麻黄杏仁甘草石膏汤治疗急性脑梗死并发肺部感染的临床疗效观察

Clinical efficacy of Mahuang Xingren Gancao Decoction in the treatment of acute cerebral infarction complicated with pulmonary infection

关键词:  麻黄杏仁甘草石膏汤  急性脑梗死  肺部感染  可溶性髓样细胞触发受体1  可溶性血红蛋白道夫受体

Key words:  Mahuang Xingren Gancao Decoction  acute cerebral infarction  lung infection  soluble myeloid cell trigger receptor 1  soluble hemoglobin scavenger receptor CD163

摘要:

[目的] 探讨麻黄杏仁甘草石膏汤联合西药治疗急性脑梗死（ACI）并发肺部感染的疗效以及对血清可溶性髓样细胞触发受体1（sTREM-1）、可溶性血红蛋白道夫受体（sCD163）的影响。方法 选择2020年3月至2023年3月河北省沧州中西医结合医院收治的142例ACI并发肺部感染患者，随机数字表法将患者分为两组，每组各71例。对照组采用西药治疗，观察组采用麻黄杏仁甘草石膏汤联合西药治疗。比较两组疗效和不良反应，咳嗽消失时间、病灶吸收时间、啰音消失时间、中医症候积分、肺功能、临床肺部感染评分（CPIS）、外周血CD3⁺T细胞、CD4⁺ T细胞、CD8⁺ T细胞以及血清sTREM-1、sCD163水平。结果 观察组治疗总有效率高于对照组（P＜0.05），观察组咳嗽消失时间、病灶吸收时间、啰音消失时间短于对照组（P＜0.05）。两组治疗后中医症候积分、CPIS评分，血清sTREM-1、sCD163水平以及外周血CD8⁺ T细胞较治疗前降低（P＜0.05），FVC、FEV1、FEV1/FVC，外周血CD3⁺ T细胞、CD4⁺ T细胞较治疗前增高（P＜0.05）。观察组治疗后中医症候积分、CPIS评分，血清sTREM-1、sCD163水平以及外周血CD8⁺ T细胞低于对照组（P＜0.05），FVC、FEV1、FEV1/FVC，外周血CD3⁺ T细胞、CD4⁺ T细胞高于对照组（P＜0.05）。观察组不良反应发生率低于对照组（P＜0.05）。结论 麻黄杏仁甘草石膏汤联合西药治疗ACI并发肺部感染能显著改善临床症状和肺功能，降低血清sTREM-1、sCD163水平，提高免疫功能和临床疗效。

Abstract:

[Objective] To investigate the curative effect of Mahuang Xingren Gancao Decoction combined with Western medicine in the treatment of acute cerebral infarction complicated with pulmonary infection and the effect on serum soluble myeloid cell trigger receptor 1（sTREM-1） and soluble hemoglobin dorf receptor（sCD163）.[Methods] A total of 142 patients with ACI complicated with pulmonary infection admitted to our hospital from March 2020 to March 2023 were selected and divided into two groups with 71 cases in each group by random number table method. The control group was treated with Western medicine，and the observation group was treated with Mahuang Xingren Gancao Decoction combined with Western medicine. The efficacy and adverse reactions of the two groups were compared，including cough resolution time，lesion absorption time，rills disappearance time，Traditional Chinese medicine（TCM） syndrome score，lung function，clinical pulmonary infection score（CPIS），peripheral blood CD3⁺T cells，CD4⁺T cells，CD8⁺ T cells，and serum sTREM-1，sCD163 levels. [Results] The total effective rate of the observation group was higher than that of the control group（P<0.05），the cough disappearance time，lesion absorption time and rales disappearance time of the observation group were shorter than that of the control group（P<0.05）. After treatment，TCM syndrome score，CPIS score，serum sTREM-1，sCD163 levels and peripheral blood CD8⁺ T cells were decreased compared with before treatment（P<0.05），FVC，FEV1，FEV1/FVC，peripheral blood CD3⁺ T cells and CD4⁺ T cells were increased compared with before treatment（P<0.05）. After treatment，TCM syndrome score，CPIS score，serum sTREM-1，sCD163 levels and peripheral blood CD8⁺ T cells in observation group were lower than those in control group（P<0.05），FVC，FEV1，FEV1/FVC，peripheral blood CD3⁺ T cells and CD4⁺ T cells were higher than those in control group（P<0.05）. The incidence of adverse reactions in observation group was lower than that in control group（P<0.05）.[Conclusion] The combined treatment of ACI with Western medicine can significantly improve the clinical symptoms and lung function，reduce the levels of serum sTREM-1 and sCD163，and improve the immune function and clinical efficacy.