升降散保留灌肠对痰热壅肺型呼吸机相关性肺炎患者中医证候积分、临床疗效及相关炎症因子的影响

顾雯艳; 王蠡; 马彩毓; 丁纯蕾; 钱风华; 赵雷

doi:10.7619/jcmp.202001018

升降散保留灌肠对痰热壅肺型呼吸机相关性肺炎患者中医证候积分、临床疗效及相关炎症因子的影响

1. 上海中医药大学附属岳阳中西医结合医院急诊医学科, 上海, 200437;
2. 上海永慈康复医院外科, 上海, 201106

基金项目:

上海市卫生和计划生育委员会中管局［2016］中医特色诊疗能力提升项目(TSJS2016025)

详细信息

通讯作者:
赵雷, E-mail: smileqian1975@qq.com

中图分类号: R563.1
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出版历程
- 收稿日期: 2019-10-17
- 网络出版日期: 2020-12-22
- 发布日期: 2020-08-06

Effect of retention enema by Shengjiang Powder in treating ventilator-associated pneumonia differentiated as phlegm-heat congesting in lungs syndrome on TCM syndrome scores, curative effect and related inflammatory factors

1. Department of Emergency Medicine, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, 200437;
2. Surgical Department, Shanghai Yongci Rehabilitation Hospital, Shanghai, 200437

摘要

摘要: 目的探讨升降散保留灌肠辅助治疗痰热壅肺型呼吸机相关性肺炎对患者中医证候积分、疗效及相关炎症因子水平的影响。方法选取痰热壅肺型呼吸机相关性肺炎患者62例作为研究对象,按照随机数字表法分为对照组和治疗组,对照组采用常规治疗方法,治疗组在对照组治疗基础上加用保留灌肠中药汤剂升降散,观察并比较2组患者的降钙素原(PCT)、C反应蛋白(CRP)、白介素-1β(IL-1β)、白介素-2R(IL-2R)、肿瘤坏死因子-α(TNF-α)、白介素-8(IL-8)、白介素-6(IL-6)、白介素-10(IL-10)水平和中医证候积分、疗效。结果治疗后, 2组患者CRP、PCT、IL-1β、IL-2R、TNF-α、IL-6、IL-8水平均低于治疗前, IL-10水平高于治疗前,且治疗组CRP、PCT、IL-1β、IL-2R、TNF-α、IL-6、IL-8水平低于对照组, IL-10水平高于对照组,差异均有统计学意义(P<0.05或P<0.01); 治疗后, 2组患者中医证候积分均低于治疗前,且治疗组患者治疗后的中医证候积分低于对照组患者,差异均有统计学意义(P<0.05); 治疗组的治疗有效率高于对照组,差异有统计学意义(P<0.05); 治疗组患者未出现严重不良反应。结论升降散保留灌肠法联合西医治疗能降低痰热壅肺型呼吸机相关性肺炎患者CRP、PCT、IL-1β、IL-2R、TNF-α、IL-6、IL-8水平,升高IL-10水平,并降低中医证候评分,提高疗效。
- 升降散 /
- 呼吸机相关性肺炎 /
- 痰热蕴肺证 /
- 中医证候 /
- 炎症机制 /
- 保留灌肠
Abstract: Objective To explore effect of retention enema by Shengjiang Powder in treating ventilator-associated pneumonia differentiated as phlegm-heat congesting in lungs on TCM syndrome scores, curative effect and related inflammatory factors. Methods A total of 62 patients with ventilator-associated pneumonia differentiated as phlegm-heat congesting in lungs were divided into control group and treatment group according to random number table method. The control group was given conventional treatment method, and the treatment group was treated with retention enema by Shengjiang Powder Decoction of traditional Chinese medicine. The levels of procalcitonin(PCT), C reactive protein(CRP), interleukin-1β(IL-1 β), interleukin-2R(IL-2R), tumor necrosis factor- α(TNF- α), interleukin-8(IL-8), interleukin-6(IL-6), interleukin-10(IL-10)as well as TCM syndrome scores and efficacy in the two groups were observed and compared. Results After treatment, CRP, PCT, IL-1 β, IL-2R, TNF-α, IL-6, IL-8 were lower than before treatment, and IL-10 was higher- than before treatment(P<0.05), and treatment group changed more significantly than that in the control group(P<0.05 or P<0.01). After treatment, the scores of TCM syndromes in the two groups were lower than before treatment(P< 0.05), and the treatment group was lower than that in the control group(P<0.05). The effective rate of the treatment group was higher than that of the control group( P< 0.05). No serious adverse reactions occurred in the treatment group. Conclusion Retention enema combined with western medicine can reduce the levels of RP, PCT, IL-1 β, IL-2R, TNF-α, IL-6 and IL-8, increase the level of IL-10, reduce the TCM syndrome integral and improve the curative effect.
- Shengjiang Powder /
- ventilator-associated pneumonia /
- phlegm-heat congesting in lungs syndrome /
- traditional Chinese medicine syndrome /
- inflammatory mechanism /
- retention enema

