痰热清注射液治疗慢阻肺急性发作及对C反应蛋白、肿瘤坏死因子-α、降钙素原的影响

Tanreqing injection in treatment of acute exacerbation of chronic obstructive pulmonary disease and effects on C-reactive protein,tumor necrosis factor-α and procalcitonin

目的：观察并探讨慢阻肺急性发作（AECOPD）常规治疗基础上联合使用痰热清注射液的临床疗效及对C反应蛋白（CRP）、肿瘤坏死因子-α（TNF-α）、降钙素原（PCT）的影响。方法：123例AECOPD患者随机分为观察组（n=64）和对照组（n=59）,对照组患者给予常规治疗,观察组在对照组治疗方案基础上联合使用痰热清注射液,每次20 m L,每日1次,疗程10-14 d,治疗2周后,复查肺功能,采血测定CRP、TNF-α、PCT水平,判定并对比两组临床疗效。结果：治疗2周,观察组治疗后FVC（2.68±0.51）L、FEV1（1.96±0.58）L、FEV1/FVC（70.8±7.1）%均显著高于对照组（2.49±0.45）L、（1.76±0.52）L、（67.5±6.7）%（P〈0.05）;观察组外周血TNF-α（28.5±5.4）pg/m L、CRP（5.3±1.6）mg/L、PCT（132.4±25.5）pg/m L浓度均显著低于对照组（36.2±7.1）pg/m L、（8.1±2.5）mg/L、（160.5±30.4）pg/m L（P〈0.05）。观察组改有创通气比例（23.4%）显著低于对照组（42.4%）（χ2=5.016,P=0.025）。治疗后两组临床疗效总体构成无显著性差异（Z=-1.397,P=0.163）,观察组总有效率（92.2%）高于对照组（84.7%）（χ2=1.686,P=0.194）。结论：痰热清注射液辅助治疗AECOPD能显著减轻全身炎性反应,改善肺功能,有助于增强临床疗效。

Objective： To observe and explore the efficacy of Tanreqing injection in treatment of acute exacerbation of chronic obstructive pulmonary disease（ AECOPD） based on conventional treatment and its effects on C-reactive protein（ CRP）,tumor necrosis factor-α（ TNF-α）,procalcitonin（ PCT）. Methods： 123 AECOPD patients were divided into observation group（ 64 cases） and control group（ 59 cases）,control group was given conventional treatment,observation group was combined with Tanreqing injection based on the control group,daily for 20 m L per time,treatment for 10 to 14 d,after 2 weeks of treatment,pulmonary function was measured,blood samples were collected to determine the level of CRP,TNF-α,PCT,and the clinical efficacies of two groups were compared. Results： 2weeks after treatment,the FVC（ 2. 68 ± 0. 51） L、FEV1（ 1. 96 ± 0. 58） L、FEV1/ FVC（ 70. 8 ± 7. 1） % of observation group were all higher than the control group（ 2. 49 ± 0. 45） L,（ 1. 76 ± 0. 52） L,（ 67. 5 ± 6. 7） %（ P〈0. 05）. The concentration of peripheral blood in observation group TNF-α（ 28. 5 ± 5. 4） pg / m L,CRP（ 5. 3 ± 1. 6） mg / L,PCT（ 132. 4 ± 25. 5） pg / m L were significantly lower than those of the control group（ 36. 2 ± 7. 1） pg / m L,（ 8. 1 ± 2. 5） mg / L,（ 160. 5 ± 30. 4） pg / m L（ P〈0. 05）. The observation group with invasive ventilation ratio（ 23. 4%） was significantly lower than control group（ 42. 4%）（ χ2= 5. 016,P = 0. 025）. After treatment,clinical efficacy composition of 2 groups without significant difference（ Z =- 1. 397,P = 0. 163）,the total efficiency（ 92. 2%） was higher than control group（ 84. 7%）（ χ2= 1. 686,P = 0. 194）. Conclusion： Based on conventional treatment,Tanreqing injection combined with treatment of AECOPD can significantly reduce systemic inflammatory response,improve lung function,and further improve the clinical efficacy.