桑菊合麻杏石甘汤加减联合抗生素治疗对老年肺部感染患者血清及痰液中CRP、PCT、TNF-α水平的影响

Effect of combined therapy of Sangjuhemaxingshigan decoction and antibiotics on CRP, PCT and TNF-α in serum and sputum of elderly patients with pulmonary infection

目的探讨桑菊合麻杏石甘汤加减联合抗生素对老年肺部感染患者血清及痰液中的CRP、PCT及TNF-α水平的影响。方法选取我院120例老年肺部感染患者为研究对象,根据住院先后顺序分为常规组与观察组,两组均予以化痰、营养支持、抗生素等基础治疗,观察组加用桑菊合麻杏石甘汤加减治疗,疗效14 d,疗程结束后观察其症状改善情况,评估其中医疗效,并收集其外周血及痰液标本,分别检测血清及痰液中CRP、PCT、TNF-α水平变化,统计不良反应。结果常规组总有效率75.0%,显著低于观察组总有效率90.0%(P<0.05);两组外周血、痰液CRP、PCT、TNF-α较治疗前均显著下降,且观察组各炎性指标均显著低于常规组(P<0.05);治疗后常规组FEV1、FVC占预计值及Pa O2依次为(2.03±0.31)L、(83.65±12.53)、(75.35±10.82)mm Hg,显著低于观察组(2.14±0.29)L、(91.04±13.62)、(86.41±12.63)mm Hg(P<0.05),且两组均未出现不良反应。结论桑菊合麻杏石甘汤加减联合抗生素可增强老年肺部感染患者抗炎疗效,促进肺功能恢复,且具有较高安全性。

Objective To investigate the effects of combination of Sangjuhemaxingshigan decoction and antibiotics on the levels of CRP, PCT and TNF-α in serum and sputum of elderly patients with pulmonary infection. Methods 120 cases of elderly patients with pulmonary infection in our hospital were chosen for the study, according to the order of hospitalization, they were divided into routine group and observation group, both groups were given phlegm, nutritional support, antibiotics and other basic treatment, the observation group plus took Sangjuhemaxingshigan decoction for 14 d, after the end of treatment , observed the improvement of their symptoms, evaluated the efficacy of traditional Chinese medicine, and collected their peripheral blood and sputum samples, CRP, PCT, TNF-α were detected in serum and sputum. Adverse reactions were counted. Results The total effective rate was 75.0% in the conventional group, which was significantly lower than that in the observation group（90.0%, P〈0.05）. CRP, PCT and TNF-α in the peripheral blood and sputum of the two groups were significantly lower than those before treatment （P〈0.05）. The FEVI and FVC in the routine group were （2.03±0.31） L, （83.65±12.53） and （75.35±10.82） mmHg, respectively, which were significantly lower than those of the observation group （2.14±0.29） L, （91.04±13.62） and （86.41±12.63） mmHg respectively （P〈0.05）, and no adverse reactions were found in both groups. Conclusion Sangjuhemaxingshigan decoction combined with antibiotics can enhance anti-inflammatory efficacy in elderly patients with pulmonary infection, promote pulmonary function recovery with high safety.