益气化痰法对重症肺炎患者血清sTREM—1水平变化的研究(1)
【摘要】 目的 观察益气化痰法对重症肺炎气虚痰阻型患者疗效以及对血清可溶性髓系细胞触发受体-1(sTREM-1)指标的变化。方法 40例重症肺炎患者随机分成对照组和试验组， 每组20例。对照组采用西医常规治疗， 试验组在此基础上加用益气化痰法的中药汤剂治疗， 观察两组患者治疗疗效以及对血清sTREM-1、C反应蛋白及T淋巴细胞分群水平变化。结果 治疗后试验组总有效率为85.00%， 优于对照组55.00%；治疗后试验组C反应蛋白、sTREM-1水平均明显低于对照组， CD3+、CD4+明显高于对照组， 差异有统计学意义(P<0.05)。结论 益气化痰法有抑制重症肺炎血清sTREM-1活性， 提高机体免疫力的作用， 对重症肺炎疗效显著。
【关键词】 益气化痰法；重症肺炎；血清可溶性髓系细胞触发受体-1；中西医结合治疗
DOI：10.14163/j.cnki.11-5547/r.2017.12.001
【Abstract】 Objective To observe the curative effect of Yiqi Huatan therapy for Qi deficiency-caused phlegm stagnation of severe pneumonia patients and changes of serum soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) index. Methods A total of 40 severe pneumonia patients were randomly divided into control group and experimental group， with 20 cases in each group. The control group received western medicine conventional therapy， and the experimental group also received traditional Chinese medicine decoction Yiqi Huatan therapy for treatment. Observation were made on curative effect， changes of serum sTREM-1， C-reactive protein and T lymphocyte classification level in two groups. Results After treatment， the experimental group had better total effective rate as 85.00% than 55.00% in the control group. After treatment， the experimental group had obviously lower C-reactive protein and sTREM-1 level than the control group， and obviously higher CD3+ and CD4+ than the control group. Their difference had statistical significance (P<0.05). Conclusion Yiqi Huatan therapy can restrain activity of serum sTREM - 1 of severe pneumonia and improve immunity of the organism， and it also has excellent curative effect for severe pneumonia.
【Key words】 Yiqi Huatan therapy； Severe pneumonia； Serum soluble triggering receptor expressed on myeloid cells-1； Combined treatment of traditional Chinese medicine and western medicine
重症肺炎又称中毒性肺炎或暴发性肺炎， 是由各种病原体所致严重菌血症或毒血症， 进而引起血压下降、休克、神志模糊、烦躁不安、谵妄和昏迷[1]， 死亡率可高达30%～50%， 它是导致重症加强护理病房(ICU)患者死亡的重要原因之一。现代医学对其发病机制尚未完全清楚， 研究发现血浆sTREM-1与肺炎的严重程度及细菌感染具有重要意义[2]。由于重症肺炎的耐药率、死亡率逐渐升高， 严重威胁着人们的健康， 所以本病受到了越来越多的中医药工作者的重视。在中医方面， 国内虽有大量的研究， 但多单从 “痰”、“热”、“瘀”、“虚”入手。但重症肺炎有虚有实， 即使实证， 亦系本虚标实；实证当清热、化痰、化瘀， 虚证必须扶正补虚[3-5]。本研究基于重症肺炎本虚标实的理论， 通过观察中醫药益气化痰法治疗重症肺炎患者的临床疗效， 并阐述其作用机制， 探讨其副作用， 结果报告如下。
1 资料与方法
1. 1 一般资料 选取2016年5～12月入住广州市增城区中医医院ICU的重症肺炎患者40例， 应用随机单盲法分成试验组和对照组， 每组20例。两组患者在性别、年龄、急性生理学及慢性健康状况评分系统Ⅱ(APACHEⅡ)评分等方面比较， 差异无统计学意义(P>0.05)， 具有可比性。见表1。
1. 2 诊断标准
1. 2. 1 西医诊断标准 入选病例均符合2007年由美国胸科学会及感染病学会联合提出的重症肺炎诊断标准[6]。, http://www.100md.com(吕雪莹 王修平 石一杰 单浩洪 黎小满)
【关键词】 益气化痰法；重症肺炎；血清可溶性髓系细胞触发受体-1；中西医结合治疗
DOI：10.14163/j.cnki.11-5547/r.2017.12.001
【Abstract】 Objective To observe the curative effect of Yiqi Huatan therapy for Qi deficiency-caused phlegm stagnation of severe pneumonia patients and changes of serum soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) index. Methods A total of 40 severe pneumonia patients were randomly divided into control group and experimental group， with 20 cases in each group. The control group received western medicine conventional therapy， and the experimental group also received traditional Chinese medicine decoction Yiqi Huatan therapy for treatment. Observation were made on curative effect， changes of serum sTREM-1， C-reactive protein and T lymphocyte classification level in two groups. Results After treatment， the experimental group had better total effective rate as 85.00% than 55.00% in the control group. After treatment， the experimental group had obviously lower C-reactive protein and sTREM-1 level than the control group， and obviously higher CD3+ and CD4+ than the control group. Their difference had statistical significance (P<0.05). Conclusion Yiqi Huatan therapy can restrain activity of serum sTREM - 1 of severe pneumonia and improve immunity of the organism， and it also has excellent curative effect for severe pneumonia.
【Key words】 Yiqi Huatan therapy； Severe pneumonia； Serum soluble triggering receptor expressed on myeloid cells-1； Combined treatment of traditional Chinese medicine and western medicine
重症肺炎又称中毒性肺炎或暴发性肺炎， 是由各种病原体所致严重菌血症或毒血症， 进而引起血压下降、休克、神志模糊、烦躁不安、谵妄和昏迷[1]， 死亡率可高达30%～50%， 它是导致重症加强护理病房(ICU)患者死亡的重要原因之一。现代医学对其发病机制尚未完全清楚， 研究发现血浆sTREM-1与肺炎的严重程度及细菌感染具有重要意义[2]。由于重症肺炎的耐药率、死亡率逐渐升高， 严重威胁着人们的健康， 所以本病受到了越来越多的中医药工作者的重视。在中医方面， 国内虽有大量的研究， 但多单从 “痰”、“热”、“瘀”、“虚”入手。但重症肺炎有虚有实， 即使实证， 亦系本虚标实；实证当清热、化痰、化瘀， 虚证必须扶正补虚[3-5]。本研究基于重症肺炎本虚标实的理论， 通过观察中醫药益气化痰法治疗重症肺炎患者的临床疗效， 并阐述其作用机制， 探讨其副作用， 结果报告如下。
1 资料与方法
1. 1 一般资料 选取2016年5～12月入住广州市增城区中医医院ICU的重症肺炎患者40例， 应用随机单盲法分成试验组和对照组， 每组20例。两组患者在性别、年龄、急性生理学及慢性健康状况评分系统Ⅱ(APACHEⅡ)评分等方面比较， 差异无统计学意义(P>0.05)， 具有可比性。见表1。
1. 2 诊断标准
1. 2. 1 西医诊断标准 入选病例均符合2007年由美国胸科学会及感染病学会联合提出的重症肺炎诊断标准[6]。, http://www.100md.com(吕雪莹 王修平 石一杰 单浩洪 黎小满)