清金化痰汤联合头孢哌酮钠舒巴坦钠对肺癌术后肺部感染的疗效观察

Efficacy of Qingjin Huatan decoction combined with cefoperazone sodium and sulbactam sodium for postoperative lung infection in patients with lung cancer undergoing radical resection

目的探讨清金化痰汤联合头孢哌酮钠舒巴坦钠对老年肺癌术后肺部感染患者炎症因子、巨噬细胞移动抑制因子和D-二聚体的影响。方法选取2015年8月到2018年4月间延安市中医医院收治的64例老年肺癌术后肺部感染患者进行回顾性分析,其中,将采用清金化痰汤联合头孢哌酮钠舒巴坦钠治疗的32例患者纳入观察组,采用头孢哌酮钠舒巴坦钠治疗的32例患者纳入对照组。两组患者均以10d为1个疗程,治疗1个疗程后,比较两组患者治疗前后临床症状积分(发热、咳嗽、喘促、咳痰及啰音)、肺功能参数[肺总量(TLC)、肺活量(VC)和肺CO一口气弥散量(DLCO)]和实验室指标检测[血清肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)、白细胞介素-2(IL-2)、巨噬细胞移动抑制因子(MIF)及D-二聚体(D-D)]的变化情况,并比较两组患者的临床疗效。结果治疗后,观察组总有效率为90.6%,显著高于对照组的68.8%,差异有统计学意义(P<0.05);两组患者治疗后发热、咳嗽、喘促、咳痰及啰音等症状积分均显著降低,且观察组上述指标降低程度更为显著,差异均有统计学意义(均P<0.05)。两组患者治疗后TLC、VC和DLCO均显著升高,且观察组治疗后上述指标升高程度更明显,差异均有统计学意义(均P<0.05)。两组患者治疗后血清CRP、TNF-α、IL-2、MIF及D-D水平均显著降低,且观察组治疗后上述指标降低程度更为显著,差异均有统计学意义(均P<0.05)。结论清金化痰汤联合头孢哌酮钠舒巴坦钠能够调节老年肺癌术后肺部感染患者体内炎性反应,促进患者肺功能康复,快速缓解患者临床症状。

Objective To investigate the effect of Qingjin Huatan decoction combined with cefoperazone sodium and sulbactam sodium on inflammatory factors,macrophage migration inhibitory factors and D-dimer in patients with lung infection after radical resection for lung cancer. Methods A total of 64 patients with lung infection after radical resection for lung cancer treated at Yan＇an Hospital of Traditional Chinese Medicine from August 2015 to April 2018 were selected and retrospectively analyzed. They were randomly divided into an observation group and a control group with 32 patients in each group. The observation group was treated with the Qing Jin Huatan decoction combined with cefoperazone sodium and sulbactam sodium,while the control group was only treated with cefoperazone sodium and sulbactam sodium. The two groups were treated with 10 d as 1 course. After 1 course of treatment,the scores of clinical symptoms（ fever,cough,asthma,expectoration and rale）,pulmonary function parameters [total lung volume（ TLC）,vital capacity（ VC）,lung CO one breath dispersion（ DLCO） ],and the changes in detection of the laboratory indexes [serum tumor necrosis factor-α（ TNF-α）,C reactive protein（ CRP）,interleukin-2（ IL-2）,macrophage migration inhibitory factor（ MIF） and D-dimer（ D-D） ]before and after treatment were observed between two groups. The clinical efficacy was also compared between the two groups. Results After treatment,the overall efficacy rate was 90. 6% for the observation group which was significantly higher than 68. 8% of the control group（ P〈0. 05）. After treatment,the symptom scores of fever,cough,wheezing,expectoration and rales decreased significantly in the two groups and the above indicators in the observation group decreased more significantly than in the control group（ all P〈0. 05）. The levels of TLC,VC and DLCO increased significantly in the two groups after treatment with the increase higher in the observation group than in the control group（ all P〈0. 05）. After treatment,the levels of serum CRP,TNF-α,IL-2,MIF and D-D decreased significantly in the two groups with the decrease significantly higher in the observation group than in the control group（ all P〈0. 05）. Conclusion The combination of Qing Jin Huatan decoction combined with cefoperazone sodium and sulbactam sodium can regulate the inflammatory response,improve the pulmonary function and quickly relieve the clinical symptoms in patients with lung infection after radical resection for lung cancer.