清金化痰汤加减辅助抗生素治疗老年重症肺炎疗效及对患者炎症反应递质的影响

目的:探讨清金化痰汤加减辅助抗生素治疗老年重症肺炎的临床疗效及对炎症反应递质的影响.方法:选择82例老年重症肺炎为研究对象,依照随机数字表法分为观察组和对照组各41例.对照组采用抗生素降阶梯疗法,观察组在对照组治疗的基础上采用清金化痰汤治疗,两组均持续治疗14 d.比较两组治疗前后痰热壅肺证评分、血清中性粒细胞弹性蛋白...

Modified Qingjin Huatan decoction with antibiotics in the treatment of elderly severe pneumonia and its influence on inflammatory response transmitters

Objective:To explore the clinical efficacy of Qingjin Huatan decoction with adjuvant antibiotics in the treatment of severe pneumonia in the elderly and its influence on inflammatory response transmitters.Methods: A total of 82 elderly patients with severe pneumonia were selected as the research objects,and they were divided into observation group(41 cases)and control group(41 cases)according to the numerical table method.The control group was treated with antibiotic de-escalation therapy,and the observation group was treated with Qingjin Huatan decoction on the basis of the treatment of the control group.Both groups were treated continuously for 14 days.The phlegm-heat stagnation syndrome score,serum neutrophil elastase(NE),interleukin-8(IL-8),interleukin-10(IL-10),CD4⁺,CD8⁺,CD4⁺/CD8⁺ levels,were compared before and after treatment.The clinical efficacy and adverse drug reactions of the two groups were compared.Results: There was no significant difference in the scores of phlegm-heat stagnation syndrome between the two groups before treatment(P>0.05).After treatment,the scores of the phlegm-heat stagnation syndrome in the two groups were reduced(P<0.05),and the observation group was even lower(P<0.05).The total effective rate of the observation group(92.68%)was higher than that of the control group(75.61%).There was no significant difference in the levels of serum NE,IL-8 and IL-10 between the two groups before treatment(P>0.05).Serum NE,IL-8 and IL-10 levels after treatment in the two groups decreased(P<0.05),and the observation group was even lower(P<0.05).There was no statistically significant difference between the two groups of CD4⁺,CD8⁺,CD4⁺/CD8⁺ before treatment(P>0.05).CD4⁺,CD4⁺/CD8⁺ after treatment in the two groups increased(P<0.05),and the observation group was even higher(P<0.05).After treatment,the CD8⁺ of the two groups was lower than before treatment(P<0.05),and the observation group was lower than the control group(P<0.05).There was no significant difference in the incidence of total adverse reactions between the two groups during the treatment period(P>0.05).Conclusion: Qingjin Huatan decoction is effective in treating severe pneumonia in elderly patients(phlegm-heat obstructing the lung syndrome)by adding or subtracting supplementary antibiotic de-escalation therapy.It can reduce the level of inflammatory response transmitters,improve immune function.