加味宣白承气汤治疗痰热壅肺型老年社区获得性肺炎临床疗效及对免疫功能的影响

Clinical effect of modified Xuanbai Chengqi Decoction on elderly community-acquired pneumonia with phlegm-heat stagnation in the lung and its influence on immune function

关键词:  加味宣白承气汤  老年社区获得性肺炎  中药疗法  免疫功能

Key words:  modified Xuanbai Chengqi Decoction  community acquired pneumonia in the elderly  traditional Chinese medicine therapy  immunity

摘要:

[目的] 观察加味宣白承气汤治疗痰热壅肺型老年社区获得性肺炎患者的临床疗效及对免疫功能的影响。[方法] 将 80 例年龄在 60~85 岁之间的痰热壅肺型老年社区获得性肺炎患者随机分为两组。对照组 40 例采用西医常规治疗， 治疗组 40 例采用加味宣白承气汤联合西医常规治疗。比较两组患者治疗前后临床 CURB-65 评分、临床疗效以及 C 反应蛋白（CRP）、白细胞计数（WBC）、中性粒细胞百分比、CD3⁺、CD4⁺/CD8⁺、血清免疫蛋白（Ig）G、IgA、IgM 的水平变化。[结果] 治疗组的临床有效率优于对照组， 两组患者的 CURB-65 评分较治疗前下降， 且治疗组优于对照组， 差异均具有统计学意义（P<0.05）； 两组患者治疗后的 CRP， WBC， 中性粒百分比均较治疗前有所下降， 且治疗组的下降幅度明显， 差异均具有统计学意义（P<0.05）； 两组患者治疗后的 CD4⁺/CD8⁺， IgG， IgM 指标均有所上升（P<0.05）， 治疗组患者 CD3⁺指标治疗后较治疗前也有所改善， 同时， 这 4 项免疫指标治疗组的上升幅度要优于对照组， 差异均具有统计学意义（P<0.05）；两组患者的 IgA 指标治疗前后均无明显变化， 差异无统计学意义（P>0.05）。[结论] 加味宣白承气汤治疗痰热壅肺型老年社区获得性肺炎能有效地缓解患者的临床主要症状， 具有良好的临床疗效， 不仅能有效地抑制炎症反应， 还能提高机体的免疫功能。

Abstract:

[Objective] To observe the clinical efficacy and immune function of modified Xuanbai Chengqi Decoction in the treatment of elderly patients with community-acquired pneumonia of phlegm heat blocking the lung. [Methods] The 80 elderly patients with community-acquired pneumonia aged 60 to 85 years were randomly divided into two groups. The 40 cases in the control group were treated with routine western medicine，and 40 cases in the treatment group were treated with modified Xuanbai Chengqi Decoction Combined with routine western medicine. The clinical CURB-65 score，clinical efficacy，C-reactive protein （CRP），white blood cell count （WBC），percentage of neutrophils，CD3⁺，CD4⁺/CD8⁺，serum immune protein IgG，IgA，IgM levels were compared between the two groups before and after treatment. [Results] The effective rate of the treatment group was significantly higher than that of the control group （P<0.05）；the CURB-65 score of patients in the two groups decreased significantly compared with that before treatment （P<0.05），and the treatment group was superior to the control group （P<0.05）；the percentage of CRP，WBC and neutrophil in the two groups after treatment decreased compared with that before treatment （P<0.05），and the decrease in the treatment group was more significant （P<0.05）；the CD4⁺/CD8⁺，IgG and IgM indexes of patients in both groups increased after treatment （P<0.05）；The CD3⁺ indexes of patients in the treatment group also improved after treatment compared with those before treatment （P<0.05），at the same time，the increase of these four immune indexes in the treatment group was better than that in the control group （P<0.05）；there was no significant change in IgA indexes of the two groups before and after treatment （P>0.05）. [Conclusion] Modified Xuanbai Chengqi Decoction can effectively alleviate the main clinical symptoms of elderly patients with community-acquired pneumonia of phlegm heat blocking the lung，and has good clinical efficacy. It can not only effectively inhibit the inflammatory response，but also improve the immune function of the body.