清源生化汤联合乌司他丁在重症肺炎患者中的应用效果

Application Effect of Qingyuan Shenghua Decoction Combined with Ulinastatin in Severe Pneumonia Patients

目的探讨清源生化汤联合乌司他丁在重症肺炎患者中的应用效果。方法本研究以河南省直第三人民医院的重症肺炎患者为研究对象,选择2019年10月至2022年10月收治的符合纳入和排除标准的患者90例。将患者以抛硬币法分为观察组、对照组,各46例。两组均接受基础干预,对照组加以乌司他丁治疗,观察组加以乌司他丁、清源生化汤治疗。两组均治疗7 d。比较两组治疗总有效率、炎症指标、免疫功能相关指标水平、肺功能指标、预后评分以及不良反应发生率。结果观察组总有效率(91.30%)高于对照组(76.09%),差异有统计学意义(χ^(2)=3.903,P=0.048)。干预前,两组患者炎症指标水平差异无统计学意义(P>0.05);干预7 d后,两组炎症指标水平均降低(P<0.001),且观察组低于对照组(P<0.05)。干预前,两组患者的免疫功能差异无统计学意义(P>0.05),干预后,两组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平升高(P<0.005),CD8^(+)升高无统计学意义(P>0.05);且观察组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平高于对照组(P<0.05)。干预前,两组患者第1秒用力呼气容积占预计值百分比(FEV_(1)%)、第1秒用力呼气容积/用力肺活量(FEV_(1)/FVC)差异无统计学意义(P>0.05),干预7 d后,两组肺功能指标均升高(P<0.001),且观察组高于对照组(P<0.05)。干预前,两组患者预后评分差异无统计学意义(P>0.05),干预7 d后,两组评分均降低(P<0.001),且观察组低于对照组(P<0.001)。观察组不良反应发生率(10.87%)与对照组相比(13.04%),差异无统计学意义(χ^(2)=0.103,P=0.748)。结论清源生化汤联合乌司他丁能够改善肺炎患者免疫功能及肺功能,发挥肺保护作用,减轻炎症反应,提高治疗效果,改善预后,且相对安全。

Objective To explore the application effect of Qingyuan Shenghua decoction combined with Ulinastatin in severe pneumonia patients.Methods In this study,patients with severe pneumonia in the Third People’s Hospital of Henan Province were selected as the research objects,and 90 patients who met the inclusion and exclusion criteria were selected from October 2019 to October 2022.Patients were separated into observation and control groups using the coin toss approach,with 46 cases in each group.Both groups received basic intervention;the control group received ulinastatin,while the observation group received both ulinastatin and Qingyuan Shenghua decoction.Both groups were treated for seven days.The two groups were compared in terms of total effective rate,inflammatory indicators,immune function-related indicators,lung function indicators,prognosis ratings,and adverse reaction incidence.Results The total effective rate of observation group(91.30%)was higher than that of control group(76.09%),and the difference was statistically significant(χ^(2)=3.903,P=0.048).Before intervention,there was no significant difference in the level of inflammatory indicators between the two groups(P>0.05).After 7 days of intervention,the levels of inflammatory indicators in both groups were decreased(P<0.001),and the observation group was lower than the control group(P<0.05).Before intervention,there was no statistically significant difference in immune function between the two groups(P>0.05).After intervention,the levels of CD3^(+),CD4^(+),CD4^(+)/CD8^(+)in the two groups increased(P<0.05),CD8^(+)was not significantly increased(P>0.05).The observation group had significantly greater levels of CD3^(+),CD4^(+),and CD4^(+)/CD8^(+)compared to the control group(P<0.05).Before the intervention,there was no significant difference in forced expiratory volume in one second as a percentage of predicted value(FEV_(1)%)or forced expiratory volume in one second/forced vital capacity(FEV_(1)/FVC)between the two groups(P>0.05).After intervention for 7 days,the pulmonary function indexes of the two groups were increased(P<0.05),and observation group was higher than control group(P<0.05).Before intervention,there was no significant difference in prognostic scores between the two groups(P>0.05).After 7 days of intervention,scores in both groups decreased(P<0.05).The observation group was significantly lower than the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the observation group(10.87%)and the control group(13.04%)(χ^(2)=0.103,P=0.748).Conclusion The combination of Qingyuan Shenghua decoction and ulinastatin can improve the immune and lung function of pneumonia patients,exert lung protective effects,reduce inflammatory reactions,improve treatment effectiveness,improve prognosis,and is relatively safe.