七味白术散治疗老年肺炎肺脾气虚证的疗效及对胃肠功能的影响

Effect of Qiwei Baizhu Powder on gastrointestinal function in senile pneumonia with lung spleen-deficiency

目的 观察七味白术散对老年肺炎肺脾气虚证的疗效及对胃肠功能的影响。方法 将60例老年肺炎肺脾气虚证患者按照随机数字表法分为2组,对照组30例予常规基础治疗,治疗组30例在对照组治疗基础上予七味白术散加减治疗。2组均治疗2周。比较2组治疗前后中医证候评分、外周血炎症因子[白细胞介素6(IL-6)、白细胞计数(WBC)、C反应蛋白(CRP)、降钙素原(PCT)]水平、胃肠功能指标(腹内压、肠鸣音次数)及肠道菌群情况,并统计2组疗效及安全性。结果 治疗组总有效率93.33%(28/30),对照组总有效率73.33%(22/30),治疗组临床疗效优于对照组(P<0.05)。2组治疗后中医证候各项评分均较本组治疗前降低(P<0.05),且治疗组治疗后均低于对照组(P<0.05)。2组治疗后IL-6、WBC、CRP、PCT水平均较本组治疗前降低(P<0.05),且治疗组治疗后均低于对照组(P<0.05)。2组治疗后腹内压均较本组治疗前降低(P<0.05),肠鸣音次数均增加(P<0.05),且治疗组治疗后腹内压低于对照组(P<0.05),肠鸣音次数高于对照组(P<0.05)。2组治疗后肠道乳酸杆菌、双歧杆菌菌落数均较本组治疗前增加(P<0.05),肠球菌、肠杆菌菌落数均降低(P<0.05),且治疗组治疗后乳酸杆菌、双歧杆菌菌落数均高于对照组(P<0.05),肠球菌、肠杆菌菌落数均低于对照组(P<0.05)。2组治疗期间未出现肝肾功能异常。结论 七味白术散治疗老年肺炎肺脾气虚证疗效显著,可有效降低炎症因子水平,调节肠道菌群,改善胃肠功能,安全性高。

Objective To explore the clinical effect of Qiwei Baizhu Powder on gastrointestinal function in senile pneumonia with lung spleen-deficiency.Methods Sixty senile pneumonia patients were randomly assigned into the treatment group(n=30)and the control group(n=30).All patients were managed by conventional therapy,and those in the treatment group were additionally treated with modified Qiwei Baizhu Powder.Treated for 2 weeks,the aim was to compare traditional Chinese medicine(TCM)syndrome score,peripheral blood inflammatory factors including interleukin-6(IL-6),white blood cell count(WBC),C-reactive protein(CRP)and calcitonin(PCT),gastrointestinal function indexes including intra-abdominal pressure,frequency of bowel sounds,as well as intestinal flora before treatment and after treatment.The efficacy and safety between groups were analyzed.Results The total effective rate in the treatment group was significantly higher than that in the control group(93.33%[28/30]vs 73.33%[22/30],P<0.05).After treatment,the TCM syndrome scores,peripheral blood inflammatory factors including IL-6,WBC,CRP,PCT were significantly decreased in the two groups(P<0.05),and the decrease was more prouniunced in the treatment group compared with the control group(P<0.05).After treatment,significantly decreased intra-abdominal pressure and increased frequency of bowel sounds were detected in the two groups(both P<0.05),the treatment group was superior to the control group for the intra-abdominal pressure and frequency of bowel sounds(both P<0.05).After treatment,significantly higher colony numbers of intestinal lactobacilli and bifidobacteria and lower enterococci and enterobacteria were found in the two groups(both P<0.05),the treatment group was better than the control group for colony numbers of lactobacilli and bifidobacteria,as well as enterococci and enterobacteria(both P<0.05).No treatment-emergent adverse events for abnormal liver and kidney function occurred in the two groups.Conclusion Qiwei Baizhu Powder has significant curative effect in the treatment of senile pneumonia with lung spleen-deficiency.It can effectively reduce the level of inflammatory factors,regulate intestinal flora,improve gastrointestinal function,and has high safety.