中西医结合序贯疗法治疗老年肺炎的有效性及安全性研究

Effectiveness and Safety of Sequential Therapy of Traditional Chinese and Western Medicine in Treating Elderly Patients with Pneumonia

目的分析中西医结合序贯疗法治疗老年肺炎的有效性及安全性。方法选取2016年2月—2017年2月西安交通大学第二附属医院收治的老年肺炎患者120例,采用随机数字表法分为对照组和观察组,每组60例。两组患者入院后均予退热、去痰、止咳、平喘等常规治疗,对照组患者在常规治疗基础上单用阿奇霉素序贯疗法,观察组患者采用阿奇霉素联合中医辨证论治序贯疗法;两组患者均治疗3周。比较两组患者中医证候疗效、临床疗效及治疗前后血清白介素6(IL-6)、肿瘤坏死因子α(TNF-α)、C反应蛋白(CRP)及粒细胞集落刺激因子(G-CSF)水平,并观察两组患者治疗期间不良反应发生情况。结果观察组患者中医证候疗效、临床疗效优于对照组(P<0.05)。两组患者治疗前血清IL-6、TNF-α、CRP、G-CSF水平比较,差异无统计学意义(P>0.05);观察组患者治疗后血清IL-6、TNF-α、CRP、G-CSF水平低于对照组(P<0.05)。观察组患者治疗期间不良反应发生率低于对照组(P<0.05)。结论中西医结合序贯疗法治疗老年肺炎患者的临床疗效确切,可有效提高中医证候疗效,减轻炎性反应,且安全性较高。

Objective To analyze the effectiveness and safety of sequential therapy of Traditional Chinese and Western medicine in treating elderly patients with pneumonia.Methods A total of 120 elderly patients with pneumonia were selected in the Second Affiliated Hospital of Xi'an Jiaotong University from February 2016 to February 2017,and they were divided into control group and observation group according to random number table method,with 60 cases in each group.Patients in the two group received conventional treatment such as abatement of fever,eliminating phlegm,relieving cough and asthma,moreover patients in control group received azithromycin sequential therapy only,while patients in observation group received azithromycin combined with sequential therapy based on TCM syndrome differentiation;both groups continuously treated for 3 weeks.Curative effect of TCM symptoms,clinical effect,serum levels of IL-6,TNF-α,CRP and G-CSF before and after treatment were compared between the two groups,and incidence of adverse reactions during treatment.Results Compared with control group,the observation group showed better curative effect of TCM symptoms and clinical effect(P<0.05).Compared with control group,the observation group showed similar serum levels of IL-6,TNF-α,CRP or G-CSF before treatment(P>0.05),but lower serum levels of IL-6,TNF-α,CRP and G-CSF after treatment(P<0.05).Compared with control group,the observation group showed lower incidence of adverse reactions during treatment(P<0.05).Conclusion Sequential therapy of Traditional Chinese and Western medicine has certain clinical effect in treating elderly patients with pneumonia,can effectively improve the curative effect of TCM symptoms,relieve the inflammatory reaction,with relatively high safety.