平喘止咳汤对慢阻肺急性加重期患者炎症标志物水平和动脉血气指标的影响被引量：1

Influence of Pingchuan Zhike decoction on inflammatory markers levels and arterial blood gas indicators in patients with acute exacerbation of chronic obstructive pulmonary disease

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摘要目的探究平喘止咳汤对痰热郁肺型慢阻肺急性加重期患者炎症标志物水平和动脉血气指标的影响。方法按随机数表法将2019年7月至2021年9月期间于开封市中医院肺病科且病房住院就诊的80例痰热郁肺型慢阻肺急性加重期患者分为观察组和对照组各40例。对照组患者接受常规西医治疗,持续治疗一周,观察组患者在对照组治疗的基础上接受平喘止咳汤治疗,连续服用一周。治疗前和治疗一周后比较两组患者的中医症状积分、炎症标志物水平[血清血清降钙素原(PCT)、超敏C反应蛋白(hs-CRP)、白细胞介素-6(IL-6)、γ干扰素(IFN-γ)]、动脉血气指标[氧分压(PaO_(2))、二氧化碳分压(PaCO_(2))、氧饱和度(SaO_(2))]和疾病严重程度[慢性阻塞性肺疾病评测量表(CAT)],同时比较两组患者治疗期间的不良反应发生情况。结果治疗前,两组患者的中医证候积分、炎症标志物水平、动脉血气指标和CAT评分比较差异均无统计学意义(P>0.05);治疗一周后,两组患者的中医证候积分较治疗前显著降低,且观察组[主症(5.48±1.07)分、次症(4.30±0.85)分、舌脉(2.05±0.23)分]明显低于对照组[主症(7.53±1.61)分、次症(5.75±1.11)分、舌脉(2.55±0.40)分],差异均有统计学意义(P<0.05);治疗一周后,两组患者的PCT、hs-CRP、IL-6和IFN-γ水平均较治疗前明显降低,且观察组[(0.28±0.09)ng/mL、(8.82±2.89)mg/L、(2.98±0.57)pg/mL、(8.94±2.27)ng/mL]明显低于对照组[(0.44±0.06)ng/mL、(14.55±3.25)mg/L、(3.29±0.61)pg/mL、(14.22±3.27)ng/mL],差异均有统计学意义(P<0.05);治疗一周后,两组患者的PaO_(2)和SaO_(2)水平较治疗前明显提高,且观察组分别为(68.87±4.48)mmHg、(92.33±1.84)%,明显高于对照组的(61.71±4.13)mmHg、(90.01±1.11)%,但两组患者的PaCO_(2)值均较治疗前明显降低,且观察组为(39.89±3.06)mmHg,明显低于对照组的(45.35±3.13)mmHg,差异均有统计学意义(P<0.05)。治疗一周后,两组患者的CAT评分较治疗前显著降低,且观察组为(12.60±2.56)分,明显低于对照组的(17.50±2.70)分,差异均有统计学意义(P<0.05);治疗期间,观察组患者的不良反应总发生率为7.5%,略低于对照组的10.0%,但差异无统计学意义(P>0.05)。结论平喘止咳汤治疗痰热郁肺型慢阻肺急性加重期的效果显著,其不仅能有效降低中医症状积分,缓解疾病严重程度,还可改善患者炎症标志物水平和改善动脉血气指标,促进患者康复。 Objective To explore the influence of Pingchuan Zhike decoction on inflammatory markers levels and arterial blood gas indicators in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)of phlegm-heat lung stagnation type.Methods According to the random number table method,80 patients with AECOPD of phlegm-heat lung stagnation type who were hospitalized in Department of Pulmonary Disease,Kaifeng Traditional Chinese Medicine Hospital from July 2019 to September 2021 were divided into an observation group and a control group,with 40 cases in each group.The patients in the control group received conventional western medicine treatment and continued treatment for 1 week,while the patients in the observation group were continuously treated with Pingchuan Zhike decoction for 1 week on the basis of treatment in the control group.The TCM symptoms scores,inflammatory markers[serum procalcitonin(PCT),hypersensitivity C-reactive protein(hs-CRP),interleukin-6(IL-6),and interferon-γ(IFN-γ)],arterial blood gas indicators[partial pressure of oxygen(PaO_(2)),partial pressure of carbon dioxide(Pa-CO_(2)),oxygen saturation(SaO_(2))],and disease severity[COPD Assessment Test(CAT)]before treatment and after 1 week of treatment were compared between the two groups,as well as the occurrence of adverse reactions during treatment.Results There were no statistically significant differences in TCM syndromes scores,levels of inflammatory