千金苇茎汤治疗痰热壅肺型重症肺炎的临床疗效评估

Clinical efficacy of Qianjin Weijing Decoction in the treatment of severe pneumonia with accumulation of phlegm and heat in the lung

目的探讨千金苇茎汤治疗痰热壅肺型重症肺炎的临床疗效。方法选取温州市中医院2018年12月至2020年12月收治的重症肺炎患者80例为观察对象,采用随机数字表法分为观察组和对照组,每组40例。对照组患者采用常规治疗,观察组在对照组基础上结合千金苇茎汤治疗。两组治疗疗程7 d。比较两组治疗疗效、治疗前后血气分析和氧合指数、炎性因子[C反应蛋白(CRP)和降钙素原(PCT)]及序贯性器官功能衰竭评分(SOFA)变化。结果观察组总有效率[87.50%(35/40)]高于对照组[65.00%(26/40)](χ^(2)=5.59,P<0.05)。观察组治疗后二氧化碳分压(PaCO_(2))[(30.24±2.68)mmHg]低于对照组[(39.95±3.27)mmHg],而血氧分压(PaO_(2))[(76.85±4.56)mmHg]和氧合指数(PaO_(2)/FiO_(2))[(326.84±8.49)mmHg]均高于对照组[(68.39±4.12)mmHg和(284.16±15.56)mmHg](t=14.52、-8.70、-15.22,均P<0.05);观察组治疗后血清CRP[(23.12±6.56)mg/L]和PCT[(0.31±0.08)μg/L]均低于对照组[(38.92±5.62)mg/L和(0.78±0.20)μg/L](t=11.56、13.80,均P<0.05)。观察组治疗后患者SOFA评分[(2.31±0.46)分]低于对照组[(5.12±1.25)分](t=13.34,P<0.05)。结论千金苇茎汤治疗痰热壅肺型重症肺炎的临床疗效好,可改善患者血气分析,降低患者炎性因子水平,且可改善患者预后。

Objective To investigate the clinical efficacy of Qianjin Weijing Decoction in the treatment of severe pneumonia with the accumulation of phlegm and heat in the lung.Methods Eighty patients with severe pneumonia with the accumulation of phlegm and heat in the lung received treatment in Wenzhou Hospital of Traditional Chinese Medicine from December 2018 to December 2020.They were randomly allocated to undergo routine treatments(control group,n=40)or routine treatments combined with Qianjin Weijing Decoction(observation group,n=40)for 7 days.Clinical efficacy,blood gas analysis,oxygenation index,inflammatory factors(C-reactive protein and procalcitonin),and sequential organ failure score were compared between the two groups.Results Total response rate in the observation group was significantly higher than that in the control group[87.50%(35/40)vs.65.00%(26/40),χ^(2)=5.59,P<0.05].Partial pressure of carbon dioxide(PaCO_(2))post-treatment was significantly lower in the observation group than that in the control group[(30.24±2.68)mmHg vs.(39.95±3.27)mmHg,t=14.52,P<0.05].The partial pressure of blood oxygen(PaO_(2))and oxygenation index(PaO_(2)/FiO_(2))in the observation group were(76.85±4.56)mmHg and(326.84±8.49)mmHg,respectively,which were significantly higher than those in the control group[(68.39±4.12)mmHg,(284.16±15.56)mmHg,t=-8.70,-15.22,both P<0.05].Serum levels of C-reactive protein and procalcitonin post-treatment in the observation group were(23.12±6.56)mg/L and(0.31±0.08)μg/L,respectively,which were significantly lower than those in the control group[(38.92±5.62)mg/L,(0.78±0.20)μg/L,t=11.56,13.80,both P<0.05].Sequential organ failure score was significantly lower in the observation group than in the control group[(2.31±0.46)points vs.(5.12±1.25)points,t=13.34,P<0.05].Conclusion Qianjin Weijing Decoction has a good therapeutic effect on severe pneumonia with the accumulation of phlegm and heat in the lung.The treatment can improve blood gas analysis and decrease inflammatory factor levels with a good prognosis.