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痰热清注射液辅助治疗痰热阻肺型AECOPD合并肺炎的疗效观察
作者:吴刚  刘易珏 
单位:华中科技大学同济医学院附属武汉市中心医院 急诊内科, 湖北 武汉 430000
关键词:慢性阻塞性肺疾病急性加重 肺炎 痰热清注射液 炎性因子 
分类号:R563.1
出版年·卷·期(页码):2019·47·第二期(127-131)
摘要:

目的:探讨痰热清注射液在痰热阻肺型慢性阻塞性肺疾病急性加重(AECOPD)合并肺炎治疗中的临床价值。方法:选取2016年3月~2018年3月收治的痰热阻肺型AECOPD合并肺炎患者82例为研究对象,以随机数字表法分为对照组41例,观察组41例,对照组行常规西医治疗,观察组在对照组基础加用痰热清注射液。观察两组治疗效果,治疗前、治疗2周后肺功能、炎性因子变化及治疗期间不良反应发生情况。结果:观察组治疗总有效率为95.12%,与对照组80.49%比较,明显较高,差异有统计学意义(P<0.05);两组治疗前肺功能及炎性因子差异无统计学意义(P>0.05),治疗2周后,观察组第1秒用力呼吸容积(FEV1)、用力肺活量(FVC)、FEV1/FVC分别为(1.88±0.31)L、(2.71±0.43)L、(73.26±7.91)%,与同期对照组(1.71±0.32)L、(2.49±0.41)L、(68.43±7.82)%比较,均明显较高,观察组血清肿瘤坏死因子-α(TNF-α)、可溶性髓样细胞触发受体-1(sTREM-1)、白介素-8(IL-8)水平分别为(25.26±4.26)ng·L-1、(43.25±6.14)μg·L-1、(28.61±4.89)ng·L-1,与同期对照组(30.48±4.43)ng·L-1、(52.86±6.79)μg·L-1、(33.76±4.93)ng·L-1比较,均明显较低,差异有统计学意义(P<0.05);观察组治疗期间不良反应发生率为17.07%,与对照组12.20%比较,差异无统计学意义(P>0.05)。结论:痰热清注射液辅助治疗痰热阻肺型AECOPD合并肺炎,可有效改善患者肺功能,调节炎性因子水平,疗效确切,安全性高,值得推广。

Objective:To investigate the clinical value of Tanreqing injection in the treatment of pulmonary retention of phlegmopyrexia type acute exacerbation of chronic obstructive pulmonary disease(AECOPD) with pneumonia. Methods:82 cases of pulmonary retention of phlegmopyrexia type AECOPD with pneumonia treated in March 2016~March 2018 were enrolled in the study,and divided into 41 cases in each control group and observation group by random digital table method.The control group was treated with conventional western medicine, and the observation group was giventanninqing injection on top of what the control group received. The treatment effects,changes in lung function and inflammatory factors before treatment and after 2 weeks of treatments, adverse reactions during treatment of the two groups were observed. Results:The total effective rate in the observation group was 95.12%, which was significantly higher than that in the control group (80.49%, P<0.05). There was no significant difference in pulmonary function and inflammatory factors between the two groups before treatment (P>0. 05). After 2 weeks of treatment, the forced respiratory volume (FEV1) and forced vital capacity (FVC), FEV1)/FVC were (1. 88±0. 31) L in the observation group. (2. 71±0. 43) L, (73.26±7. 91)%, compared with the control group (1. 71±0. 32) L, (2.49±0. 41) L, (68.43±7.82)%. The serum levels of tumor necrosis factor-α (TNF-α), soluble myeloid cell trigger receptor-1 (sTREM-1) and interleukin-8 (IL-8) were (25.26±4.26) ng/L, (43.25±6.14) μg·L-1, respectively. (28.61±4.89) ng·L-1 and (30.48±4.43) ng·L-1, (52.86±6.79) μg·L-1, (33.76±4.93) ng·L-1 in the control group were significantly lower than those in the control group (30.48±4.43) ng·L-1, (52.86±6.79) μg·L-1 and (33.76±4.93) ng·L-1, respectively. The difference was statistically significant (P<0.05). The incidence of adverse reactions in the observation group was 17.07%, which was not significantly different from that in the control group (12.20%) (P>0.05). Conclusion:Tanreqing injection adjuvant treatment of AECOPD of phlegm heat obstructive lung type with pneumonia can effectively improve the pulmonary function and adjust the level of inflammatory factors. The curative effect is accurate, the safety is high, and it is worth popularizing.

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