益元清肺汤辅助治疗老年重症肺炎呼吸支持患者疗效及对临床症状的影响

Efficacy of Yiyuan Qingfei Decoction(益元清肺汤)in Adjuvant Treatment of Elderly Patients with Severe Pneumonia and Respiratory Support and The Influence on Clinical Symptoms

目的探讨益元清肺汤辅助治疗老年重症肺炎呼吸支持患者疗效及对临床症状的影响。方法将150例老年重症肺炎呼吸支持患者随机分为对照组(75例,常规综合治疗措施)和治疗组(75例,对照组基础上另加益元清肺汤辅助治疗),比较两组治疗效果。结果治疗14 d后,相较对照组,治疗组临床有效率更高[94.67%(71/75)vs.76.00%(57/75)],症状体征消失更快,脱机时间更长,炎症因子[C反应蛋白(C-reactive protein,CRP)、中性粒细胞计数(neutrophil count,NEUT)、白细胞计数(white blood cells,WBC)]更少,临床肺感染评分(clinical pulmonary infection score,CPIS)更低,血气指标[氧合指数、肺表面活性蛋白A(pulmonary surfatcant-associated protein,SP-A)]、免疫功能[免疫球蛋白A(immunoglobulin A,IgA)、免疫球蛋白G(immunoglobulin G,IgG)、免疫球蛋白M(immunoglobulin M,IgM)、嗜酸性粒细胞(eosinophil,EOS)]和氧化应激指标丙二醛(malondialdehyde,MDA)、超氧化物歧化酶(SOD)、谷胱甘肽过氧化物(GPX)改善更显著。结论益元清肺汤辅助治疗老年重症肺炎呼吸支持患者疗效显著,可进一步改善临床症状,提升肺换气功能、免疫功能和抗氧化应激能力,并减轻炎症反应,值得临床推广应用。

Objective To investigate the efficacy of Yiyuan Qingfei Decoction(益元清肺汤)in adjuvant treatment of elderly patients with severe pneumonia and respiratory support and the influence on clinical symptoms.Methods A total of 150 elderly patients with severe pneumonia and respiratory support were randomly assigned to a control group(75 patients undergoing conventional comprehensive treatments)and a treatment group(75 patients treated with Yiyuan Qingfei Decoction based on the treatments of the control group).Therapeutic effects were compared between groups.Results After 14 d of treatment,the total effective rate(94.67%,71/75)in the treatment group was higher than that(76.00%,57/75)in the control group.The clinical response rate was higher,the disappearance time of symptoms and signs was shorter,the offline period was longer,inflammatory factors[C-reactive protein(CRP),neutrophil count(NEUT)and white blood cells(WBC)]and clinical pulmonary infection score(CPIS)were lower,blood gas indexes[oxygenation index and pulmonary surfatcant-associated protein(SP-A)],immune function[immunoglobulin A(IgA),immunoglobulin G(IgG),immunoglobulin M(IgM)and eosinophil(EOS)]and oxidative stress indexes[malondialdehyde(MDA),superoxide dismutase(SOD)and glutathione peroxide(GPX)]were improved more significantly in the treatment group compared with those in the control group.Conclusion Yiyuan Qingfei Decoction is effective in treating elderly patients with severe pneumonia and respiratory support,which can improve the patients’clinical symptoms,pulmonary ventilation function,immune function and response to oxidative stress and alleviate inflammatory response.