清金化痰汤辅助治疗肺癌合并肺部感染的效果及对KPS评分的影响

Clinical efficacy and change of KPS score of Qingjinhuatan decoction in the treatment of lung cancer combined with pulmonary infection

目的分析清金化痰汤联合头孢哌酮钠舒巴坦钠治疗肺癌合并肺部感染的效果及对患者体力状态的影响。方法选取86例肺癌合并肺部感染患者。根据治疗方法不同分为对照组(头孢哌酮钠舒巴坦钠+常规对症治疗)43例和观察组(头孢哌酮钠舒巴坦钠+常规对症治疗+清金化痰汤)43例。比较两组患者的发热、咳嗽、肺部啰音的改善时间及治疗前后的痰培养阳性率、血清炎性细胞因子水平[肿瘤坏死因子-α(TNF-α)、白细胞介素-1β(IL-1β)、C反应蛋白(CRP)、降钙素原(PCT)、白细胞介素-2(IL-2)、白细胞介素-10(IL-10)、白细胞介素-13(IL-13)]、卡氏功能状态(KPS)评分。结果观察组患者发热、咳嗽、肺部啰音的改善时间分别为(7.86±2.02)、(9.87±2.14)、(11.74±1.98)天,均明显短于对照组的(9.96±1.75)、(11.75±2.36)、(13.02±2.52)天(P<0.01);两组患者治疗前的血清炎性细胞因子水平及治疗前后的痰培养阳性率、KPS评分比较,差异均无统计学意义(P﹥0.05);治疗后,观察组患者的IL-2水平明显高于对照组,TNF-α、IL-1β、CRP、PCT、IL-10、IL-13水平均明显低于对照组(P<0.01)。结论与头孢哌酮钠舒巴坦钠联合常规对症治疗比较,加用清金化痰汤治疗肺癌合并肺部感染,可调节血清炎性细胞因子水平,缩短肺部啰音、咳嗽的改善时间。

Objective To analyze the clinical effect of Qingjinhuatan decoction combined with cefoperazone sodium and sulbactam sodium in the treatment of lung cancer with pulmonary infection,and the effect on the patients’performance status.Method A total of 86 patients of lung cancer with pulmonary infection were included in the study and assigned into control group(cefoperazone sodium and sulbactam sodium+routine symptomatic treatment,n=43)and study group(cefoperazone sodium and sulbactam sodium+routine symptomatic treatment+Qingjinhuatan decoction,n=43),respectively.The time to recovery of fever,cough,lung rales,as well as the positive rate of sputum culture,serum level of inflammatory cytokines[tumor necrosis factor-α(TNF-α),interleukin-1β(IL-1β),C-reactive protein(CRP),procalcitonin(PCT),IL-2,IL-10,IL-13]and Karnofsky performance status(KPS)scores before and after treatment were compared between the two groups.Result The time to recovery of fever,cough and lung rales were(7.86±2.02),(9.87±2.14)and(11.74±1.98)d,respectively in study group,and were significantly shorter compared to those in control group at(9.96±1.75),(11.75±2.36)and(13.02±2.52)d,respectively(P<0.01).There was no statistically significant difference in regard to the level of serum inflammatory factors and positive rate of sputum culture and KPS score before and after treatment(P>0.05).After treatment,the IL-2 level in study group was significantly higher than that in the control group and the TNF-α,IL-1β,CRP,PCT,IL-10,and IL-13 levels were evidently lower(P<0.01).Conclusion Compared with the routine symptomatic therapy+cefoperazone sodium and sulbactam sodium,the addition of Qingjinhuatan decoction could mediate the level of serum inflammatory factors,shorten the time needed for recovery from lung rale and cough when treating lung cancer combined with pulmonary infection.