参附注射液辅助抗生素对重症肺炎病人临床症状消退时间、内皮细胞损伤程度因子及肺功能的影响

Effect of Shenfu injection assisted with antibiotics on the subsided time of clinical symptoms,endothelial cell damage factor and pulmonary function in elderly patients with severe pneumonia

目的探讨参附注射液辅助抗生素对老年重症肺炎(SP)病人临床症状消退时间、内皮细胞损伤程度因子及肺功能的影响。方法选择我院收治的70例老年SP病人,将其随机分为观察组和对照组,每组35例。对照组实施抗生素降阶梯治疗,观察组在此基础上给予参附注射液辅助治疗,2组均治疗7d,观察比较2组临床症状消退时间、内皮细胞损伤程度因子、心肌损伤程度及肺功能的变化。结果治疗前,2组病人可溶性E选择素(sE-selection)、血管性血友病因子(vWF)、动脉血氧分压(PaO2)、动脉血氧饱和度(SaO2)、PaO2与吸入氧浓度百分比(FiO2)的比值(PaO2/FiO2)、肌酸激酶同工酶(CKMB)、肌酸激酶(CK)、乳酸脱氢酶(LDH)、第1秒用力呼气量(FEV1)及用力肺活量(FVC)差异均无统计学意义(P>0.05)。治疗后,观察组病人咳嗽消退时间[(7.3±1.1)d]、肺部啰音消失时间[(7.6±1.4)d]及退热时间[(4.8±1.1)d]均显著优于对照组(P<0.05)。2组sE-selection、vWF、CKMB、CK、LDH水平较治疗前均明显降低(P<0.05),且观察组较对照组降低更明显(P<0.05);2组SaO2、PaO2、PaO2/FiO2、FEV1及FVC较治疗前显著增加(P<0.05);且观察组明显高于对照组(P<0.05)。结论参附注射液能显著缩短老年SP病人临床症状消退时间,改善病人血管内皮细胞功能、血气指标和肺功能,降低心肌损伤程度,临床应用效果较好。

Objective To investigate the effects of Shenfu injection assisted with antibiotics on the subsided time of clinical symptoms,endothelial cell damage factor and pulmonary function in the elderly patients with severe pneumonia(SP).Methods A total of seventy elderly patients with SP in our hospital were recruited and randomly divided into observation group and control group,with 35 cases in each group.The control group was treated with antibiotic descending step therapy,and the observation group was treated with Shenfu injection on the basis of control group.The clinical symptoms subsided time,the degree of endothelial damage and the level of pulmonary function index were compared between the two groups.Results There were no significant differences in sE-selection,von Willebrand factor(vWF),arterial oxygen saturation(SaO2),arterial partial pressure of oxygen(PaO2),PaO2/percent oxygen concentration by inhalation(FiO2),creatine kinase isoenzyme(CKMB),creatine kinase(CK),lactate dehydrogenase(LDH),forced expiratory volume in 1 s(FEV1)and forced vital capacity(FVC)between the two groups before treatment(P>0.05).After treatment,the cough resolution time(7.3±1.1 d),lung rumble disappearance time(7.6±1.4 d)and antipyretic time(4.8±1.1 d)in the observation group were significantly lower than those in the control group(P<0.05).The levels of sE-selection,vWF,CKMB,CK,LDH in the two groups were significantly lower than those before treatment,especially in the observation group(P<0.05).The levels of SaO2,PaO2,PaO2/FiO2,FEV1,FVC of the two groups were significantly higher than those before treatment,especially in the observation group(P<0.05).Conclusions Shenfu injection can significantly shorten the time of clinical symptom regression in the elderly patients with SP,improve vascular endothelial cells,blood gas index and lung function,and reduce the degree of myocardial injury.