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

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

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(PaO_(2)、PaCO_(2)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;PaO_(2)水平由治疗前的(44.36±6.21)mmHg升高到(68.61±5.74)mmHg;PaCO_(2)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,PaO_(2)水平由治疗前的(45.82±6.64)mmHg升高到(77.63±5.42)mmHg,PaCO_(2)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PaO_(2)、PaCO_(2)水平相比,差异无统计学意义(P>0.05)。治疗后,两组PaO_(2)、PaCO_(2)水平均优于治疗前(P均<0.05);同时综合组在PaO_(2)、PaCO_(2)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(PaO_(2),PaCO_(2)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 PaO_(2)increased from(44.36±6.21)mmHg to(68.61±5.74)mmHg,and the level of PaCO_(2)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 PaO_(2)increased from(45.82±6.64)mmHg to(77.63±5.42)mmHg,and the level of PaCO_(2)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 PaO_(2)and PaCO_(2)levels between the two groups before treatment(P>0.05).After treatment,the PaO_(2)and PaCO_(2)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 PaO_(2)and PaCO_(2)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.