调补固元法治疗肺脾肾虚型老年肺炎疗效观察
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摘要
目的:观察调补固元法治疗肺脾肾虚型老年肺炎患者的临床疗效及其对相关炎症因子、巨噬细胞迁移抑制因子(MIF)的影响。方法:将158例肺脾肾虚型老年肺炎患者随机分为治疗组与对照组各7 9例,对照组予常规治疗,治疗组在对照组治疗的基础上加用调补固元法治疗;观察2组临床疗效、中医证候积分、不良反应情况,并检测治疗前后肿瘤坏死因子(TNF-α)、白细胞介素-2(IL-2)、白细胞介素-6(IL-6)、超敏C-反应蛋白(h s-CRP)及MIF水平变化。结果:总有效率治疗组为89.9%,对照组为83.5%,2组比较,差异无统计学意义(P>0.05)。治疗后,2组中医证候积分均较治疗前降低(P<0.05),且治疗组积分下降较对照组更显著(P<0.05)。治疗后,2组患者TNF-α、IL-2、IL-6、h s-CRP、MIF水平均较治疗前下降(P<0.05),且治疗组上述各项指标改善较对照组更显著(P<0.05)。2组患者在治疗过程中均未见明显不良反应。结论:调补固元法辅助治疗肺脾肾虚型老年肺炎患者疗效肯定,能显著改善患者中医证候,降低炎症反应程度,且安全性高。
Objective:To observe the clinical effect of the method of regulating and reinforcing congenital qi for senile pneumonia of lung-spleen-kidney deficiency type, and its effect on the relevant inflammatory factors and macrophage migration inhibitory factor(MIF). Methods:Divided 158 cases of patients with senile pneumonia of lung-spleen-kidney deficiency type into the treatment group and the control group randomly, 79 cases in each group. The control group was given the routine treatment, while the treatment group additionally received the method of regulating and reinforcing congenital qi. Observed the clinical effect, Chinese medicine syndrome scores and occurrence of adverse reaction, in both groups, and detected the changes of levels of tumor necrosis factor(TNF-α),interleukin 2(IL-2),interleukin 6(IL-6),high sensitivity C-reactive protein(hs-CRP) and MIF before and after treatment. Results:The total effective rate was 89.9% in the treatment group and 83.5% in the control group, difference being insignificant(P > 0.05). After treatment,Chinese medicine syndrome scores in both groups were lower than those before treatment(P < 0.05),and the scores in the treatment group were decreased more significantly than those in the control group(P < 0.05). The levels of TNF-α, IL-2, IL-6,hs-CRP and MIF in both groups were lower than those before treatment(P < 0.05), and each index above in the treatment group was improved more evidently than those in the control group(P < 0.05). No significant adverse reactions occurred in both groups during treatment. Conclusion: The adjuvant therapy of the method of regulating and reinforcing congenital qi has definite clinical effect in treating senile pneumonia of lung-spleen-kidney deficiency type,can significantly improve the syndrome of patients and lower the degree of inflammatory reaction with high safety.
Objective:To observe the clinical effect of the method of regulating and reinforcing congenital qi for senile pneumonia of lung-spleen-kidney deficiency type, and its effect on the relevant inflammatory factors and macrophage migration inhibitory factor(MIF). Methods:Divided 158 cases of patients with senile pneumonia of lung-spleen-kidney deficiency type into the treatment group and the control group randomly, 79 cases in each group. The control group was given the routine treatment, while the treatment group additionally received the method of regulating and reinforcing congenital qi. Observed the clinical effect, Chinese medicine syndrome scores and occurrence of adverse reaction, in both groups, and detected the changes of levels of tumor necrosis factor(TNF-α),interleukin 2(IL-2),interleukin 6(IL-6),high sensitivity C-reactive protein(hs-CRP) and MIF before and after treatment. Results:The total effective rate was 89.9% in the treatment group and 83.5% in the control group, difference being insignificant(P > 0.05). After treatment,Chinese medicine syndrome scores in both groups were lower than those before treatment(P < 0.05),and the scores in the treatment group were decreased more significantly than those in the control group(P < 0.05). The levels of TNF-α, IL-2, IL-6,hs-CRP and MIF in both groups were lower than those before treatment(P < 0.05), and each index above in the treatment group was improved more evidently than those in the control group(P < 0.05). No significant adverse reactions occurred in both groups during treatment. Conclusion: The adjuvant therapy of the method of regulating and reinforcing congenital qi has definite clinical effect in treating senile pneumonia of lung-spleen-kidney deficiency type,can significantly improve the syndrome of patients and lower the degree of inflammatory reaction with high safety.
引文
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[10]宋培光,刘昕.参麦注射液雾化吸入对放射性肺炎患者血清C-反应蛋白和体液免疫功能变化的影响[J].中国实验方剂学杂志,2015,21(10):170-173.
[11]欧玉荣,康敏,周蕾,等.胃癌中幽门螺杆菌L型感染与MIF、MMP9、VEGF表达的关系[J].南方医科大学学报,2014,34(2):180-187.
[12]刘倩,杨红,张尚福.MIF和CD147在非小细胞肺癌中的表达及意义[J].四川大学学报:医学版,2010,41(1):85-90.
[2]Mishra R,Sahoo PK,Mishra S,et al.Bancroftianfilariasis:circulating B-1 cells decreased in microfilaria carriers and correlate with immunoglobulin M levels[J].Parasite Immunology,2014,36(5):207-217.
[3]中华医学会呼吸病学分会.中国成人社区获得性肺炎诊断和治疗指南(2016年版)[J].中华结核和呼吸杂志,2016,39(4):253-279.
[4]王洪蓓.扶正清肺化痰方治疗老年肺炎临床观察[J].东南大学学报:医学版,2015,34(4):616-619.
[5]李猛,徐红日,王成祥.中医扶正祛邪治则在老年肺炎治疗中的运用[J].北京中医药,2017,36(8):686-688.
[6]国家中医药管理局.ZY/T001.1~001.9-94中医病证诊断疗效标准[S].南京:南京大学出版社,1994:5.
[7]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,2002:36.
[8]Reynolds CA,Finkelstein JA,Ray GT,et al.Attributable healthcare utilization and cost of pneumoniae due to drug-resistant Streptococcus pneumoniae:a cost analysis[J].Antimicrobial Resistance&Infection Control,2014,3(1):1-8.
[9]董西华,阿布都外力·吐尼牙孜,杜毅鑫.PCT和CRP联合检测在细菌性肺炎和支原体肺炎鉴别诊断中的价值[J].广东医学,2014,35(10):1532-1534.
[10]宋培光,刘昕.参麦注射液雾化吸入对放射性肺炎患者血清C-反应蛋白和体液免疫功能变化的影响[J].中国实验方剂学杂志,2015,21(10):170-173.
[11]欧玉荣,康敏,周蕾,等.胃癌中幽门螺杆菌L型感染与MIF、MMP9、VEGF表达的关系[J].南方医科大学学报,2014,34(2):180-187.
[12]刘倩,杨红,张尚福.MIF和CD147在非小细胞肺癌中的表达及意义[J].四川大学学报:医学版,2010,41(1):85-90.