Clinical Efficacy of Modified Shenling Baizhusan on Stroke-associated Pneumonia with Lung-Qi Deficiency Syndrome

De-xu LI; Xin-wen ZHANG

doi:10.13422/j.cnki.syfjx.20192233

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Clinical Efficacy of Modified Shenling Baizhusan on Stroke-associated Pneumonia with Lung-Qi Deficiency Syndrome

Clinic | 更新时间：2021-02-09

- Clinical Efficacy of Modified Shenling Baizhusan on Stroke-associated Pneumonia with Lung-Qi Deficiency Syndrome
- Chinese Journal of Experimental Traditional Medical Formulae Vol. 26, Issue 5, Pages: 75-80(2020)
- 作者机构：
  
  河北大学　附属医院，河北保定　 071015
- 作者简介：
- 基金信息：
- DOI：10.13422/j.cnki.syfjx.20192233
  CLC： R5; R56; R563; R563.1
- Received：12 June 2019，
  
  Published Online：16 August 2019，
  
  Published：05 March 2020
- 稿件说明：
移动端阅览
De-xu LI, Xin-wen ZHANG. Clinical Efficacy of Modified Shenling Baizhusan on Stroke-associated Pneumonia with Lung-Qi Deficiency Syndrome[J]. Chinese journal of experimental traditional medical formulae, 2020, 26(5): 75-80.
DOI：

De-xu LI, Xin-wen ZHANG. Clinical Efficacy of Modified Shenling Baizhusan on Stroke-associated Pneumonia with Lung-Qi Deficiency Syndrome[J]. Chinese journal of experimental traditional medical formulae, 2020, 26(5): 75-80. DOI： 10.13422/j.cnki.syfjx.20192233.

摘要

目的：

观察参苓白术散加减治疗卒中相关性肺炎(SAP)肺脾气虚证的临床疗效及对炎症因子和免疫功能的调节作用。

方法：

将110例患者按随机数字表法分为观察组和对照组各55例。对照组注射用哌拉西林钠他唑巴坦钠，4.5 g/次，缓慢静脉滴注，3次/d，并根据药物结果重新选择抗生素，连续注射7～10 d；盐酸氨溴索注射液，30 mg/次，慢速静脉输注，2次/d，疗程连续注射10 d，并给予营养支持及对症综合治疗。观察组西医治疗措施同对照组，并内服参苓白术散加减，1剂/d，共连续治疗10 d。进行临床肺部感染评分(CPIS)，记录CPIS

6分时间、咳嗽消失时间、体温恢复时间、白细胞恢复正常、肺部湿啰音消失时间；进行治疗前后肺脾气虚证评分；检测治疗前后降钙素原(PCT)，

-干扰素(IFN-

)，肿瘤坏死因子-

(TNF-

)，高敏C反应蛋白(hs-CRP)水平；检测治疗前后免疫球蛋白A(IgA)，免疫球蛋白G(IgG)，免疫球蛋白M(IgM)，T淋巴细胞亚群(CD4

＋

，CD8

＋

，CD4

＋

/CD8

＋

)水平。

结果：

采用秩和检验分析，观察组患者临床疗效好于对照组(

＝2.106，

0.05)；观察组患者CPIS，肺脾气虚证积分均低于对照组(

0.01)；观察组患者CPIS

6分时间、咳嗽消失时间、体温恢复时间、白细胞恢复正常、肺部湿啰音消失时间均短于对照组(

0.01)；观察组PCT，TNF-

，hs-CRP水平均低于对照组(

0.01)，IFN-

水平高于对照组(

0.01)；观察组IgA和IgM水平均高于对照组(

0.05)；观察组CD4

＋

，CD4

＋

/CD8

＋

均高于对照组(

0.05)，CD8

＋

低于对照组(

0.05)。

结论：

在抗感染等综合治疗的基础上，参苓白术散加减治疗SAP肺脾气虚证患者，可进一步控制病情程度，减轻症状，并能调节炎症因子表达，增强机体免疫功能，提高综合疗效。

Abstract

Objective:

To observe the clinical efficacy of modified Shenling Baizhusan on stroke-associated pneumonia (SAP) with lung-Qi deficiency syndrome and its regulatory effect on inflammatory factors and immune function.

