桃仁承气汤加减联合针刺疗法治疗肺肾气虚、阳明腑实证急性呼吸衰竭的临床疗效及对血清降钙素原、C反应蛋白和白细胞介素10水平的影响

Clinical effect of modified Taoren Chengqi Decoction combined with acupuncture on serum levels of procalcitonin,C-reactive protein and interleukin-10 in acute respiratory failure of lung and kidney qi deficiency and yangmingfu-visceraexcess syndrome

目的观察桃仁承气汤加减联合针刺疗法治疗肺肾气虚、阳明腑实证急性呼吸衰竭患者的临床疗效及对血清降钙素原(PCT)、C反应蛋白(CRP)和白细胞介素10(IL-10)水平的影响。方法将72例肺肾气虚、阳明腑实证急性呼吸衰竭患者按照随机数字表法分为2组,对照组36例予以常规对症治疗,治疗组36例在对照组基础上予以桃仁承气汤加减联合针刺疗法治疗,均治疗7天。统计2组疗效、不良反应、治疗后排便间隔时间,比较2组治疗前后心率、呼吸频率、血气指标[动脉血氧分压(PaO_(2))及动脉血二氧化碳分压(PaCO_(2))]、血清炎症因子(PCT、CRP和IL-10)水平。结果治疗组总有效率97.22%(35/36),对照组总有效率83.33%(30/36),治疗组临床疗效优于对照组(P<0.05)。2组治疗后心率、呼吸频率均较本组治疗前降低(P<0.05),且治疗组治疗后低于对照组(P<0.05)。2组治疗后PaO_(2)水平均较本组治疗前升高(P<0.05),PaCO_(2)水平均降低(P<0.05),且治疗组治疗后PaO_(2)水平高于对照组(P<0.05),PaCO_(2)水平低于对照组(P<0.05)。2组治疗后血清PCT、CRP水平均较本组治疗前降低(P<0.05),IL-10水平均升高(P<0.05),且治疗组治疗后血清PCT、CRP水平均低于对照组(P<0.05),IL-10水平高于对照组(P<0.05)。治疗组治疗后排便间隔时间短于对照组(P<0.05)。2组治疗过程中未见不良反应。结论桃仁承气汤加减联合针刺疗法可降低急性呼吸衰竭患者炎症水平,提高临床疗效,改善临床症状。

Objective To observe the clinical efficacy of modified Taoren Chengqi Decoction combined with acupuncture on serum levels of procalcitonin(PCT),C-reactive protein(CRP)and interleukin10(IL-10)in acute respiratory failure(ARF)of lung and kidney qi deficiency and yangmingfu-visceraexcess syndrome.Methods Seventy-two ARF patients(lung and kidney qi deficiency and yangmingfu-visceraexcess syndrome)were randomized assigned into the control group(n=36)and the treatment group(n=36).All patients were managed by conventional symptomatic treatment,and those in the treatment group were additionally treated with modified Taoren Chengqi Decoction combined with acupuncture therapy.Treated for 7 days,the aim was to compare efficacy,treatment-emergent adverse events(TEAEs),and defecation interval time between groups.The levels of heart rate,respiratory rate,blood gas index including arterial partial oxygen pressure(PaO_(2))and arterial partial pressure of carbon dioxide(PaCO_(2)),serum inflammatory factors including PCT,CRP and IL-10 before and after treatment were assessed.Results The total effective rate of the treatment group was better than that of the control group(97.22%[35/36]vs 83.33%[30/36],P<0.05).After treatment,the levels of heart rate,respiratory rate of the two groups were significantly lower(P<0.05),and which were significantly lower in the treatment group than the control group(P<0.05).After treatment,significantly increased PaO_(2)and decreased PaCO_(2)were detected in both groups(P<0.05),and the treatment group was better than the control group for the levels of PaO_(2),PaCO_(2)(P<0.05).After treatment,significantly reduced PCT,CRP and elevated IL-10 were found in both groups(P<0.05),and there were significant differences in the serum levels of PCT,CRP and IL-10 between the treatment group and the control group(P<0.05).After treatment,the defecation interval time in the treatment group was significantly shorter than that in the control group(P<0.05).No TEAEs were found in groups.Conclusion For ARF patients,Taoren Chengqi Decoction combined with acupuncture can reduce the inflammatory level,improve clinical efficacy and clinical symptoms.