effect of retention enema by Shengjiang Powder in treating ventilator-associated pneumonia differentiated as phlegm-heat congesting in lungs on TCM syndrome scores,curative effect and related inflammatory factors.Methods A total of 62 patients with ventilator-associated pneumonia differentiated as phlegm-heat congesting in lungs were divided into control group and treatment group according to random number table method.The control group was given conventional treatment method,and the treatment group was treated with retention enema by Shengjiang Powder Decoction of traditional Chinese medicine.The levels of procalcitonin(PCT),C reactive protein(CRP),interleukin-1β(IL-1β),interleukin-2R(IL-2R),tumor necrosis factor-α(TNF-α),interleukin-8(IL-8),interleukin-6(IL-6),interleukin-10(IL-10)as well as TCM syndrome scores and efficacy in the two groups were observed and compared.Results After treatment,CRP,PCT,IL-1β,IL-2R,TNF-α,IL-6,IL-8 were lower than before treatment,and IL-10 was higher than before treatment(P<0.05),and treatment group changed more significantly than that in the control group(P<0.05 or P<0.01).After treatment,the scores of TCM syndromes in the two groups were lower than before treatment(P<0.05),and the treatment group was lower than that in the control group(P<0.05).The effective rate of the treatment group was higher than that of the control group(P<0.05).No serious adverse reactions occurred in the treatment group.Conclusion Retention enema combined with western medicine can reduce the levels of RP,PCT,IL-1β,IL-2R,TNF-α,IL-6 and IL-8,increase the level of IL-10,reduce the TCM syndrome integral and improve the curative effect.
作者
顾雯艳
王蠡
马彩毓
丁纯蕾
钱风华
赵雷
GU Wenyan;WANG Li;MA Caiyu;DING Chunlei;QIAN Fenghua;ZHAO Lei(Department of Emergency Medicine,Yueyang Hospital of Integrated Traditional Chinese and Western Medicine Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai,200437;Surgical Department,Shanghai Yongci Rehabilitation Hospital,Shanghai,200437)
出处
《实用临床医药杂志》
CAS
2020年第1期69-72,77,共5页
Journal of Clinical Medicine in Practice
基金
上海市卫生和计划生育委员会中管局[2016]中医特色诊疗能力提升项目(TSJS2016025)
关键词
升降散
呼吸机相关性肺炎
痰热蕴肺证
中医证候
炎症机制
保留灌肠
Shengjiang Powder
ventilator-associated pneumonia
phlegm-heat congesting in lungs syndrome
traditional Chinese medicine syndrome
inflammatory mechanism
retention enema
