清热化痰祛瘀法治疗支气管扩张症急性加重期患者的效果及对动脉血气、气道炎性因子及蛋白分解的影响

Effect of clearing heat and removing blood stasis on acute exacerbation of bronchiectasis and its influence on arterial blood gas,airway inflammatory factors and proteolysis

目的:探讨清热化痰祛瘀法治疗支气管扩张症急性加重期患者的效果及对动脉血气、气道炎性因子及蛋白分解的影响。方法:按照随机数字表法将我院2019年7月至2021年2月期间收治的117例支气管扩张症急性加重期患者分为两组,对照组58例给予注射用哌拉西林钠他唑巴坦钠,观察组59例联合清热化痰祛瘀法治疗,观察两组患者临床疗效、动脉血气分析指标、气道炎性因子以及蛋白分解活动水平。结果:治疗后,观察组总有效率高于对照组(P<0.05);观察组氧分压(Oxygen partial pressure,PaO_(2))、血氧饱和度(Oxygen saturation,SaO_(2))高于对照组,二氧化碳分压(Carbon dioxide partial pressure,PaCO_(2))低于对照组(P<0.05);观察组白细胞计数(White cell count,WBC)、中性粒细胞计数(Neutrophil count,GRAN)、C反应蛋白(C reactive protein,CRP)和降钙素原(Procalcitonin,PCT)水平均低于对照组(P<0.05);观察组中性粒细胞弹性蛋白酶(Eutrophil elastase,NE)和组织蛋白酶G水平水平均低于对照组(P<0.05)。结论:清热化痰祛瘀法用于支气管扩张症急性加重期患者,通过调节蛋白分解以及炎症因子水平,改善血气分析指标,进而提高临床疗效。

Objective:To explore the effect of clearing heat,resolving phlegm and removing blood stasis on patients with acute exacerbation of bronchiectasis and its influence on arterial blood gas,airway inflammatory factors and proteolysis.Methods:According to the random number table method,117 patients with acute exacerbation of bronchiectasis in our hospital from July 2019 to February 2021 were divided into two groups.The control group(58 cases)was given piperacillin sodium tazobactam sodium for injection,and the observation group(59 cases)was treated with the method of clearing heat,resolving phlegm and removing blood stasis.The clinical efficacy,arterial blood gas analysis indexes,airway inflammatory factors and proteolytic activity levels of the two groups were observed.Results:After treatment,the total effective rate in the observation group was higher than that in the control group(P<0.05).Oxygen partial pressurePaO_(2),Oxygen saturation SaO_(2)in observation group were higher than those in control group,while carbon dioxide partial pressure paco2 was lower than that in control group(p<0.05).The white cell count WBC,Neutrophil count GRAN,c-reactive protein CRP and Procalcitonin.PCT in the observation group were all lower than those in the control group(p<0.05).The levels of Neutrophil elastase.NE and cathepsin g in observation group were lower than those in control group(P<0.05).Conclusion:The method of clearing heat,resolving phlegm and removing blood stasis is used in patients with acute exacerbation of bronchiectasis,which can improve blood gas analysis indexes by regulating proteolysis and inflammatory factors,and then improve clinical efficacy.