升降散对呼吸机相关性肺炎TLR-4/NF-κB表达的影响

Effect on TLR- 4/NF- κB of Shengjiang Powder in Treating Patients with VAP

目的:观察升降散对VAP患者CPIS评分、降钙素原、TNF-α、TLR-4、NF-κB、中医证候积分的影响及病原菌分布情况。方法:将60例VAP患者随机分为治疗组与对照组,对照组给予常规西药治疗;治疗组同时予升降散鼻饲治疗,疗程为7 d。检测治疗前后CPIS评分、降钙素原、TNF-α、TLR-4、NF-κB、中医证候积分变化,取肺泡灌洗液培养病原菌。结果:治疗第3天、第7天后两组CPIS评分、降钙素原、TNF-α、TLR-4、NF-κB、中医证候积分较治疗前显著变化(P<0.05),治疗组相对对照组数值差异明显(P<0.05);升降散能明显减轻VAP患者喘息、黄白黏痰、发热和伤阴证候,解除热毒内盛证。结论:升降散对呼吸机相关性肺炎毒热内盛证具有显著疗效,可能通过TLR-4/NF-κBTNF-α通路实现。

Objective： To investigate the effect of Shengjiang Powder on the lungs and the clinical efficiency variations on TLR- 4,NF- κB,TNF- α,CPIS,PCTand TCM symptom scores in patients with VAP. Methods： Totally 60 cases were randomly divided into two groups： control group in which 30 cases were treated by routine modality and treatment group in which 30 cases treated by routine modality and Shengjiang Powd. Both of these two groups were rated by TLR- 4,NF- κB,TNF- α,CPIS,PCT and TCM Symptom scores were detected before and after 7- day treatments. Results： After 3- day and 7- day treatments,the TLR-4,NF- κB,TNF- α,CPIS,PCT and TCM Symptom scores changed more in the treatment group than those in the control group.Conclusion： Shengjiang Powder possesses some protective effect on the lungs in patients with VAP.