清热解毒方联合布地奈德治疗重症肺炎的疗效及对肺表面蛋白和应激因子水平的影响

Observation on Curative Effect of Qingre Jiedu Prescription Combined with Budesonide for Severe Pneumonia and Its Effect on Pulmonary Surfactant Protein and Level of Stress Factors

目的:探讨清热解毒方联合布地奈德雾化吸入治疗重症肺炎的疗效及对肺表面蛋白和应激因子水平的影响。方法:选取重症肺炎患者118例,按随机数字表法分为对照组和观察组。2组患者均积极处理原发病的常规治疗,对照组患者在常规治疗基础上给予布地奈德雾化吸入治疗,观察组在对照组基础上加用清热解毒方治疗。分析2组患者治疗后的临床效果,观察2组患者治疗后痰液情况、应用呼吸机时间及治疗前后血清肺表面蛋白、血管紧张素Ⅰ(AngⅠ)、血管紧张素Ⅱ(AngⅡ)、降钙素原(PCT)、基质金属蛋白酶-2(MMP-2)水平。结果:治疗前,2组血清肺表面蛋白SP-A、SP-B、SP-C、SP-D,AngⅠ,AngⅡ,PCT,MMP-2水平比较,差异无统计学意义(P>0.05)。与同组治疗前比较,2组SP-A、SP-B、SP-C、SP-D,AngⅠ,AngⅡ,PCT,MMP-2水平明显降低,差异均有统计学意义(P<0.05)。观察组痰液黏稠度较对照组降低,痰量较对照组减少,无创呼吸机应用时间和总呼吸机应用时间短于对照组,差异均有统计学意义(P<0.05)。治疗后,观察组SP-A、SP-B、SP-C、SP-D,AngⅠ,AngⅡ,PCT,MMP-2水平低于对照组,差异均有统计学意义(P<0.05)。结论:清热解毒方联合布地奈德雾化吸入治疗重症肺炎可缩短应用呼吸机时间,降低血清肺表面蛋白、AngⅠ、AngⅡ、PCT、MMP-2的表达,降低痰量和黏稠度。

Objective： To discuss the curative effect of Qingre Jiedu prescription combined with budesonide for severe pneumonia and its effect on pulmonary surfactant protein and level of stress factors. Methods：Selected 118 cases of patients with severe pneumonia and divided them into the control group and the observation group according to random number table method. The two groups were treated with routine treatment for primary disease. The control group was treated with aerosol inhalation of budesonide based on the routine treatment, while the observation group was additionally treated with Qingre Jiedu prescription based on the treatment of the control group. Analyzed the clinical effect in the two groups after treatment,observed the sputum,the applying time of ventilator in the two groups after treatment and the levels of pulmonary surfactant protein in serum, angiotensin I（Ang I）, angiotensin II（Ang II）,procalcitonin（PCT）, matrix metalloproteinase-2（MMP-2） in the two groups before and after treatment. Results： Before treatment, no significant difference was found in the comparisons of the levels of pulmonary surfactant protein A,B, C and D（SP-A、SP-B、SP-C and SP-D）, Ang I, Ang II, PCT and MMP-2 in serum between the two groups（P〉0.05）. Compared with those before treatment,levels of SP-A、SP-B、SP-C、SP-D,Ang I,Ang II, PCT and MMP-2 in the two groups were obviously decreased,the difference being significant（P〈0.05）. In the observation group, the sputum viscosity was decreased and the sputum volume was reduced when compared respectively with that in the control group;the applying time of noninvasive ventilator and the total applying time of ventilator was shorter than that in the control group,the difference being significant（P〈0.05）. After treatment, levels of SP-A、 SP-B、 SP-C、SP-D, Ang I, Ang II, PCT and MMP-2 in the observation group were lower than those in the control group, the difference being significant（P〈0.05）. Conclusion：The therapy of Qingre Jiedu prescription combined with aerosol inhalation of budesonide for severe pneumonia can shorten the applying time of ventilator,decrease the expression of levels of pulmonary surfactant protein in serum,Ang I,Ang II, PCT and MMP-2 and reduce the sputum volume and viscosity.