参苓白术散对老年社区获得性肺炎肺脾气虚证患者血清炎症因子及免疫功能的影响

发布时间：2018-10-08 13:21

【摘要】：目的:探讨参苓白术散加减联合抗生素对老年社区获得性肺炎(community-acquired pneumonia,CAP)肺脾气虚证患者临床疗效、血清炎症因子及免疫功能的影响。方法:选取天津中医药大学第一附属医院2014年1月到2016年1月符合入选标准的老年CAP肺脾气虚证患者236例,按照随机数字表法分为对照组(118例)和治疗组(118例),对照组给予抗生素治疗,治疗组在对照组的基础上给予参苓白术散加减治疗,两组患者连续治疗10 d,观察并比较两组患者临床疗效、血清炎症介质、体液免疫指标和T淋巴细胞亚群水平变化情况。结果:治疗组临床总有效率和细菌清除率均高于对照组(P0.05);治疗组患者临床症状恢复时间低于对照组(P0.05);治疗后,治疗组患者血清白细胞介素-6(interleukin-6,IL-6),肿瘤坏死因子-α(tumor necrosis factor-alpha,TNF-α),降钙素原(procalcitonin,PCT),C反应蛋白(C-reactive protein,CRP)水平降低,且明显低于对照组(P0.05);治疗组治疗后血清免疫球蛋白A(immunoglobulin A,Ig A),免疫球蛋白M(immunoglobulin M,IgM),CD4~+和CD4~+/CD8~+水平上升,且治疗组高于对照组(P0.05);两组患者治疗后CD8+水平下降,且治疗组低于对照组(P0.05)。结论:参苓白术散加减联合抗生素治疗老年CAP肺脾气虚证患者的临床效果显著,对于抑制机体炎症反应和增强机体免疫功能具有重要作用。
[Abstract]:Objective: to investigate the effect of Shenling Atractylodes Powder plus or minus antibiotics on the clinical effect, serum inflammatory factors and immune function of elderly patients with lung qi deficiency syndrome of community acquired pneumonia (community-acquired pneumonia,CAP). Methods: from January 2014 to January 2016, 236 elderly CAP patients with lung and temper deficiency syndrome were selected from the first affiliated Hospital of Tianjin University of traditional Chinese Medicine. According to the random number table method, the control group (118 cases) and the treatment group (118 cases) were divided into two groups: the control group was treated with antibiotics, and the treatment group was treated with Shenling Baizhu powder on the basis of the control group. The clinical efficacy, serum inflammatory mediators, humoral immune indexes and T lymphocyte subsets were observed and compared between the two groups for 10 days. Results: the total clinical effective rate and bacterial clearance rate in the treatment group were higher than those in the control group (P0.05), the recovery time of clinical symptoms in the treatment group was lower than that in the control group (P0.05). The serum levels of interleukin-6 (interleukin-6,IL-6), tumor necrosis factor- 伪 (tumor necrosis factor-alpha,TNF- 伪 (TNF- 伪) and procalcitonin (procalcitonin,PCT) C-reactive protein (C-reactive protein,CRP) were decreased in the treatment group. It was significantly lower than that of the control group (P0.05); after treatment, the levels of serum immunoglobulin Ag A), immunoglobulin M (immunoglobulin IgM in the treatment group increased, and the level of CD4~ / CD8 ~ in the treatment group was higher than that in the control group (P0.05). The level of CD8 in the two groups decreased after treatment and was lower than that in the control group (P0.05). Conclusion: the clinical effect of Shenling Baizhu Powder combined with antibiotics in treating senile CAP patients with deficiency of lung and temper is remarkable, and it plays an important role in inhibiting the inflammatory reaction and enhancing the immune function of the body.
【作者单位】：天津中医药大学第一附属医院;天津市第一中心医院;天津市公安医院;
【基金】：国家自然科学基金项目(81303021) 天津市高等学校科技发展基金计划项目(20110223)
【分类号】：R259

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