清肺益肾方治疗痰热壅肺型老年肺炎临床疗效及对血清CD4+、CD8+水平的影响

目的] 探讨清肺益肾方治疗老年肺炎（痰热壅肺证）的疗效及对血清CD4⁺、CD8⁺水平的影响。方法] 将老年肺炎患者随机分为对照组和治疗组，对照组给予抗炎、祛痰平喘、退热等对症治疗，治疗组在此基础上给予清肺益肾方汤剂口服，比较两组临床疗效及治疗前后、随访1个月的血常规、C反应蛋白、症状评分、影像学、血清CD4⁺、CD8⁺水平的变化。结果] 治疗后，对照组总有效率为80.00%，治疗组总有效率为96.67%，较对照组显著升高（P<0.05）；治疗组咳嗽、黄痰、口渴症状积分较对照组显著下降（P<0.05）；治疗组白细胞计数、中性粒细胞比率、C-反应蛋白、胸部CT积分较对照组显著下降（P<0.05）；治疗组CD4⁺于治疗14 d和随访1个月均较对照组显著升高（P<0.05，P<0.01），且CD8⁺于随访1个月较对照组显著降低（P<0.05）。结论] 清肺益肾方治疗痰热壅肺型老年肺炎疗效显著，其作用机制可能与减轻炎症反应，同时增强免疫力有关。

Clinical effect of Qingfei Yishen decoction on senile pneumonia and its effect on serum CD4+ and CD8+ levels

Objective] To explore the curative effect of Qingfei Yishen decoction on the senile pneumonia (heat obstruct pulmonary syndrome) and the impact on serum CD4⁺ and CD8⁺ levels.Methods] Senile pneumonia patients were randomly divided into control group and treatment group, control group given anti-inflammatory, eliminating phlegm treatment to smooth wheezing, antifebrile; on the basis of the control treatment, the treatment group was given Qingfei Yishen decoction. Clinical curative effect was compared between the two groups before and after treatment, and follow-up 1 month, like routine blood, c-reactive protein, symptom scores, imaging, the change of serum level of CD4⁺, CD8⁺.Results] The total effective rate was 80.00% in the control group, and the treatment group was significantly higher than the control group (96.67%, P<0.05). The scores of cough, yellow phlegm and thirst symptoms in the treatment group were significantly lower than those in the control group (P<0.05). After treatment, the leukocyte count, neutrophil ratio, c-reactive protein, and chest CT scores were significantly lower than those in the control group (P<0.05). CD4⁺ in the treatment group was increased in the treatment group (P<0.05, P<0.01), CD8⁺ in the treatment group showed a significant decrease than those in the control group (P<0.05).Conclusion] The curative effect of Qingfei Yishen decoction of senile pneumonia (heat obstruct pulmonary syndrome) is significant, and its mechanism may be related to reducing inflammatory response and regulating immunity.