清金化痰汤对痰热壅肺型重症肺炎炎性细胞因子、动脉血气指标及T细胞亚群的影响

Effect of Qingjin Huatan Decoction on Inflammatory Cytokines, Arterial Blood Gas Index and T Cell Subsets in Severe Pneumonia Patients with Phlegm-Heat Obstructing Lung

目的探讨清金化痰汤在痰热壅肺型重症肺炎治疗中的应用价值。方法将92例痰热壅肺型重症肺炎以随机数字表法分为对照组46例,观察组46例,对照组行常规西医治疗,观察组在对照组基础上加用清金化痰汤,观察两组治疗效果及治疗前、后炎性细胞因子、动脉血气指标、T细胞亚群变化。结果观察组治疗总有效率为93.48%,与对照组78.26%对比,显著较高(P<0.05);治疗前,两组炎性细胞因子无显著差异(P>0.05),观察组治疗后血清白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、白介素-10(IL-10)水平与同期对照组对比,明显较低(P<0.05);治疗前,两组动脉血气指标差无显著差异(P>0.05),观察组治疗后动脉血氧分压(PaO2)、动脉血酸碱度(pH)与同期对照组对比,明显较高,动脉血二氧化碳分压(PaCO2)与同期对照组对比,明显较低(P<0.05);治疗前,两组T细胞亚群无显著差异(P>0.05),观察组治疗后CD+4、CD+4/CD+8与同期对照组对比,明显较高,CD+8与同期对照组对比,明显较低(P<0.05)。结论清金化痰汤配合西医治疗痰热壅肺型重症肺炎,可显著增强疗效,并能降低患者炎性细胞因子水平,改善患者动脉血气指标,调节免疫功能,值得推广。

Objective To explore the value of Qingjin Huatan Decoction in the treatment of severe pneumonia with phlegm-heat obstructing lung. Methods A total of 92 severe pneumonia patients with phlegm-heat obstructing lung were randomly divided into the control group(46 cases) and the observation group(46 cases). The control group received routine western medicine treatment and the observation group added Qingjin Huatan Decoction on the basis of the control group. We observed the therapeutic effects and the changes of inflammatory cytokines, arterial blood gas indexes, T cell subsets before and after treatment of two groups.Results The total effective rate of the observation group was 93.48% which was significantly higher compared with that of the control group(78.26%)(P<0.05). Before treatment, there was no significant difference in inflammatory cytokines between the two groups(P>0.05). After treatment, the levels of serum interleukin-6(IL-6), tumor necrosis factor-α(TNF-α) and interleukin-10(IL-10) in the observation group were significantly lower compared with those in the control group(P<0.05). Before treatment, there was no significant difference in arterial blood gas index between the two groups(P>0.05). After treatment, the arterial partial pressure of oxygen(PaO2) and arterial blood pH(pH) in the observation group were significantly higher compared with those in the control group(P<0.05). The partial pressure of carbon dioxide(PaCO2) was significantly lower compared with that of the control group(P<0.05). Before treatment, there was no significant difference in T cell subsets between the two groups(P>0.05). After treatment, the CD+4 and CD+4/CD+8 in the observation group were significantly higher compared with those in the control group and the CD+8 was significantly lower compared with that of the control group(P<0.05). Conclusion Qingjin Huatan Decoction combined with western medicine for treating severe pneumonia with phlegm-heat obstructing lung can significantly enhance the curative effect, reduce the level of inflammatory cytokines, improve the arterial blood gas index and regulate the immune function, worthy of promoting.