益气养阴清肺化痰对细菌性肺炎机械通气率退热时间及免疫功能的影响

Effects of Supplementing Qi and Nourishing Yin,Clearing Lung and Eliminating Phlegm on Mechanical Ventilation Rate,Time of Abatement of Fever and Immune Function in Patients with Bacterial Pneumonia

目的:观察益气养阴、清肺化痰对细菌性肺炎患者机械通气率、退热时间及免疫功能的影响。方法:选择我院2013年7月至2014年5月收治的106例细菌性肺炎患者为研究对象。经随机数字表法分为观察组与对照组,每组53例。对照组均采取西药抗菌治疗,首先进行左氧氟沙星经验性治疗,后根据细菌培养报告选择合适抗生素,观察组在此基础上增加益气养阴、清肺化痰中药治疗。比较两组机械通气率、退热时间和住院时间,治疗10天后评估两组临床疗效,以流式细胞仪、血常规检查两组治疗前、治疗后10天的血清免疫球蛋白Ig G、Ig A、Ig M含量及白细胞计数(WBC),经实验室检查与临床观察评估两组药物安全性。结果:观察组机械通气率、退热时间及住院时间分别为7.55%、(3.37±0.93)天、(8.46±1.83)天,均显著少于对照组(P<0.05);观察组治疗有效率可达86.79%,显著优于对照组(67.92%)(P<0.05);观察组治疗后Ig G、Ig A、Ig M含量分别为(16.77±3.28)g/L、(3.07±0.83)g/L、(2.14±0.68)g/L,均明显高于对照组(P<0.05),WBC为(8.84±0.93)×109/L,明显低于对照组(P<0.05);观察组仅1例出现恶心症状,经对症治疗后3天内消失,药物安全性良好。结论:以益气养阴、清肺化痰中药方剂治疗细菌性肺炎,可明显降低机械通气率、退热时间,提升机体免疫功能,是值得临床推广的治疗方式。

Objective： To explore the effects of supplementing Qi and nourishing Qin,clearing lung and eliminating phlegm on mechanical ventilation rate,time of abatement of fever and immune function in patients with bacterial pneumonia. Methods：106cases of patients with bacterial pneumonia who were treated in our hospital from July 2013 to May 2014 were selected as study subjects. By random number table method,they were divided into observation group and controlled group,53 cases in each. The controlled group was treated with western medicine as antibiotic therapy. First of all,the empirical treatment of levofloxacin was performed. Then,according to the report of bacterial culture,appropriate antibiotics were chosen. On this basis,the observation group was additionally treated with traditional Chinese medicine for supplementing Qi and nourishing Yin,clearing lung and eliminating phlegm. The mechanical ventilation rate,time of abatement of fever and hospitalization time were compared between the two groups. 10 days after treatment,the clinical curative effects in the two groups were evaluated. The flow cytometry and blood routine were applied to detect the contents of serum immune globulin IgG,IgA,and IgM and white blood cell count（ WBC） in the two groups before treatment and 10 days after treatment. The drug safety was evaluated by laboratory examination and clinical observation. Results： The mechanical ventilation rate,time of abatement of fever and hospitalization time of the observation group[7. 55%,（ 3. 37 ± 0. 93） d,（ 8. 46 ± 1. 83） d]were significantly lower than those of the controlled group（ P〈0. 05）; The effective rate in the observation group（ 86. 79%） was significantly higher than that the controlled group（ 67. 92）（ P〈0. 05）;After treatment,the contents of IgG,IgA and IgM,in the observation group [（ 16. 77 ± 3. 28） g / L,（ 3. 07 ± 0. 83） g / L,（ 2. 14± 0. 68） g / L] were significantly higher than those in the controlled group（ P〈0. 05） while WBC [（ 8. 84 ± 0. 93） × 10^9/ L]was significantly lower than that in controlled group（ P〈0. 05）; in the observation group,there only was 1case with nausea,and it disappeared after 3days of symptomatic treatment. The drug safety is good. Conclusion： To apply traditional Chinese medicine for supplementing Qi and nourishing Yin,clearing lung and eliminating phlegm in the treatment of bacterial pneumonia can significantly reduce mechanical ventilation rate and time of abatement of fever and enhance immune function,which is worthy of clinical promotion.