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参考文献(17)

陈凡, 张汉业, 胡敏锋, 等. 探索支气管镜肺泡灌洗术用于呼吸机相关性肺炎治疗的效果[J]. 中国现代药物应用, 2017, 11(4): 113-114.

Treschan T A, Kaisers W, Schaefer M S, et al. Ventilation with low tidal volumes during upper abdominal surgery does not improve postoperative lung function[J]. Br J Anaesth, 2012, 109(2): 263-271.

Yalçlnsoy M, Salturk C, Taklr H B, et al. Case fatality rate related to nosocomial and ventilator-associated pneumonia in an ICU: a single-centre retrospective cohort study[J]. Wien Klin Wochenschr, 2016, 128(3/4): 95-101.

中华医学会重症医学分会. 呼吸机相关性肺炎诊断、预防和治疗指南(2013)[J]. 中华内科杂志, 2013, 52(6): 524-524.

王永炎. 中医内科学[M]. 上海: 上海科学技术出版社, 2006: 60-60.

郑筱萸. 中药新药临床研究指导原则(试行)[M]. 北京: 中国医药科技出版社, 2002: 54-54.

Khurana S, Mathur P, Kumar S, et al. Incidence of ventilator-associated pneumonia and impact of multidrug-resistant infections on patient's outcome: experience at an apex trauma centre in North India[J]. Indian J Med Microbiol, 2017, 35(4): 504-510.

Yoon B H, Romero R, Park J S, et al. The relationship among inflammatory lesions of the umbilical cord(funisitis), umbilical cord plasma interleukin 6 concentration, amniotic fluid infection, and neonatal Sepsis[J]. Am J Obstet Gynecol, 2000, 183(5): 1124-1129.

Lagier D, Platon L, Lambert J, et al. Protective effect of early low-dose hydrocortisone on ventilator-associated pneumonia in the cancer patients: a propensity score analysis[J]. Ann Intensive Care, 2017, 7(1): 106-106.

Ahmad S, Bacha N, Bakht J, et al. Characterization of pathogens involved in ventilator associated pneumonia in surgical and medical intensive care units - A single center experience[J]. Pak J Pharm Sci, 2017, 30(6): 2091-2099.

Kim K E, Han J Y. Evaluation of the clinical performance of an automated procalcitonin assay for the quantitative detection of bloodstream infection[J]. Korean J Lab Med, 2010, 30(2): 153-159.

刘文军, 薛燕星, 胡东鹏. 升降散的现代药理机制研究进展[J]. 北京中医药, 2012, 31(12): 939-943.

张慧林, 赵妍. 大黄的药理作用及临床应用分析[J]. 光明中医, 2015, 30(5): 1119-1121.

石朝积, 冉春艳, 吴兴文, 等. 肠内营养联合益生菌减少呼吸机相关性肺炎的价值分析[J]. 医学研究与教育, 2017, 34(3): 1-5.

王定淼, 陈琳, 陈勇, 等. 早期应用复合乳酸菌预防呼吸机相关肺炎的临床疗效及对炎症因子的影响研究[J]. 临床肺科杂志, 2015, 20(9): 1645-1648.

于建玉, 廖欣, 丁厚伟, 等. 中药大黄药理作用研究进展及其临床应用[J]. 中国现代药物应用, 2016, 10(11): 286-287.

朱亮, 奚耀, 赵雷, 等. 升降散对脓毒症小鼠Th1/Th2和 Th17/Treg失衡的干预[J]. 中国急救医学, 2015, 35(5): 402-402.