益气活血化痰法对老年心力衰竭合并肺部感染GDF-15及sTREM-1的影响

Effects of Qi-Boosting Blood-Quickening Phlegm-dispersing Therapy for Elderly Heart Failure Complicated With Pulmonary Infection

目的:观察益气活血化痰法对老年心力衰竭合并肺部感染患者的GDF-15及sTREM-1的影响。方法:66例诊断为老年心力衰竭合并肺部感染气虚血瘀痰阻型的患者,随机分为治疗组33例,对照组33例。两组均给予常规西医治疗,治疗组在此基础上加用参麦注射液、丹参酮ⅡA磺酸钠注射液入液静滴,咳喘平口服,两组疗程均为7 d。两组分别于治疗前及治疗7 d进行急性生理学与慢性健康状况评分系统(APACHEⅡ)评分、临床肺部感染评分(CPIS),比较两组患者血清生长分化因子-15(GDF-15)、可溶性髓样细胞触发受体-1(sTREM-1)、B型钠尿肽(BNP)和超敏C反应蛋白(hs-CRP)的变化及临床疗效。结果:治疗7 d后,治疗组和对照组APACHE-Ⅱ分值和CPIS分值及GDF-15、BNP、sTREM-1、hs-CRP水平均改善(P<0.05),治疗组改善更为明显(P<0.05);治疗组有效率为90.9%,对照组有效率66.7%,两组比较有统计学差异(P<0.05)。结论:益气活血化痰法治疗老年心力衰竭合并肺部感染,可抑制炎症因子,调节神经内分泌,改善机体整体状况,有更好的治疗效果。

Objective ： To observe the clinical therapeutic effects of qi-boosting blood-quickening phlegm-dispersing therapy on growth differenliation fact0r-15 （ GDF-15 ）and soluble triggering receptor expressed on myeloid cell-1 （ sTREM-1 ）. Methods： 66 patients were randomly divided into the treatment group （ n=33 ） and the control group （ n=33 ） .The general therapy of the two groups was the same, the treatment group received Shenmai injection, Sodium Tanshinone I] Asilate injection and Kec.huanpin granules on the basis of the general therapy.Course of treatment was 7 days.Before and seven days after treatment, two groups were estimated separately on traditional Chinese medical scores and acute physinlogy and chronic health evaluation Ⅱ （ APACHE- Ⅱ ）and clinical pulmonary infection score （ CPIS ）, the changes of serum GDF-15, sTREM-1 , BNP, scores, CPIS scores and the serum GDF-15, sTItEM-1 , BNP, hs-CRP levels in both groups after treatment were improved obviously （ P〈0.05 ）, the treatment group was more apparent （ P〈0.05 ） .The efficiency was 90.9%？ in the treatment group and the control group was 66.7%, the two groups had a significant difference （P〈0.05 ）. Conclusion ： The qi-boosting blood-quickening phlegm-dispersing method has a better therapeutic effect by inhibiting inflammatory eytokines, regulating neuroendocrine and improving the overall condition of the body.