黄连解毒汤加减治疗老年全身炎症反应综合征的临床研究

Clinical Research on the Treatment of Systematic Inflammatory Response Syndrome in Elderly Patients with Modified Coptidis Decoction for Detoxification

目的:观察黄连解毒汤加减对老年全身炎症反应综合征患者属气分证的临床疗效,并分析对血清主要炎性因子的影响,研究其作用机理。方法:将54例入选病患随机分为观察组和对照组。对照组使用常规抗感染西药,观察组在西药常规给药基础上,加黄连解毒汤治疗。两组均连用14 d,并观察治疗前后临床疗效相关指标及血清主要炎性因子。结果:中医证候疗效总有效率观察组100%,对照组86.21%,两组有显著差异(P<0.01);两组治疗前后SIRS评分均有显著变化(P<0.01),治疗后SIRS评分观察组较对照组有统计学意义的差异(P<0.05)。观察组和对照组治疗前后两组CRP和IL-6均有显著变化(P<0.01),TNF-α和IL-8均有具有统计学意义的变化(P<0.05);对CRP干预程度,两组没有统计学意义的差异(P>0.05);对IL-6和TNF-α的干预,观察组优于对照组(P<0.05);对IL-8的干预作用,观察组明显优于对照组(P<0.01)。结论:黄连解毒汤加减治疗老年全身炎症反应综合征是有效的、安全的,对改善临床症状、促进恢复与好转方面优于单纯的西医治疗;从炎性因子的角度来看,对CRP、IL-6、IL-8和TNF-α的干预是其发挥作用的机理,而且,对IL-6、TNF-α和IL-8的干预优于单纯的西医治疗。

Objective ： To observe the clinical effect on the treatment of the syndrome of Qi Feng Zheng among elderly pa- tients with modified coptidis decoction for detoxification. And to analyze the influence of the main inflammatory factors, and to study its mechanism. Methods： 54 patients were randomly divided into an observation group and a control group. The control group was treated by conventional anti -infective western medicine, and the observation group was treated by modified coptidis decoction on the basis of routine treatment of western medicine. The treatment was used for 14 days. Observe the clinical effect and the main inflammatory factors in serum before and after treatment. Results： The total effective rates of TCM syndromes were 100% in the observation group and 86.21% in the control group, and the difference between two groups was significant （P 〈0.01 ）. The SIRS scores of two groups were significantly changed before and after treatment （P 〈 0.01 ）. After treatment, the SIRS score of the observation group was significantly different from that of the control group （P 〈 0.05 ）. The changes of IL - 6 and CRP in the observation group and control group were observed before and after treatment（P 〈 0.01 ）. The changes of IL - 8 and TNF -α in the observation group and the control group were statistically significant （P 〈 0.05 ）. There was no significant difference between two groups in the intervention of CRP（P 〉 0.05 ）. The intervention of IL- 6 and TNF -α in the observation group was better than that in the control group （P 〈 0.05 ）. The intervention of IL - 8 in the observation, group was significantly better than that in the control group （P 〈 0.01 ）. Conclusion ： It is effective and safe to treat elderly patients with systematic inflammatory response syndrome by modified coptidis decoction for detoxification , which is superior to the western medicine treatment for improving clinical symptoms, promoting recovery and improvement. From the perspective of inflammatory factors, the intervention of IL - 6, IL - 8, CRP and TNF -α is the mechanism of its function, and the intervention of IL - 6, TNF -α and IL - 8 is better than that of western medicine alone.