清肺消炎丸联合拉氧头孢钠治疗老年社区获得性肺炎的临床研究

Clinical study on Qingfei Xiaoyan Pills combined with latamoxef in treatment of community acquired pneumonia in the elderly

目的研究清肺消炎丸联合注射用拉氧头孢钠治疗老年社区获得性肺炎的临床疗效。方法选取2018年8月—2019年8月在方城县人民医院治疗的100例老年社区获得性肺炎患者,将所有患者随机分为对照组和治疗组,每组各50例。对照组静脉滴注注射用拉氧头孢钠,1.5 g溶于250 mL生理盐水,2次/d。治疗组在对照组基础上口服清肺消炎丸,1袋/次,3次/d。两组患者持续治疗14d。观察两组患者治疗后临床疗效,比较肺炎严重指数(PSI)评分、英国胸科协会改良肺炎评分(CURB-65评分)、血气指标和血清炎性因子水平。结果治疗后,对照组和治疗组的总有效率分别为74.00%、92.00%,两组比较差异具有统计学意义(P<0.05)。治疗后,治疗组患者退热、咳嗽咳痰缓解、肺部啰音消失时间均明显短于对照组(P<0.05)。治疗后,两组患者PSI评分、CURB-65评分显著降低(P<0.05),且治疗组PSI评分、CURB-65评分降低更明显(P<0.05)。治疗后,两组二氧化碳分压(pCO2)水平显著降低,血氧分压(pO2)水平显著升高(P<0.05);并且治疗组血气指标改善程度较大(P<0.05)。治疗后,两组血清超敏C反应蛋白(hs-CRP)、降钙素(PCT)、白细胞介素-6(IL-6)水平均显著降低(P<0.05);并且治疗组血清炎性因子水平降低更明显(P<0.05)。结论清肺消炎丸联合注射用拉氧头孢钠治疗老年社区获得性肺炎具有较好的临床疗效,能够改善患者临床症状,降低血清炎性因子水平,值得在临床上推广应用。

Objective To study the clinical efficacy of Qingfei Xiaoyan Pills combined with Latamoxef Sodium for injection in treatment of community acquired pneumonia in the elderly.Methods Elderly patients(100 cases)with community acquired pneumonia in Fangcheng County People’s Hospital from August 2018 to August 2019 were randomly divided into control and treatment groups,and each group had 50 cases.Patients in the control group were iv administered with Latamoxef Sodium for injection,1.5 g added into 250 mL normal saline,twice daily.Patients in the treatment group were po administered with Qingfei Xiaoyan Pills on the basis of the control group,1 bag/time,three times daily.Patients in two groups were treated for 14 d.After treatment,the clinical efficacies were evaluated,and PSI score,CURB-65 score,blood gas index,and serum inflammatory index in two groups were compared.Results After treatment,the clinical efficacies in the control and treatment groups were 74.00%and 92.00%,respectively,and there was difference between two groups(P<0.05).After treatment,the antipyretic time,cough and sputum relieving time,pulmonary rales disappear times in the treatment group were significantly shorter than those in the control group(P<0.05).After treatment,the PSI score and CURB-65 score in the two groups were significantly decreased(P<0.05),and the PSI score and CURB-65 score in the treatment group were significantly decreased(P<0.05).After treatment,the levels of pCO2 in the two groups were significantly decreased,but the levels of pO2 in the two groups were significantly increased(P<0.05),and the improvement of blood gas index in the treatment group was more significant than that in the control group(P<0.05).After treatment,the serum levels of IL-6,hs-CRP and PCT in the two groups were significantly decreased(P<0.05),and the serum inflammatory indexes in the treatment group were significantly lower than those in the control group(P<0.05).Conclusion Qingfei Xiaoyan Pills combined with Latamoxef Sodium for injection has clinical curative effect in treatment of community acquired pneumonia in the elderly,can improve the clinical symptoms of patients,and reduce the serum level of inflammatory factors,which is worthy of clinical application.