清胰汤对呼吸机相关肺炎患者免疫功能的影响

目的:探讨中药清胰汤在改善呼吸机相关肺炎患者免疫功能中的应用。方法:将106例呼吸机相关肺炎患者随机分为常规治疗组(对照组)和清胰汤治疗组(研究组),分别于治疗前,治疗后第7 d、第10 d,采用流式细胞仪检测外周血T淋巴细胞亚群及NK细胞比例,运用ELISA和放射免疫法测定细胞因子IL-8、IL-17、髓过氧化物酶(MPO)浓度;并比较两组患者的治愈率、死亡率以及ICU住院时间。结果:研究组于治疗后第7 d、第10 d,CD4+T细胞、CD4+/CD8+、NK细胞百分率明显高于对照组(P<0.05),CD8+T细胞百分率明显低于对照组(P<0.05);IL-8、IL-17、MPO浓度显著低于对照组(P<0.05)。研究组治愈率明显高于对照组(P<0.05),死亡率显著低于对照组(P<0.05)。对照组和研究组ICU住院时间分别为(19.7±3.5)d、(12.2±2.7)d(P<0.05)。结论:清胰汤治疗可以显著改善呼吸机相关肺炎患者的免疫功能,减轻炎症和应激反应,提高临床疗效。

The Role of Qingyi Decoction on Improving Immune Function in Patients with Ventilator-associated Pneumonia

Objective To investigate the effects of Qingyi decoction on the improvement of immune function in patients with ventilator-associated pneumonia(VAP).Methods One hundred and six patients with VAP were randomly divided into two groups.One group was given routine therapy,the other was fed with Qingyi decoction on the basis of routine therapy.T lymphocyte subsets and NK cell were tested by flow cytometry in 0 day,7 day,10 day after treatment.The concentrations of IL-8,IL-17 and MPO were detected by ELISA and radioimmunoassay.Clinical effects were also observed.Results The percentages of CD4 + T lymphocytes 、 CD4 + /CD8 + 、 NK cell in research group were significantly higher than those in control group in 7 day,10 day after treatment(P<0.05).The percentage of CD8 + T lymphocytes in research group was obviously lower than that in control group in respective time points(P<0.05).And the levels of IL-8,IL-17,and MPO in research group were significantly lower than those in control group(P < 0.05).There were obvious differences in the curative rate,mortality and average time of ICU hospitalization(P<0.05).Conclusion The application of Qingyi decoction significantly improves the immune function in patients with VAP and positively modulates immunosuppressive and inflammatory responses,moreover it obviously enhances clinical effects.