清金化痰汤对呼吸机相关性肺炎sTREM-1影响的研究

目的:观察清金化痰汤联合西医治疗呼吸机相关性肺炎痰热壅肺证患者的髓系细胞启动受体-1(sTREM-1)指标的影响。方法:选择2010年3月—2012年2月收入上海市岳阳医院急诊医学科病房的70例呼吸机相关性肺炎痰热壅肺证患者,随机分为治疗组34例和对照组36例,两组患者均予西医规范治疗,治疗组在西医规范治疗基础上加服清金化痰汤,每日2次,每次200 mL,两组患者疗程均为7天。观察治疗前后的患者临床肺部感染评分和支气管肺泡灌洗液sTREM-1水平变化,进行统计学分析。结果:经治疗两组患者的临床肺部感染评分有所改善(P<0.05),治疗组患者改善情况优于对照组,差异有统计学意义(P<0.05);经治疗两组患者sTREM-1水平较前下降(P<0.05),治疗组比对照组下降明显,差异有统计学意义(P<0.05)。结论:在西医规范治疗基础上,清金化痰汤能够降低临床肺部感染评分,提高治疗有效率,可能与其降低患者髓系细胞启动受体-1(sTREAM-1)水平有关。

Research on Influence of Qingjie Huatan Decoction on sTREM - 1 of Ventilator Associated Pneumonia

Objective ：To observe the clinical effect of Qingjin Huatan Decoction in treatment of patients with ventilator associ- ated pneumonia（VAP） of retention of heat- phlegm in the lung syndrome and to discuss the curative effects on the pneumonia as well as its potential intervention mechanisms. Methods ： We conducted a prospective case - control study on 70 patients with venti-lator associated pneumonia in the emergency ward during March 2010 to February 2012. The 70 patients were randomly divided into the management group which consisted of 34 patients and the control group which consisted of 36 patients. The management group received routine western medicine therapy combining Qingjin Huatan Decoction by oral or nasal feeding for 7 days, and the other group only received routine western medicine therapy. On the first day before starts of treatment and day 7 after the treat- ment, we recorded clinical pulmonary infection score, and sTREM - 1 level was measured with the ELISA method. All data was statistically by SPSS 15.0 for windows. Results：Mter seven days treatment,the level of CPIS score in all patients declined signifi- cantly（P 〈 0.05 ）. There were no significant differences in the level of sTREAM - 1 of two groups before treatment（ P 〉 0. 05 ）. After seven days treatment, the level of sTREAM - 1 declined significantly in the management group （ P 〈 O. 05 ）. Conclusion： Qingjin Huatan Decoction combined routine western medicine could significantly reduce CPIS and sTEAM - 1 ,which suggests that Qingjin Huatan Decoction could relieve the pulmonary inflammation, and the curative effects may be carried on through signifi- cantly reducing the level of sTREAM - 1 in the serum.