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
-
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。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.
-
-
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. -
期刊类型引用(15)
1. 薛彦霞,刘雨情,续自凤. 升降散加减治疗重症肺炎(痰热壅肺型)的效果及对炎症因子和外周血T淋巴细胞群的影响. 中外医疗. 2024(09): 31-34 . 百度学术
2. 张敏. 中医定向透药疗法对肺炎患儿临床疗效及炎性因子水平的影响. 反射疗法与康复医学. 2024(17): 8-10+17 . 百度学术
3. 李文艳,许志强. 呼吸机相关肺炎危重症患者使用合生元制剂联合肠内营养序贯治疗的临床研究. 中国药物与临床. 2024(20): 1341-1345 . 百度学术
4. 闵翼,殷智,潘旭. 清金降火汤治疗痰热壅肺型肺炎的临床研究. 航空航天医学杂志. 2023(01): 66-68 . 百度学术
5. 李思灵,颜沃志,廖夏萍. 纤维支气管镜下盐酸氨溴索注射液肺泡灌洗治疗COPD合并呼吸衰竭的效果. 中国医学创新. 2023(02): 50-54 . 百度学术
6. 郑相,范青红,邱芳晖. 清肺化痰汤联合西医常规治疗呼吸机相关性肺炎老年患者临床研究. 新中医. 2023(04): 21-24 . 百度学术
7. 董璐阳,张琳,李怡辉. 中医护理干预对呼吸机相关肺炎患者血气指标、生活质量的影响. 实用中医内科杂志. 2023(02): 80-83 . 百度学术
8. 丁鑫,钱占红. 升降散对脓毒症所致急性肺损伤小鼠的保护作用. 环球中医药. 2023(04): 591-597 . 百度学术
9. 罗志辉,王昆秀,张艳琳,陈子琴,陈贝,陈佳,周婷,顾骁磊,李崇立,闫鹏,田玲玲,徐驰成,陈柏霖,陈松,祁青. 回顾性分析三消饮加减方治疗轻型/普通型新型冠状病毒肺炎患者的临床疗效. 中国实验方剂学杂志. 2022(01): 150-156 . 百度学术
10. 周同鑫,石静娟,裴昶,曹振华,殷智,钱丽. “支炎一号”方治疗成人痰热壅肺型支气管扩张临床疗效分析. 中外医疗. 2022(02): 103-106 . 百度学术
11. 章文莉,汪芬华,陈梅. 天枢穴贴敷联合升降散保留灌肠治疗呼吸机相关性肺炎52例. 中国中医药科技. 2022(05): 931-932+935 . 百度学术
12. 马文静,张维利,刘素梅,祁佩红. 加味温胆汤对痰湿蕴肺型慢性阻塞性肺疾病急性加重期患者炎症细胞因子表达及BODE指数的影响. 中医药信息. 2022(09): 53-57+62 . 百度学术
13. 姜立娟,魏岩,张文风. 升降散证治探微. 长春中医药大学学报. 2022(10): 1063-1066 . 百度学术
14. 张爱宝,白小丽,成媛,薛云霞. 超声脉冲电导辅助治疗小儿支气管肺炎的临床观察. 中国民间疗法. 2021(15): 77-79 . 百度学术
15. 刘蓉. 心外科ICU呼吸机相关性肺炎患者病原菌的分布分析与研究. 名医. 2020(10): 85-86 . 百度学术
其他类型引用(2)
计量
- 文章访问数: 217
- HTML全文浏览量: 24
- PDF下载量: 10
- 被引次数: 17