[1]王 敏,闫 蕾△.白虎承气汤治疗重症肺炎疗效及其作用机制研究[J].陕西中医,2019,(12):1693-1696.
　WANG Min,YAN Lei..Study on the efficacy and mechanism of Baihu Chengqi decoction in the treatment of severe pneumonia[J].,2019,(12):1693-1696.
点击复制

白虎承气汤治疗重症肺炎疗效及其作用机制研究
分享到：

《陕西中医》[ISSN:1000-7369/CN:61-1281/TN]

卷:
期数:
2019年12期
页码:
1693-1696
栏目:
临床研究
出版日期:
2019-12-05

文章信息/Info

Title:
Study on the efficacy and mechanism of Baihu Chengqi decoction in the treatment of severe pneumonia
文章编号:
DOI:10.3969/j.issn.10007369.2019.12.010
作者:
王 敏1; 闫 蕾2△
1.西安高新医院呼吸科（西安 710075）；2.宁夏回族自治区人民医院（西北民族大学第一附属医院）（银川 750002）
Author(s):
WANG Min; YAN Lei.
Department of Respiratory,Xi’an Gaoxin Hospital（Xi’an 710075）
关键词:
白虎承气汤; 痰热壅肺证; 重症肺炎; 肺功能; 炎症; 免疫功能
Keywords:
Key words Baihu Chengqi decoction; Phlegmheat obstructing lung syndrome; Severe pneumonia; Pulmonary function; Inflammatory; Immune function
分类号:
R563.1
文献标志码:
A
摘要:
摘 要 目的：探讨白虎承气汤辅助治疗痰热壅肺证重症肺炎患者的疗效及作用机制。方法：选取216例痰热壅肺证型重症肺炎患者，根据患者意愿纳入对照组和观察组。对照组患者按西医重症肺炎治疗方案，观察组在治疗方法基础上辅助使用白虎承气汤治疗。分析治疗后两组患者的临床疗效，比较两组患者治疗前后的中医主证积分、PEF、FEV1以及FEV%、SaO2、PaO2、PaCO2、CRP、PCT、IL6、CD3+、CD4+、CD8+、CD4+/CD8+。结果：观察组的总有效率为86.11%，高于对照组的75.00%（P＜005），治疗后观察组的咳嗽、痰壅、发热、气促积分、PaCO2、CRP、PCT、IL6分别为（0.81±0.34）分、（0.76±0.42）分、（0.81±0.67）分、（0.77±0.43）分、（46.34±7.52）mmHg、（43.65±10.14）mg/L、（0.12±0.10）ng/ml、（8.45±1.43）μg/L，低于对照组的（1.56±0.54）分、（1.68±0.48）分、（1.74±0.64）分、（1.65±0.57）分、（53.15±7.78）mmHg、（50.42±12.37）mg/L、（0.25±0.17）ng/ml、（13.68±2.12）μg/L。观察组的PEF、FEV1、FEV%、SaO2、PaO2、CD3+比例、CD4+比例、CD4+/CD8+比例分别为（7.35±2.25）L/s、（2.38±0.67）L、（79.54±7.11）%、（90.52±7.03）%、（78.59±7.74）mmHg、（64.31±9.24）%、（47.33±6.95）%、（1.72±0.43），高于对照组的（6.26±2.14）L/s、（1.75±0.61）L、（68.16±6.47）%、（84.64±7.37）%、（63.75±6.33）mmHg、（60.36±8.94）%、（44.18±7.02）%、（1.59±0.45）（P＜005）。结论：白虎承气汤辅助治疗显著提高重症肺炎患者免疫能力，减轻机体炎症及改善患者肺功能，具有较好的临床疗效。
Abstract:
Abstract Objective:To explore the efficacy and mechanism of Baihu Chengqi decoction in the adjuvant treatment of severe pneumonia patients with phlegmheat obstructing lung syndrome. Methods：216 cases of severe pneumonia with phlegmheat obstructing lung syndrome were selected. According to the random number table method，the patients were divided into control group and observation group. The control group was treated with routine western medicine，while the observation group was treated with Baihu Chengqi decoction combined with routine western medicine.The clinical efficacy of the two groups was analyzed. The scores of main syndromes，PEF，FEV1，FEV%，SaO2，PaO2，PaCO2，CRP，PCT，IL6，CD3+，CD4+，CD8+，CD4+/CD8+ of the two groups were compared before and after treatment.Results：The total effective rate of the observation group was 86.11%，which was higher than 75.00% of the control group (P＜005).After treatment，the cough，phlegm obstruction，fever，dyspnea score，PaCO2，CRP，PCT and IL6 in the observation group were (0.81±0.34)scores，(0.76±0.42)scores，(0.81±0.67)scores，(0.77±0.43)scores，(46.34±7.52)mmHg，(43.65±10.14)mg/L，(0.12±0.10)ng/ml，(8.45±1.43)g/L respectively，which were lower than those in the control group (1.56±0.54)scores，(1.68±0.48)scores，(1.74±0.64)scores，(1.65±0.57)scores，(53.15±7.78)mmHg，(50.42±12.37)mg/L，(0.25±0.17)ng/ml，(13.68±2.12)μg/L，respectively.The PEF，FEV1，FEV，SaO2，PaO2，CD3+ ratio，CD4+ ratio，CD4+/CD8+ ratio in the observation group were (7.35 ±2.25)L/s，(2.38±0.67)L，(79.54±7.11)%，(90.52±7.03)%，(78.59±7.74) mmHg，(64.31±9.24)%，(47.33±6.95)%，(1.72±0.43) respectively，which were higher than those in the control group (6.26±2.14)L/s，(1.75±0.61)L，(68.16±6.47)%，(84.64±7.37)%，(63.75±6.33)mmHg，(60.36±8.94)%，(44.18±7.02)%，(1.59±0.45)(P＜005).Conclusion： Baihu Chengqi decoction can significantly improve the immunity，〖LM〗alleviate inflammation and improve pulmonary function of patients with severe pneumonia,and has a good clinical efficacy.

