加味千金苇茎汤联合纤维支气管镜灌洗术治疗重症肺炎患者的临床疗效观察

The clinical effect of the Qianjin Weijing decoction plus fiberoptic bronchoscopy lavage on severe pneumonia

目的:探究与分析加味千金苇茎汤联合纤维支气管镜灌洗术治疗重症肺炎患者的临床疗效。方法:选取福建中医药大学附属第三人民医院2018年5月-2020年5月收治的重症肺炎患者90例,采取随机数字表法分为对照组和观察组,每组45例。对照组给予纤维支气管镜灌洗术治疗,观察组在其基础上加用加味千金苇茎汤治疗,对比两组临床疗效、治疗前后血气分析指标及血清炎症指标水平,同时观察不良反应。结果:观察组与对照组相比临床总有效率较高,差异有统计学意义(P<0.05)。观察组治疗后与对照组治疗后相比动脉血氧分压(Partial Pressure of Oxygen,PaO_(2))值较高、动脉二氧化碳分压(Partial Pressure of Carbon Oxygen,PaCO_(2))值较低、血氧饱和度(Oxygen Saturation,SaO_(2))值较高、氧合指数[PaO_(2)/吸入氧体积分数(Fraction of Inspire Oxygen,FiO_(2))]值较高,差异有统计学意义(P<0.05)。观察组治疗后与对照组治疗后相比CD11b+中性粒细胞比例较低、血清可溶性髓系细胞触发受体-1(Soluble Myeloid Cell Trigger Receptor-1,sTREM-1)值较低、高迁移率族蛋白B1(High Mobility Group Box 1 Protein,HMGB1)值较低,差异有统计学意义(P<0.05)。二者不良反应差异无统计学意义(P>0.05)。结论:加味千金苇茎汤联合纤维支气管镜灌洗术治疗重症肺炎患者可有效改善临床症状及体征,改善血气指标以及血清炎症反应,但不增加不良反应,安全性较高。

Objective:To explore and analyze the clinical efficacy of the Qianjin Weijing decoction(千金苇茎汤)plus fiberoptic bronchoscopy lavage on severe pneumonia.Methods:A total of 90 cases from May 2018 to May 2020 were selected and randomly divided into groups by the random number table method,with 45 cases in each group.The control group was given fiberoptic bronchoscopy lavage,and the observation group was additionally treated with the Qianjin Weijing decoction.Results:Compared with the control group,the total efficiency in the observation group was higher,and the difference was statistically significant(P<0.05).Compared with the control group after treatment,the arterial PaO_(2) level in the observation group was higher,the partial PaCO_(2) level in the observation group was lower,the SaO_(2) level in the observation group was higher,the PaO_(2)/FiO_(2) level in the observation group was higher,and the differences were statistically significant(P<0.05).Compared with the control group after treatment,the proportion of CD11b+neutrophils,sTREM-1 level,and HMGB1 level in the observation group were lower,and the differences were statistically significant(P<0.05).There was no significant difference in adverse reactions between the two groups(P>0.05).Conclusion:The Qianjin Weijing decoction plus fiberoptic bronchoscopy lavage on severe pneumonia can effectively relieve the clinical symptoms and signs,ameliorate blood gas indexes and serum inflammatory response,but does not increase adverse reactions,with high safety.