人参汤剂干预老年重症肺炎患者的临床疗效和安全性研究

Clinical efficacy and safety of ginseng decoction in treatment of severe pneumonia in elderly patients

目的探讨人参汤剂干预老年重症肺炎患者临床疗效和安全性。方法收集2022年4月—2023年6月于上海交通大学医学院附属仁济医院重症医学病区治疗的100例老年重症肺炎病例,根据随机数字法,将100例重症肺炎病例分为对照组与试验组,每组各50例,对照组给予常规治疗,试验组在常规治疗的基础上加用人参汤剂,然后统计2组患者在治疗后症状(包括发热、咳嗽、乏力、厌食、气喘)消失时间、实验室指标(WBC、NA、L、AST、LDH、CRP)变化情况、CT影像肺部病灶吸收情况和住院时间。记录服用人参汤剂后发生的不良事件(腹痛、恶心、呕吐及肾功能损伤)。结果经过治疗后,试验验组的发热、咳嗽、乏力、厌食、气喘等症状消失时间显著低于对照组,且差异具有统计学意义。2组实验室指标有所改善,其中试验组L、LDH、CRP水平较对照组相比明显改善,且差异具有统计学意义(P<0.05),其余指标无统计学意义(P>0.05)。2组在治疗后肺部吸收情况差异有统计意义(P<0.05)。试验组住院时间为(12.14±2.01)d,对照组住院时间为(13.10±2.47)d,差异具有统计学意义(P<0.05)。50例患者服用人参汤期间,共3人次出现轻微恶心、腹泻,均未停药,均未见肝、肾功能损害。结论人参汤剂可以有效辅助改善老年重症肺炎患者症状,降低炎症指标,促进肺部病灶的吸收,安全性良好,值得在大规模人群中推广研究。

Objective To study the clinical efficacy and safety of ginseng decoction in treatment of severe pneumonia in elderly patients.Methods 100 elderly patients with severe pneumonia treated in Department of Traditional Chinese Medicine,Renji Hospital Affiliated to Medical College of Shanghai Jiaotong University from April 2022 to June 2023 were enrolled.They were divided into control group and experimental group according to random number method,with 50 cases in each group.The control group was given routine treatment,and the experimental group was given ginseng decoction on the basis of routine treatment.Then,the disappearance time of symptoms(including fever,cough,fatigue,anorexia,and asthma),changes of laboratory indexes(WBC,NA,L,AST,LDH,CRP),the absorption of lung lesions on CT images,and the length of hospital stay after treatment were compared between the two groups.Results After treatment,the disappearance time of symptoms such as fever,cough,fatigue,anorexia,and asthma in the experimental group was significantly shorter than that in the control group,and the difference was statistically significant(P<0.05).The laboratory indexes of the two groups were improved.Among these laboratory indexes,the levels of L,LDH and CRP in the experimental group were significantly improved compared with the control group,and the differences were statistically significant(P<0.05),while the other indexes were not statistically significant(P>0.05).There was statistical significance in absorption of lung lesions between the two groups after treatment(P<0.05).The length of hospital stay of the experimental group was(12.14±2.01)d,and that of the control group was(13.10±2.47)d,and the difference was statistically significant(P<0.05).During the administration of ginseng decoction,mild nausea and diarrhea occurred in 3 cases of 50 patients.None of the patients stopped taking the drug and no liver or kidney function damage was observed.Conclusion Ginseng decoction can effectively assist in improving symptoms of elderly patients with severe pneumonia,reducing inflammatory indexes,promoting the absorption of lung lesions,and has good safety.It is worth promoting and researching in a large-scale population.