苇茎汤合麻杏石甘汤加减治疗卒中相关性肺炎痰热蕴肺证疗效及对患者外周血T淋巴细胞亚群、血清炎症因子的影响

目的:探讨苇茎汤合麻杏石甘汤加减治疗卒中相关性肺炎痰热蕴肺证疗效及对患者外周血T淋巴细胞亚群、血清炎症因子的影响。方法:2014年3月—2016年3月,重庆市中医院共收治207例SAP患者,以该批患者为研究对象,随机数字表法分为治疗组(104例)、对照组(103例)。对照组采用西医基础治疗,治疗组患者此基础上加用苇茎汤合麻杏石甘汤加减进行治疗,比较两组患者治疗后的临床疗效与相关指标,T细胞亚群水平,血清炎症因子的变化情况。结果:治疗组患者总有效率为94.23%,对照组为81.55%,治疗组优于对照组(P0.05);治疗后,与治疗前比较,治疗组患者在退热、咳嗽缓解时间明显短于对照组(P0.05);与治疗前比较,治疗后两组患者在体温,呼吸次数,心率方面均有所改善,且治疗组明显优于对照组(P0.05);治疗后两组CD3~+,CD4~+水平,CD4~+/CD8~+均有明显上升,CD8~+水平明显下降(P0.05);与对照组治疗后相比,治疗组CD3~+,CD4~+水平,CD4~+/CD8~+明显升高,CD8~+水平明显降低(P0.05);与治疗前比较,治疗后两组患者血清超敏C-反应蛋白(hypersensitive C-reactive protein,hr-CRP),降钙素原(procalcitonin,PCT)水平均明显降低,且治疗组明显低于对照组(P0.05)。结论:苇茎汤合麻杏石甘汤可以明显改善SAP痰热蕴肺证患者心肺功能与临床症状,提高患者免疫功能,疗效较好。

Clinical Efficacy of Weijingtang Combined with Maxing Shigan Tang and Effect on T cell Subset and Inflammatory Cytokines in Treating Stroke-associated Pneumonia with Phlegm-hot in Lung

Objective: To study the clinical efficacy of Weijingtang combined with Maxing Shigan Tang and investigate its effect on T cell subset and inflammatory cytokines in treating stroke-associated pneumonia with phlegm-hot in the lung. Method: The 207 cases of patients with stroke-associated pneumonia treated in our hospital from March 2014 to March 2016, were selected and divided into two groups according to the random number table, with 104 cases in treatment group and 103 cases in control group. Patients in two groups were treated by routine western medicine, while the treatment group was also given with additive Weijingtang combined with Maxing Shigan Tang. Then the treatment efficacy and related indicators, T cell subset and inflammatory cytokines of two groups were compared. Result: The total effective rate was 94.23% in treatment group, higher than 81.55% in control group (P<0.05). The relieving time for fever and cough in treatment group was significantly shorter than that in control group (P<0.05); as compared with the conditions before treatment, both groups had improvement in body temperature, respiration, and heart rate, and the above indicators in treatment group were significantly better than those in control group after treatment (P<0.05). After the treatment, the levels of CD3⁺, CD4⁺ and CD4⁺/CD8⁺ were significantly increased in both groups, but the level of CD8⁺ was significantly decreased (P<0.05). As compared with the control group, the levels of CD3⁺, CD4⁺ and CD4⁺/CD8⁺ were significantly higher in the treatment group, while the level of CD8⁺ was significantly lower (P<0.05). As compared with the conditions before treatment, hypersensitive C-reactive protein (hr-CRP), and procalciton in (PCT) were decreased in both groups after treatment, and the levels in treatment group were significantly lower than those in control group (P<0.05). Conclusion: Weijingtang combined with Maxing Shigan Tang can significantly improve clinical efficacy and cardio-pulmonary function of stroke-associated pneumonia with phlegm-hot in the lung, strengthen the immune system and reduce the level of serum inflammatory cytokines, with better efficacy.