清肺消炎丸联合西药治疗社区获得性肺炎的效果及对免疫功能及炎性因子水平的影响

Effect of Qingfei Xiaoyan pills combined with western medicine on community-acquired pneumonia,immune function and inflammatory factors

目的探讨清肺消炎丸联合西药治疗社区获得性肺炎(CAP)的效果及对免疫功能及炎性因子水平的影响。方法选取2016年4月至2018年11月海南省万宁市人民医院收治的CAP患者123例,根据随机数字表法将患者分为对照组(61例)和观察组(62例)。对照组在常规治疗基础上采用头孢曲松和阿奇霉素治疗,观察组在对照组基础上联合清肺消炎丸治疗,2组均持续治疗14 d。比较2组患者的临床疗效、免疫功能指标、炎性因子及不良反应发生情况。结果观察组总有效率明显高于对照组[87.1%(54/62)比70.5%(43/61)],差异有统计学意义(P=0.024)。治疗后2组患者CD4+、CD4+/CD8+比值、免疫球蛋白A、免疫球蛋白M水平均明显升高,且观察组明显高于对照组[(46±4)%比(38±3)%、(1.87±0.39)比(1.35±0.24)、(3.4±0.6)g/L比(3.0±0.6)g/L、(1.75±0.31)g/L比(1.31±0.27)g/L];CD8+、白细胞介素6、肿瘤坏死因子α、C反应蛋白水平均明显降低,且观察组明显低于对照组[(24±4)%比(28±5)%、(27±4)ng/L比(38±4)ng/L、(38±5)ng/L比(49±8)ng/L、(17.4±2.3)mg/L比(28.8±4.3)mg/L],差异均有统计学意义(均P<0.05)。观察组发热、咳嗽、咳痰、肺部湿啰音症状消退时间均明显短于对照组[(2.5±0.3)d比(3.6±0.3)d、(7.7±0.8)d比(9.8±0.5)d、(7.4±0.6)d比(9.5±0.7)d、(7.1±0.5)d比(8.8±0.5)d],差异均有统计学意义(均P<0.05)。2组不良反应发生率差异无统计学意义(P=0.598)。结论清肺消炎丸联合西药治疗CAP疗效确切,可有效改善机体免疫功能及降低炎性因子指标水平,且不增加不良反应发生率。

Objective To investigate the curative effect of Qingfei Xiaoyan pills combined with western medicine on community-acquired pneumonia( CAP) and the influence on immune function and inflammatory factors. Methods Totally 123 patients with CAP admitted to People’ s Hospital of Wanning,Hainan Province from April 2016 to November 2018 were randomly divided into control group( n = 61) and observation group( n =62). The control group was treated with azithromycin and ceftriaxone on the basis of routine therapy;the observation group was treated with Qingfei Xiaoyan pills on the basis of control group. Clinical efficacy,immune function indexes,inflammatory factors and adverse reactions were analyzed. Results The total effective rate in observation group was 87. 1%(54/62),which was significantly higher than 70. 5%(43/61) in control group( P = 0. 024).After treatment,serum levels of CD4+,CD4+/CD8+,immunoglobulin A and immunoglobulin M significantly increased in both groups and the indexes in observation group were significantly higher than those in control group[(46 ± 4)% vs(38 ± 3)%,(1. 87 ± 0. 39) vs(1. 35 ± 0. 24),(3. 4 ± 0. 6)g/L vs(3. 0 ± 0. 6)g/L,(1. 75 ±0. 31) g/L vs(1. 31 ± 0. 27) g/L];serum level of CD8+ significantly decreased and it was lower in observation group than that in control group[(24 ± 4) % vs(28 ± 5) % ]( all P < 0. 05). Serum levels of interleukin-6,tumor necrosis factor-α and C-reactive protein significantly decreased after treatment in both groups;the levels in observation group were significantly lower than those in control group [(27 ± 4) ng/L vs( 38 ± 4) ng/L,(38 ±5) ng/L vs(49 ± 8) ng/L,(17. 4 ± 2. 3) mg/L vs(28. 8 ± 4. 3) mg/L]( all P < 0. 05). Disappearing time of fever,cough,expectoration and lung moist rales in observation group were significantly shorter than those in control group[(2. 5 ± 0. 3) d vs(3. 6 ± 0. 3) d,( 7. 7 ± 0. 8) d vs( 9. 8 ± 0. 5) d,( 7. 4 ± 0. 6) d vs( 9. 5 ± 0. 7) d,(7. 1 ± 0. 5)d vs(8. 8 ± 0. 5) d]( all P < 0. 05). There was no significant difference in incidence of adverse reactions between groups( P = 0. 598). Conclusions Qingfei Xiaoyan pills combined with western medicine treating CAP can effectively improve immune function and reduce inflammatory factors without increasing adverse reactions.