痰热清注射液联合胸腺肽对卒中相关性肺炎患者炎症因子及神经功能的影响

Effects of Tanreqing injection combined with thymosin on inflammatory factors and neurological function in patients with stroke associated pneumonia

目的观察痰热清注射液联合胸腺肽对卒中相关性肺炎患者炎症因子及神经功能的影响。方法将90例卒中相关性肺炎患者随机分为2组,对照组45例采用痰热清注射液治疗,治疗组45例采用痰热清注射液联合胸腺肽治疗,2组均治疗10 d。比较2组治疗前后炎症相关因子[C反应蛋白(CRP)、白细胞介素6(IL-6)、肿瘤坏死因子α(TNF-α)]及N-末端脑钠肽前体(NT-proBNP)水平、美国国立卫生研究院卒中量表评分(NIHSS)、急性期末临床神经功能缺损程度评分(NFDS)、日常生活能力评分(ADL)变化情况;比较2组患者肺炎相关的临床症状体征消失时间(即退热时间、咯痰消失时间、咳嗽消失时间、肺湿啰音消失时间、X线摄片阴影消失时间、白细胞计数复常时间)及住院时间,观察统计2组肺炎的临床疗效及治疗期间不良反应(包括恶心呕吐、皮肤瘙痒、头痛乏力)发生的情况。结果 2组治疗后炎症相关因子CRP、IL-6、TNF-α及NT-proBNP水平均较本组治疗前降低(P<0.05),且治疗组低于对照组(P<0.05)。2组治疗后NIHSS、NFDS均较本组治疗前降低(P<0.05),ADL升高(P<0.05),且治疗组治疗后NIHSS、NFDS低于对照组(P<0.05),ADL高于对照组(P<0.05)。治疗组退热时间及咯痰、咳嗽、肺湿啰音、X线摄片阴影消失时间,白细胞计数复常时间均早于对照组(P<0.05),住院时间少于对照组(P<0.05)。治疗组总有效率100%,对照组88.89%,2组总有效率比较差异有统计学意义(P<0.05),治疗组临床疗效优于对照组。2组不良反应发生率比较差异无统计学意义(P>0.05)。结论痰热清注射液联合胸腺肽可明显降低卒中相关性肺炎患者炎症因子水平,有很好的抗炎、改善神经功能状况的作用,疗效显著且安全性高。

Objective To observe the effects of Tanreqing injection combined with thymosin on inflammatory factors and neurological function in patients with stroke associated pneumonia. Methods 90 patients with stroke associated pneumonia were randomly divided into two groups. 45 cases in the control group were treated by Tanreqing injection,and 45 cases in the treatment groups were treated by Tanreqing injection combined with thymosin. The treatment course was 10 d in two groups. The inflammatory factors including C reactive protein( CRP),interleukin-6( IL-6),tumor necrosis factor-α( TNF-α) and plasma nitrogen-terminal pro brain natriuretic peptide( NT-proBNP), and the changes of the National Institutes of Health Stroke Scale( NIHSS),Neurological Function Defect Scale( NFDS) and Activity of Daily Living( ADL) before and after treatment were compared in two groups. The improvement times of pneumonia-related clinical signs and symptoms including the fever clearance time,the disappearance times of cough,expectoration,pulmonary rales and X-ray shadow,white blood cell recovery time and hospital stay were compared in two groups. The adverse reactions including nausea and vomiting,pruritus,headache and fatigue were observed and evaluated in two groups. Results The levels of CRP,IL-6,TNF-α and NT-proBNP after treatment were reduced in two groups( P < 0. 05),and the reduction in the treatment group was lower than that in the control group( P < 0. 05). The NIHSS,NFDS after treatment were reduced in two groups( P < 0. 05),and the ADL increased( P < 0. 05). The NIHSS,and NFDS after treatment in the treatment group were lower than that in the control group( P < 0. 05),and ADL was higher( P < 0. 05). The fever clearance time,the disappearance times of cough,expectoration,pulmonary rales and X-ray shadow,white blood cell recovery time in the treatment group were earlier than those in the control group( P < 0. 05),and the hospital stay in the treatment group was shorter than that in the control group( P < 0. 05). There were statistical differences on the total effective rate between the treatment group( 100%) and the control group( 88. 89%,P < 0. 05),and the effects in the treatment group was superior to that in the control group( P < 0. 05). There was no statistical difference on the the incidence of adverse reactions( P > 0. 05). Conclusion Tanreqing injection combined with thymosin can obviously reduce inflammatory factors and improve neurological function in patients with stroke associated pneumonia,with significant effects and high safety.