血府逐瘀汤联合西药对结核性胸膜炎肺功能及外周血细胞的影响

Effects of Xuefu Zhuyu Decoction Combined with Western Medicine on Pulmonary Function and Peripheral Blood Cells of Patients with Tuberculous Pleurisy

目的:观察血府逐瘀汤联合西药治疗结核性胸膜炎对患者肺功能及外周血细胞的影响。方法:选取2018年1月至2020年6月河北北方学院附属第一医院呼吸内科收治的结核性胸膜炎患者90例作为研究对象,按照随机数字法分为2组,每组45例。对照组给予抗结核及胸腔穿刺引流治疗,观察组在对照组治疗方案上给予血府逐瘀汤治疗。对比2组患者临床总有效率、胸水引流量、胸膜厚度、胸水胸痛消失时间、肺活量占预计值百分比(VC%pred)、用力肺活量预计值百分比(FVC%pred)、肺总量占预计值百分比(TLC%pred)、外周血树突状细胞(DC)细胞亚群占外周血单个核细胞(PBMC)的百分比以及安全性评价。结果:治疗后,观察组总有效率(91.11%)高于对照组(66.67%),差异有统计学意义(P<0.05),2组患者DC1/PBMC,DC2/PBMC及DC1/DC2均显著高于治疗前,差异有统计学意义(P<0.05),且观察组显著高于对照组,差异有统计学意义(P<0.05);观察组胸水引流量显著高于对照组,差异有统计学意义(P<0.05),胸水消失时间、胸痛消失时间以及胸膜厚度明显低于对照组,差异有统计学意义(P<0.05);观察组VC%pred、FVC%pred、TLC%pred均明显高于对照组,差异有统计学意义(P<0.05),2组不良反应发生率比较差异无统计学意义(P>0.05)。结论:血府液瘀汤联合西药可提高结核性胸膜炎患者的临床疗效,促进胸水吸收,降低胸膜肥厚,减少胸痛持续时间,改善肺功能,调控机体DC细胞亚群水平。

Objective:To observe the effect of Xuefu Zhuyu Decoction combined with Western medicine on lung function and peripheral blood cells of patients with tuberculous pleurisy.Methods:A total of 90 patients with tuberculous pleurisy admitted to the Department of Respiratory Medicine,the First Affiliated Hospital of Hebei North University from January 2018 to June 2020 were selected as the research objects and randomly divided into an observation group and a control group,with 45 patients in each group.The control group was given conventional anti-tuberculosis and pleural puncture and drainage treatment,and the observation group was given Xuefu Zhuyu Decoction on the basis of the control group.The total clinical response rate,pleural effusion flow,pleural effusion,time of chest pain disappearance,pleural thickness,percentage of vital capacity in estimated value(VC%pred),estimated percentage of forced vital capacity(FVC%pred),total lung volume in estimated value(TLC%preD),peripheral blood dendritic cells(DENDRItic)were compared between 2 groups.The percentage of cells,DC cell subsets in peripheral blood mononuclear cells(PBMC)and safety evaluation.Results:After treatment,the total effective rate in control group(66.67%)was lower than that in control group(91.11%)(P<0.05),DC1/PBMC,DC2/PBMC and DC1/DC2 were higher than those before treatment(P<0.05),and the control group was lower than the observation group(P<0.05).The discharge of pleural effusion in the control group was lower than that in the observation group(P<0.05),and the disappearance time of pleural effusion and chest pain and pleural thickness in the control group were higher than that in the control group(P<0.05).VC%PRED,FVC%PRED and TLC%PRED in the control group were lower than those in the observation group(P<0.05),and there was no statistical difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Xuefu Yuyu Decoction combined with Western medicine can effectively improve the clinical efficacy of tuberculous pleurisy patients,promote pleural fluid absorption,reduce the risk of pleural hypertrophy,reduce the duration of chest pain,improve lung function,and regulate the level of DC cell subsets in the body.