宣白承气汤加味治疗老年社区获得性肺炎的临床研究

Effects of Modified Xuanbai Chengqi Decoction on Senile Community-acquired Pneumonia

目的观察宣白承气汤加味治疗重症肺炎的临床疗效。方法将86例老年社区获得性肺炎痰热壅肺证患者分为对照组和治疗组各43例,对照组给予西医常规治疗,治疗组在对照组基础上加用宣白承气汤加味治疗。比较两组的临床疗效、中医证候积分、症状消失时间,血清超敏C反应蛋白(hs-CRP)、白细胞计数(WBC)、N%、降钙素原(PCT)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、IgM、IgA、IgG、CD4^+、CD8^+、CD4^+/CD8^+的水平。结果治疗组的总有效率明显高于对照组(P<0.05),两组治疗后中医证候积分、hs-CRP、WBC、N%、PCT、IL-6、TNF-α、CD8^+水平均较治疗前降低,IgM、IgA、CD4^+、CD4^+/CD8^+的水平均较治疗前升高,且治疗组的改善程度优于对照组(P<0.05),体温、咳嗽、肺啰音等症状消失时间低于对照组(P<0.05)。结论宣白承气汤加味治疗老年CAP可以提高临床疗效,改善症状,抑制炎症反应和提高机体免疫功能。

Objective:To observe the effects of modified Xuanbai Chengqi Decoction on senile community-acquired pneumonia. Methods:86 patients were divided into the control group and the treatment group,43 cases in each. The control group was treated with conventional Western medicine,the treatment group modified Xuanbai Chengqi Decoction on that basis. The clinical effect,TCM syndrome score,levels of serum hs-CRP,WBC,N%,PCT,IL-6,TNF-α,IgM,IgA,IgG,CD4^+,CD8^+ and CD4^+/CD8^+ were compared between groups. Results:After treatment,the clinical efficacy of the treatment group was significantly higher than that of the control group(P < 0.05). The scores of TCM syndrome,level of hs-CRP,WBC,N%,PCT,IL-6,TNF-α and CD8+ were lower than those before the treatment(P < 0.05),while IgM,IgA,CD4^+ and CD4^+/CD8^+ were higher,and the improvement of the treatment group was better than that of the control group(P < 0.05). Conclusion:Modified Xuanbai Chengqi Decoction can improve the clinical efficacy,improve symptoms,inhibit inflammatory reaction and improve immune function in senile community-acquired pneumonia.