通腑清热化痰中药治疗重症肺炎疗效及对sICAM-1、RAGE的影响

Effect of Tongfu Qingre Huatan Chinese medicine on severe pneumonia and its effect on sICAM-1 and RAGE

目的探讨通腑清热化痰中药治疗重症肺炎疗效及对血清可溶性细胞间黏附分子-1(sICAM-1)、晚期糖化终产物受体(RAGE)的影响。方法将190例重症肺炎患者随机分为2组,对照组95例给予单纯西医对症治疗,观察组95例在此基础上加用通腑清热化痰中药辅助治疗,统计2组近期疗效,观察2组治疗前后中医证候积分、APACHEⅡ评分、CPIS评分、Marshall评分、动脉血气指标、炎症细胞因子及sICAM-1、RAGE水平变化情况。结果观察组近期总有效率显著高于对照组(P<0.05);治疗后2组发热、咳嗽、痰壅及气促证候积分及APACHEⅡ评分、CPIS评分、Marshall评分均显著低于治疗前(P均<0.05),且观察组各项评分均显著低于对照组(P均<0.05);2组治疗后动脉血气指标水平均显著优于治疗前(P均<0.05),炎症细胞因子、sICAM-1及RAGE水平均显著低于治疗前(P均<0.05),且观察组各指标改善情况均显著优于对照组(P均<0.05)。结论通腑清热化痰中药治疗重症肺炎可有效减轻临床症状,降低机体感染及病情严重程度,改善动脉血气指标,并有助于下调炎症细胞因子、sICAM-1及RAGE水平。

Objective it is to study the effect of Tongfu Qingre Huatan Chinese medicine on severe pneumonia, and on se- rum soluble intercellular adhesion molecule-1 （sICAM-1） and receptor for advanced glycation end products （RAGE）. Meth- ods 190 patients with severe pneumonia were randomly divided into 2 groups, the control group （n = 95 ） were treated only with symptomatic treatment with western medicine, the observation group （n = 95） were treated with adjuvant therapy with Tongfu Qingre Huatan Chinese medicine on the basis of therapy in cotnrol group. The recent curative effect was evaluated, and the changes of scores of TCM syndrome, APACHE II scores, CPIS scored, Marshall scores, levels of arterial blood gas inde- xes, inflammatory cytokines and sICAM-1, RAGE before and after treatment in both groups were observed. Results The recent total effective rate in observation group was significantly higher than that in control group （P 〈 0.05）. After treatment, the scores of TCM syndrome such as fever, cough, expectoration of much phlegm and shortness of breath, and APACHE II scores, CPIS scores, Marshall scores were significantly lower than that before treatment in both groups （ P 〈 0.05 ） , and the scores in observation group were significantly lower than that in control group （ P 〈 0.05 ） ; the levels of arterial blood gas inde- xes were significantly better while the levels of inflammatory eytokine, slCAM - 1 and RAGE were significantly lower than be- fore treatment in both groups（P 〈 0.05 ） , and the improvements of the indexes in observation group were significantly better than that in control group （ P 〈 0.05）. Conclusion Tongfu Qingre Huatan Chinese medicine can effectively relieve clinical symptoms, relieve body infection and illness severity, improve arterial blood gas index, and are helpful for down-regulating the levels of inflammatory cytokine, sICAM 1 and RAGE in the treatment for severe pneumonia.