痰热清注射液治疗重症肺炎痰热壅肺证临床观察

Tanreqing Injection in Treatment of Severe Pneumonia with the Syndrome of Phlegm-Heat Obstructing the Lung:A Clinical Observation

目的观察痰热清注射液治疗重症肺炎的临床疗效。方法将42例重症肺炎患者随机分为对照组和治疗组,每组21例。两组均给予西医常规治疗,治疗组在常规治疗的基础上加用痰热清注射液,7 d为1个疗程。采用二氧化碳分压(partial pressure of carbon dioxide,PaCO2)和氧合指数评价两组患者治疗前后呼吸功能改善情况;采用白细胞(white blood cell,WBC)计数、超敏C反应蛋白(hyper-sensitive C-reactive protein,hs-CRP)及降钙素原(procalcitonin,PCT)评价两组患者治疗前后炎症指标变化情况;采用急性生理与慢性健康Ⅱ(acute physiology and chronic health evaluationⅡ,APACHEⅡ)评分和临床肺部感染评分(clinical pulmonary infection score,CPIS)评价两组患者治疗前后病情严重程度;比较两组病原菌清除率及临床疗效。结果与治疗前比较,两组患者治疗后PaCO2均显著降低(P<0.05),氧合指数均显著升高(P<0.05);治疗组患者PaCO2降低程度及氧合指数升高程度显著大于对照组(P<0.05)。两组治疗后WBC计数,hs-CRP、PCT水平,APACHEⅡ评分,CPIS均较治疗前明显降低(P<0.05),且治疗组治疗后WBC计数,hs-CRP、PCT水平,APACHEⅡ评分,CPIS降低程度较对照组更显著(P<0.05)。治疗组的病原菌清除率显著高于对照组(71.43%vs 38.10%,P<0.05)。两组患者临床疗效分布比较,差异有统计学意义(P<0.05)。结论痰热清注射液能够改善重症肺炎患者呼吸功能,减轻炎症反应,协同抗生素能够增强杀菌效果,明显提高临床疗效。

Objective To investigate the clinical effect of Tanreqing Injection on patients with severe pneumonia.Methods A total of 42 patients with severe pneumonia were randomly divided into control group and treatment group,with 21 patients in each group.The patients in the control group were given conventional Western medicine treatment,and those in the treatment group were given Tanreqing Injection in addition to the treatment in the control group;each course of treatment was 7 days.Arterial partial pressure of carbon dioxide(PaCO2)and oxygenation index(OI)were used to evaluate the improvement in respiratory function after treatment;white blood cell count(WBC),high-sensitivity C-reactive protein(hs-CRP),and procalcitonin(PCT)were used to evaluate the changes in inflammatory indices after treatment;Acute Physiology and Chronic Health EvaluationⅡ(APACHEⅡ)score and Clinical Pulmonary Infection Score(CPIS)were used to evaluate disease severity before and after treatment;clearance rate of pathogenic bacteria and clinical outcome were compared between the two groups.Results After treatment,both groups had a significant reduction in PaCO2(P<0.05)and a significant increase in OI(P<0.05),and compared with the control group,the treatment group had a significantly greater reduction in PaCO2 and a significantly greater increase in OI(P<0.05).After treatment,both groups had significant reductions inWBC,hs-CRP,PCT,APACHEⅡscore,and CPIS(P<0.05),and the treatment group had significantly greater reductions than the control group(P<0.05).The treatment group had a significantly higher clearance rate of pathogenic bacteria than the control group(71.43%vs 38.10%,P<0.05).There was a significant difference in the distribution of clinical outcomes between the two groups(P<0.05).Conclusion For patients with severe pneumonia,Tanreqing Injection can improve respiratory function,alleviate inflammatory response,enhance the bactericidal effect in combination with antibiotics,and significantly improve clinical outcome.