痰热清治疗慢性阻塞性肺疾病患者肺部感染疗效及对肺表面活性蛋白与克拉氏细胞蛋白的影响

Curative effect of Tanreqing on pulmonary infections in patients with chronic obstructive pulmonary disease and influence on lung surfactant protein and Clara cell protein

目的探讨痰热清治疗慢性阻塞性肺疾病(COPD)患者肺部感染的疗效及对肺表面活性物质蛋白D(Surfactant protein D,SP-D)、克拉氏细胞蛋白16(Clara cell protein,CC16)水平的影响,以降低COPD肺部感染。方法选择2011年1月-2013年12月COPD肺部感染患者130例为研究对象,按照随机数字表法分为观察组和对照组各65例,对照组给予沙美特罗替卡松粉剂治疗,观察组在对照组基础上加以痰热清注射液治疗,统计两组患者治疗前后心率、呼吸频率、血氧分压(PaO2)、二氧化碳分压(PaCO2)、FEV1%预计值、FEV1/FVC及血清SP-D、CCl6等各项指标含量。结果治疗后24h、48h观察组心率、呼吸频率、PaO2及PaCO2改善率均高于对照组,差异有统计学意义(P<0.05);治疗后观察组肺功能较治疗前明显改善,差异有统计学意义(P<0.05);治疗后观察组血清SP-D、CC16水平均较治疗前降低,差异有统计学意义(P<0.05)。结论痰热清联合西医治疗COPD肺部感染,可有效改善患者临床症状、血气指标及肺功能,降低外周血SP-D、CC16水平。

OBJECTIVE To explore the efficacy of Tanreqing in treatment of pulmonary infections in the patients with chronic obstructive pulmonary disease （COPD） and the influence on the levels of lung surfactant protein D （SP-D） and Clara cell protein 16 （CC16） so as to reduce the incidence of pulmonary infections in the COPD pa-tients .METHODS A total of 130 COPD patients complicated with pulmonary infections who were treated from Jan 2011 to Dec 2013 were recruited as the study objects and randomly divided into the observation group and the con-trol group ,with 65 cases in each ;the control group was treated with salmeterol and fluticasone propionate pow -der ,while the observation group was given the additional Tanreqing injection on the basis of the control group . The heart rate ,breathing rate ,partial pressure of arterial oxygen （PaO2 ） ,partial pressure of arterial carbon diox -ide （PaCO2 ） ,FEV1% predictive value ,FEV1/FVC ,and the levels of serum SP-D and CC16 were observed and statistically analyzed before and after the treatment .RESULTS At 24h or 48h of treatment ,the rates of improve-ment of the heart rate ,breathing rate ,PaO2 ,and PaCO2 of the observation group were higher than those of the control group ,there was significant difference （P〈 0 .05） .The lung function of the observation group was signifi-cantly improved after the treatment as compared with that before the treatment ,there was significant difference （P〈 0 .05） .The levels of serum SP-D and CC16 of the observation group were remarkably lower after the treat-ment than before the treatment ,there was significant difference （P〈 0 .05） .CONCLUSION As for the treatment of the COPD patients with pulmonary infections ,Tanreqing combined with western drug therapy can effectively im -prove the clinical symptoms ,blood gas indicators ,and lung function so as to reduce the levels of SP-D and CC16 in peripheral blood .