宣肺祛痈方联合纤维支气管镜肺泡灌洗治疗老年重症肺炎的临床效果

Clinical Effect of Xuanfei Quyong Prescription Combined with Bronchoscopic Alveolar Lavage in the Treatment of Severe Pneumonia in the Elderly

目的 探讨宣肺祛痈方联合纤维支气管镜(纤支镜)肺泡灌洗治疗老年重症肺炎的临床效果。方法 选取河南省第二人民医院2020年8月至2022年3月94例老年重症肺炎患者为研究对象,通过随机数字表法将其分为对照组(47例)和观察组(47例)。所有患者确诊后即刻接受吸氧、升压、抗感染等常规治疗,对照组患者在此基础上进行纤维支气管镜肺泡灌洗治疗,观察组在对照组基础上加用宣肺祛痈方治疗,两组均治疗14 d。比较所有患者,治疗前、治疗14 d时C反应蛋白(CRP)、白细胞计数(WBC)、降钙素原(PCT)指标变化;统计并对比临床肺部感染评分表(CPIS)、急性生理学和慢性健康状况评价Ⅱ(APACHEⅡ)评分。于治疗14 d评定并对比两组患者临床疗效,并记录14 d内不良反应发生情况。结果 治疗14 d,观察组治疗总有效率高于对照组,差异有统计学意义(P<0.05);治疗14 d,两组患者血清CRP、WBC、PCT水平降低,且观察组低于对照组,差异有统计学意义(P<0.05);治疗14 d,两组CPIS、APACHEⅡ评分降低,且观察组低于对照组,差异有统计学意义(P<0.05);治疗14 d内,两组不良反应发生率对比,差异无统计学意义(P>0.05)。结论 宣肺祛痈方联合纤支镜肺泡灌洗治疗老年重症肺炎的效果显著,可有效控制肺部感染,促进疾病恢复。

Objective To explore the clinical effect of Xuanfei Quyong prescription combined with bronchoscopic alveolar lavage in the treatment of severe pneumonia in the elderly.Methods A total of 94 elderly patients with severe pneumonia from the Second People’s Hospital of Henan Province from August2020 to March 2022 were selected as the study subjects.According to random number table,they were divided into control group(47 cases)and observation group(47 cases).All patients received routine treatment such as oxygen inhalation,pressure boosting and anti-infection immediately after diagnosis.On this basis,patients in control group were treated with bronchoscopic alveolar lavage.On the basis of control group,patients in observation group were treated with Xuanfei Quyong prescription therapy.The two groups were treated for 14 days.The changes of C-reactive protein(CRP),white blood cell count(WBC)and procalcitonin(PCT)in all patients before and 14 days after treatment were compared.The clinical pulmonary infection scale(CPIS),acute physiology and chronic health evaluationⅡ(APACHEⅡ)score were recorded.The clinical efficacy of the two groups was evaluated and compared on the 14th day of treatment,and occurrence of adverse reactions within the 14 days was recorded.Results After 14 days of treatment,compared with control group,the total effective rate of the observation group was higher,with a statistical significant difference(P<0.05).After 14 days of treatment,compared with control group,the levels of serum CRP,WBC and PCT in both groups were lower,with a statistical significant difference(P<0.05).After 14 days of treatment,scores of CPIS and APACHEⅡin both groups decreased,and compared with control group,observation group was lower,with a statistical significant difference(P<0.05).Within 14 days of treatment,the difference was not statistically significant in incidence of adverse reactions in both groups(P>0.05).Conclusion Xuanfei Quyong prescription combined with bronchoscopic alveolar lavage has a significant effect on treatment of severe pneumonia in the elderly,which can effectively control lung infection and promote the recovery of the disease.