益气活血化痰法对气虚血瘀痰阻型医院获得性肺炎患者炎症因子、动脉血气及免疫功能的影响

Effect of Inflammatory Factors,Arterial Blood Gas and Immune Function on Yiqi Huoxue Huatan Therapy in the Treatment of Patients with Qi Deficiency and Phlegm and Blood Stasis Type Hospital Acquired Pneumonia

目的:探讨益气活血化痰法治疗气虚血瘀痰阻型医院获得性肺炎(HAP)患者的疗效及其对炎症因子、动脉血气和免疫功能的影响。方法:选取2017年1月到2018年1月在我院接受治疗的HAP患者84例,根据随机数字表法将患者分为对照组和观察组,两组均42例。对照组采用常规西医治疗,观察组在此基础上联用益气活血化痰法进行治疗。比较两组患者治疗前后的中医症状积分、急性生理与慢性健康评估II(APACHE II)、动脉血氧分压(PaO_2)、动脉二氧化碳分压(PaCO_2)、超敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)、降钙素原(PCT)、免疫球蛋白(Ig G、Ig M、Ig A)的水平,比较两组患者的不良反应。结果:治疗后两组患者的PaO_2水平明显升高,中医症状积分、APACHE II评分、PaCO_2、hs-CRP、TNF-α、IL-6、PCT水平明显降低(P<0.05),且治疗后观察组的PaO_2水平高于对照组,中医症状积分、APACHE II评分、PaCO_2、hs-CRP、TNF-α、IL-6、PCT水平低于对照组(P<0.05);治疗后观察组的IgG、IgM水平明显升高,且高于对照组(P<0.05),两组患者在治疗过程中均未出现明显的不良反应。结论:益气活血化痰法可有效治疗气虚血瘀痰阻型HAP患者,能明显改善患者的动脉血气、免疫功能和炎症反应,且无明显不良反应。

Objective： To explore the effect of Yiqi Huoxue Huatan therapy on the treatment of patients with Qi deficiency and phlegm and blood stasis type hospital acquired pneumonia（HAP） and its effect on inflammatory factors,arterial blood gas and immune function. Methods： 84 cases of HAP patients who were treated in our hospital from January 2017 to January 2018 were selected.The patients were divided into the control group and the observation group according to the random digital table method,and all the two groups were 42 cases. The control group using conventional western medicine treatment,the observation group on the basis of treatment with Yiqi Huoxue Huatan therapy. The scores of TCM symptom scores,acute physiology and chronic health evaluation II（APACHE II）,arterial partial pressure of oxygen（PaO2）,arterial partial pressure of carbon dioxide（PaCO2）,hypersensitive C reactive protein（hs-CRP）,tumor necrosis factor-α（TNF-α）,interleukin 6（IL-6）,procalcitonin（PCT）,immunoglobulin（Ig G,Ig M,I g A）were compared before and after treatment of the two groups,the adverse reactions of the two groups were compared. Results： After treatment,the level of PaO2 in the two groups was significantly higher,and the TCM symptom scores,APACHE II scores,PaCO2,hs-CRP,TNF-α,IL-6 and PCT were significantly reduced（P〈0.05）. After treatment,the level of PaO2 in the observation group was higher than that of the control group,the TCM symptom scores,the APACHE II score,PaCO2,hs-CRP,TNF-α,IL-6 and PCT were lower than those of the control group（P〈0.05）. After treatment,the levels of Ig G and Ig M in the observation group increased significantly,which was higher than that in the control group（P〈0.05）. No obvious adverse reactions were observed in the two groups during the treatment. Conclusion： Yiqi Huoxue Huatan therapy can effectively treat HAP patients due to deficiency of vital energy,blood stasis and phlegm type,which can significantly improve arterial blood gas,immune function and inflammatory factors,and has no obvious adverse reactions.