markers,arterial blood gas indicators and CAT score between the two groups before treatment(P>0.05).After 1 week of treatment,the TCM syndromes scores in the two groups were significantly reduced compared with those before treatment,and the scores of primary symptom,secondary symptom,and tongue and pulse in the observation group were(5.48±1.07)points,(4.30±0.85)points,and(2.05±0.23)points,significantly lower than(7.53±1.61)points,(5.75±1.11)points,and(2.55±0.40)points in the control group,with statistically significant differences(all P<0.05).The PCT,hs-CRP,IL-6,and IFN-γ in the two groups were significantly reduced after 1 week of treatment than those before treatment,and the levels were(0.28±0.09)ng/mL,(8.82±2.89)mg/L,(2.98±0.57)pg/mL,and(8.94±2.27)ng/mL in the observation group,which were significantly lower than(0.44±0.06)ng/mL,(14.55±3.25)mg/L,(3.29±0.61)pg/mL,and(14.22±3.27)ng/mL in the control group(P<0.05).The PaO_(2) and SaO_(2) after 1 week of treatment were significantly increased in both groups compared with those before treatment,and the PaO_(2) and SaO_(2) in the observation group were(68.87±4.48)mmHg and(92.33±1.84)%,significantly higher than(61.71±4.13)mmHg and(90.01±1.11)% in the control group;PaCO_(2) in the two groups was significantly lower than that before treatment,and the PaCO_(2) in the observation group was(39.89±3.06)mmHg,significantly lower than(45.35±3.13)mmHg in the control group;the differences were statistically significant(P<0.05).After 1 week of treatment,the CAT scores were significantly lower in the two groups than those before treatment,and the score in the observation group was(12.60±2.56)points,significantly lower than(17.50±2.70)points in the control group,with statistically significant differences(P<0.05).During treatment,there was no statistically significant difference in the total incidence rate of adverse reactions between the two groups(7.5%vs 10.0%,P>0.05).Conclusion Pingchuan Zhike decoction has a significant effect in the treatment of AECOPD of phlegm-heat lung stagnation type.It can not only reduce the scores of TCM symptoms and alleviate the disease severity,but also significantly improve the inflammatory markers and arterial blood gas indicators and promote the rehabilitation of patients.

作者刘志勇韩圣宾杨增祥吴启相 LIU Zhi-yong;HAN Sheng-bin;YANGZeng-xiang;WU Qi-xiang(Department of Pulmonary Disease,Kaifeng Traditional Chinese Medicine Hospital,Kaifeng 475000,Henan,CHINA)

机构地区开封市中医院肺病科

出处《海南医学》 CAS 2024年第11期1565-1570,共6页 Hainan Medical Journal

基金河南省开封市科技发展计划项目(编号:1903014)。

关键词慢阻肺急性加重期平喘止咳汤血清炎症标志物动脉血气指标疗效 Acute exacerbation of chronic obstructive pulmonary disease Pingchuan Zhike decoction Serum inflammatory markers Arterial blood gas indicators Efficacy

分类号 R563 [医药卫生—呼吸系统]

作者简介第一作者:刘志勇(1982-),男,硕士,副主任医师,主要研究方向为慢阻肺、哮喘、肺间质纤维化等疾病的中医药治疗;通讯作者:吴启相(1974-),男,硕士,主任医师,主要研究方向为慢阻肺、肺纤维化及肺结节等疾病的中医药治疗,E-mail:wqxly2005@163.com。