疏风解毒胶囊治疗重症肺炎痰热壅肺证的临床观察

Clinical efficacy of Shufeng Jiedu Capsule in severe pneumonia with phlegm-heat obstructing lung syndrome

关键词:  疏风解毒胶囊  重症肺炎  痰热壅肺证  临床观察

Key words:  Shufeng Jiedu Capsule  severe pneumonia  syndrome of phlegm-heat obstructing lung  clinical observation

摘要:

[目的] 探讨疏风解毒胶囊治疗重症肺炎痰热壅肺证的临床疗效。[方法] 选取2023年7月—2024年4月福建中医药大学附属第三人民医院重症医学科收治入院的符合纳入标准患者74例作为研究对象，随机分为治疗组和对照组各37例。对照组采用西医常规治疗，治疗组在对照组基础上加用疏风解毒胶囊。治疗7 d后比较两组患者的临床疗效、中医证候积分、炎症指标[白细胞（WBC）、C反应蛋白（CRP）、降钙素原（PCT）、白介素（IL）-6）]、氧合指数、临床肺部感染评分（CPIS）及急性生理与慢性健康状况Ⅱ（APACHEII）评分、14 d病死率、重症监护病房（ICU）住院时间。[结果] 1）治疗后治疗组有效率高于对照组（86.5%＞75.7%），差异有统计学意义（P＜0.05）。2）治疗后两组中医证候积分均较前降低，且治疗组改善程度优于对照组，差异有统计学意义（P＜0.05）。3）治疗后两组单项症状（咳嗽、痰性、痰量、喘息、发热）分数均较前降低，且在咳嗽、痰性、痰量方面，治疗组比对照组改善更明显，差异有统计学意义（P＜0.05）。4）治疗后两组炎症指标（WBC、CRP、PCT、IL-6）均较前降低，氧合指数均较前升高，且治疗组改善程度均优于对照组，差异有统计学意义（P＜0.05）。5）治疗后两组CPIS及APACHEII评分均较前下降，且治疗组下降程度均比对照组更显著，差异有统计学意义（P＜0.05）。6）治疗后治疗组14 d病死率与对照组相比，差异无统计学意义（P＞0.05）；治疗组ICU住院时间短于对照组，差异有统计学意义（P＜0.05）。[结论] 疏风解毒胶囊联合西医常规治疗对重症肺炎痰热壅肺证患者的临床疗效优于西医单一治疗，能有效改善患者临床症状，抑制炎症反应，提高氧合，降低CPIS及APACHEⅡ评分，使重症肺炎得到一定控制，缩短ICU住院时间。

Abstract:

[Objective] To investigate the clinical effect of Shufeng Jiedu capsule on severe pneumonia syndrome of phlegm-heat obstructing lung.[Methods] A total of 74 patients admitted to the Intensive Care Unit of Fujian University of Traditional Chinese Medicine Affiliated Third People's Hospital from July 2023 to April 2024 were selected as the research subjects and randomly divided into the treatment group and the control group, each consisting of 37 cases. The control group received conventional Western medicine treatment, while the treatment group was administered Shufeng Jiedu Capsules in addition to the conventional Western medicine treatment. After 7 days of treatment, the clinical efficacy, Traditional Chinese medicine(TCM) syndrome score, inflammatory indicators[white blood cell(WBC), C-reactive protein(CRP), procalcitonin(PCT), interleukin(IL)-6], oxygenation index, clinical pulmonary infection score(CPIS), Acute Physiology and Chronic Health Evaluation II(APACHEII) score, 14 day mortality rate, and the length of stay in the Intensive Care Unit(ICU) were compared between the two groups of patients.[Results] 1) After treatment, the effective rate of the treatment group was higher than that of the control group (86.5%>75.7%), and the difference was statistically significant (P<0.05). 2) After treatment, the TCM syndrome scores of both groups were lower than before, and the improvement degree of the treatment group was better than that of the control group, with statistical significance (P<0.05). 3) After treatment, the scores of single symptoms(cough, phlegm, sputum volume, wheezing and fever) in both groups were lower than before, and the improvement in cough, phlegm volume and sputum volume was more obvious in the treatment group than in the control group, with statistical significance (P<0.05). 4) After treatment, the inflammatory indexes(WBC, CRP, PCT, IL-6) of both groups were decreased, and the oxygenation index was increased, and the improvement degree of the treatment group was better than that of the control group, with statistical significance(P<0.05). 5) After treatment, the CPIS and APACHEII score of both groups decreased compared with before, and the decrease degree of the treatment group was more significant than that of the control group, with statistical significance(P<0.05). 6) After treatment, there was no statistically significant difference in the 14 day mortality rate between the treatment group and the control group(P>0.05);The length of stay in the ICU of the treatment group was shorter than that of the control group, and the difference was statistically significant(P<0.05).[Conclusion] The clinical efficacy of Shufeng Jiedu Capsules combined with conventional Western medicine treatment for patients with phlegm-heat congestion in the lung syndrome of severe pneumonia is superior to that of single Western medicine treatment.It can effectively improve the clinical symptoms of patients, inhibit inflammatory responses, increase oxygenation, reduce CPIS and APACHEⅡ scores, control severe pneumonia to a certain extent, and shorten the length of stay in the ICU.