清肺消炎汤联合盐酸氨溴索治疗老年重症肺炎的疗效及对其血清IL-1β、sTREM-1、HMGB1表达的影响

Effect of Qingfei Xiaoyan Decoction Combined with Ambroxol Hydrochloride on the Treatment of Severe Pneumonia in the Elderly and the Expression of IL-1Β,Strom-1 and HMGB1 in the Serum of Patients

目的观察清肺消炎汤联合盐酸氨溴索治疗老年重症肺炎的疗效及其对血清IL-1β、sTREM-1、HMGB1表达的影响。方法按照治疗方案将103例重症肺炎患者分为对照组51例与治疗组52例。常规对症支持治疗基础上,对照组给予盐酸氨溴索治疗,治疗组给予盐酸氨溴索+清肺消炎汤治疗,两组均于治疗7 d后评价相关指标。对比两组治疗后临床疗效,治疗前后中医证候积分、病情评分、肺功能指标[第1秒用力呼气量(FEV1)、用力肺活量(FVC)及1 s率(FEV1/FVC)]、血清因子白细胞介素-1β(IL-1β)、溶性髓样细胞触发受体-1(sTREM-1)、高迁移率族蛋白B1(HMGB1)水平及治疗安全性。结果治疗组治疗后临床总有效率高于对照组(P<0.05),差异有统计学意义;治疗后两组中医证候积分、临床肺部感染评分(CPIS)均较本组治疗前下降,且治疗组低于对照组(P<0.05);治疗后两组FEV1、FVC、FEV1/FVC均较本组治疗前增加,且治疗组高于对照组(P<0.05);治疗后两组血清IL-1β、sTREM-1、HMGB1水平均较本组治疗前降低,且治疗组低于对照组(P<0.05);两组治疗期间均未发生严重并发症或不良反应。结论清肺消炎汤联合盐酸氨溴索治疗老年重症肺炎安全、有效,有利于改善中医证候、缓解病情,提高患者肺功能,且可能与下调血清IL-1β、sTREM-1、HMGB1表达有关。

Objective To observe the efficacy of Qingfei Xiaoyan Decoction combined with ambroxol hydrochloride in the treatment of elderly severe pneumonia and its effect on the expression of serum IL-1β,s TREM-1 and HMGB1.Method According to the treatment plan,103 patients with severe pneumonia were divided into 51 cases in the control group and 52 cases in the treatment group.On the basis of routine symptomatic and supportive treatment,the control group was treated with ambroxol hydrochloride,and the treatment group was treated with ambroxol hydrochloride+Qingfei Xiaoyan Decoction.The two groups were treated with related indicators 7 days after treatment.The clinical efficacy,TCM syndrome score,disease score,lung function index[forced expiratory volume in the first second(FEV1),forced vital capacity(FVC)and 1 s rate(FEV1/FVC)],serum factor interleukin were compared between the two groups-1β(IL-1β),lytic myeloid cell trigger receptor-1(sTREM-1),high mobility group protein B1(HMGB1)levels and treatment safety.Result The total clinical effective rate of the treatment group after treatment was higher than that of the control group(P<0.05),and the difference was statistically significant.After treatment,the scores of TCM syndromes and CPIS in the two groups were lower than those before treatment,and the treatment group was lower than the control group Group(P<0.05);FEV1,FVC,FEV1/FVC in the two groups after treatment increased compared with this group before treatment,and the treatment group was higher than the control group(P<0.05);after treatment,the serum IL-1β,s TREM-1.The level of HMGB1 was lower than that before treatment in this group,and the treatment group was lower than the control group(P<0.05);no serious complications or adverse reactions occurred during the treatment of the two groups.Conclusion Qingfei Xiaoyan Decoction combined with ambroxol hydrochloride is safe and effective in the treatment of elderly severe pneumonia.It is beneficial to improve TCM syndromes,alleviate the condition,and improve patients’lung function.It may be related to the down-regulation of serum IL-1β,s TREM-1 and HMGB1 expression.