参考文献/References:

[1] Chisti MJ,Salam MA,Smith JH,et al.Bubble continuous positive airway pressure for children with severe pneumonia and hypoxaemia in Bangladesh：an open,randomised controlled trial[J].Lancet,2015,386(9998):10571065.
[2] Tagami T,Matsui H,Horiguchi H,et al.Antithrombin and mortality in severe pneumonia patients with sepsis‐associated disseminated intravascular coagulation：an observational nationwide study[J].J Thromb Haemost,2014,12(9):14701479.
[3] 苏 鸿,赵子文,钟维农,等.社区获得性重症肺炎病原菌分布与耐药性分析[J].中华医院感染学杂志,2015,25(5):990991,1000.
[4] Tang L,Li Q,Bai J,et al.Severe pneumonia mortality in elderly patients is associated with downregulation of Tolllike receptors 2 and 4 on monocytes[J].Am J Med Sci,2014,347(1):3441. 
[5] 金 巍,徐靖华,刘建光,等.纤维支气管镜对急诊重症肺炎合并呼吸衰竭患者呼吸功能及血清炎症因子水平的影响[J].现代生物医学进展,2016,16(24):46874689,4675.
[6] 郑彩莲,孙建光,张素蕊,等.清肺通腑汤治疗重症肺炎痰热壅肺证临床疗效及对炎症因子的影响[J].中国中医急症,2017,26(9):16431645.
[7] 韩 健.白虎汤联合还原型谷胱甘肽治疗重症肺炎伴高热临床研究[J].中医学报,2017,32(2):201205.
[8] Rello J,Diaz E,Manez R,et al.Improved survival among ICUhospitalized patients with communityacquired pneumonia by unidentified organisms：a multicenter casecontrol study[J].Eur J Clin Microbiol Infect Dis,2017,36(1):123130.
[9] 国家中医药管理局.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,2002:5758.
[10] 刘 菲,高治华.多巴酚丁胺与酚妥拉明联合小剂量多巴胺治疗小儿重症肺炎临床研究[J].陕西医学杂志,2019,48(1):8991,95. 
[11] 张世应,杨瑞玲.头孢噻肟钠联合酚妥拉明治疗重症肺炎效果观察[J].山东医药,2016,56(30):8486.
[12] 王 勤,张小方,张爱娥,等.医用磁贴联合通腑泻肺方治疗重症肺炎合并胃肠功能障碍临床研究[J].陕西中医,2019,40(2):264266. 
[13] 奚肇庆,郑 玥.中西医结合治疗重症肺炎痰热壅肺气阴两损证40例临床研究[J].江苏中医药,2016,48(3):2931.
[14] 穆廷杰,杨芬兰,金海红,等.连翘等中草药对肺炎克雷伯菌抑菌作用的实验研究及临床应用[J].西部中医药,2015,28(9):1921.
[15] 王元花,阎 芳,金永生.甘草有效成分的提取及协同氟康唑抗真菌活性研究[J].药学服务与研究,2017,17(3):218222.
[16] 明继阳,李 洋,丁 彦,等.知母在白虎汤中解热作用的研究[J].中医药信息,2017,34(3):4750.
[17] 劳穗华,俞朝贤,李德宪.肺结核并重症肺炎患者细胞免疫功能研究[J].临床肺科杂志,2013,18(11):20472048.
[18] 周 丽,徐洪山,赵 丹,等.免疫治疗对重症肺炎患者免疫功能指标及炎症因子的影响[J].检验医学与临床,2017,14(18):26582661.
[19] 胡星星,刘绛云,刘克琴,等.白虎汤对脓毒症患者的免疫调理作用[J].中国中医急症,2016,25(2):251253,258.

更新日期/Last Update: 2019-12-19