Method:

One hundred and ten patients were randomly divided into control group (55 cases) and observation group (55 cases) by random number table. Patients in control group got piperacillin sodium and tazobactam sodium for slow intravenous injection

4.5 g/time

3 times/days

for 7-10 days

and new antibiotic was chose by drug outcomes

ambroxol hydrochloride injection for low intravenous infusion

30 mg/time

2 times/days

for 10 days

and nutritional support and symptomatic comprehensive treatment. In addition to the therapy in control group

patients in observation group were added with modified Shenling Baizhusan

1 dose/day

for 10 days. And scores of pulmonary infection (CPIS)

time of CPIS

6 time of disappearance of cough

time of recovery of temperature

time of recovery of leukocyte

and time of disappearance of lung rales were recorded. And before and after treatment

lung-Qi deficiency syndromes were scored

and levels of procalcitonin (PCT)

-interferon (IFN-

)

tumor necrosis factor-

(TNF-

)

high-sensitivity C-reactive protein (hs-CRP)

immunoglobulin A (IgA)

immunoglobulin G (IgG)

immunoglobulin M (IgM)

T Lymphocyte subsets (CD4

CD8

and CD4

/CD8

) were all detected.

Result:

By rank sum test

the clinical effect in control group was better than that in control group (

=2.106

0.05). Scores of CPIS and lung-Qi deficiency syndromes were lower than those in control group (

0.01). And time of CPIS

time of disappearance of cough

time of recovery of temperature

time of recovery of leukocyte

and time of disappearance of lung moist rales were all shorter than those in control group (

0.01). And levels of PCT

TNF-

hs-CRP and CD8

were lower than those in control group (

0.01

0.05)

while levels of IFN-

IgA

IgM

CD4

and CD4

/CD8

were all higher than those in control group (

0.01

0.05).

Conclusion:

In addition to the comprehensive anti-infection therapy

modified Shenling Baizhusan can control the degree of illness

alleviate symptoms

regulate the expressions of inflammatory factors

increase the immune function of the body

and improve the comprehensive efficacy.

关键词

Keywords

references

卒中相关性肺炎诊治中国专家共识组．卒中相关性肺炎诊治中国专家共识 [J]．中华内科杂志， 2010 ， 49 ( 12 ): 1075 - 1078 .

单凯，郭伟．卒中相关性肺炎诊疗进展 [J]．中国卒中杂志， 2016 ， 11 ( 4 ): 324 - 330 .

潘希丁，周俊山．卒中相关性肺炎诊疗进展 [J]．医学综述， 2018 ， 24 ( 3 ): 538 - 542 .

李德需，张丽妍，赵永辰，等．白虎汤加减联合针灸治疗痰热腑实型卒中相关性肺炎的临床疗效以及对血清炎症因子的影响 [J]．辽宁中医杂志， 2019 ， 46 ( 4 ): 749 - 752 .

朱连雨，朱亮，余尚贞．黄芪建中汤加减治疗肺脾气虚型卒中相关性肺炎临床疗效观察 [J]．中医药临床杂志， 2018 ， 30 ( 8 ): 1474 - 1477 .

李侠，郑之俊，肖伟．肖伟教授治疗卒中相关性肺炎的经验 [J]．广西中医药， 2017 ， 40 ( 1 ): 48 - 50 .

孙志欣，陈莉，李锐，等．参苓白术散对老年社区获得性肺炎肺脾气虚证患者血清炎症因子及免疫功能的影响 [J]．中国实验方剂学杂志， 2017 ， 23 ( 21 ): 161 - 165 .

孙杰，王东晓，桑凯．参苓白术散对COPD大鼠下丘脑及胃组织Ghrelin，Obestatin的影响 [J]．中国实验方剂学杂志， 2018 ， 24 ( 1 ): 85 - 90 .

王彦芳，韩晓春，王媛，等．参苓白术散对脾虚水湿不化模型大鼠健脾功效的研究 [J]．中华中医药学刊， 2019 ， 37 ( 1 ): 60 - 63 .

国家中医药管理局．中医病证诊断疗效标准 [M]．北京：中国医药科技出版社， 2012 ： 287 - 289 .

韩正贵，陆江涛，王文静，等．宣肺通腑汤辅助治疗中老年重症肺炎合并胃肠功能障碍的临床观察 [J]．中国实验方剂学杂志， 2018 ， 24 ( 16 ): 188 - 193 .

王雪，吕晓佟，刘鑫，等．卒中诱导的免疫抑制和卒中相关性肺炎的研究进展 [J]．中国实用神经疾病杂志， 2018 ， 21 ( 15 ): 1644 - 1647 .

Q W DENG , H YANG , F L YAN , et al . Blocking sympathetic nervous system reverses partially stroke-induced immunosuppression but does not aggravate functional outcome after experimental stroke in rats [J]. Neurochemical Res ， 2016 , 41 ( 8 ): 1877 - 1886 .

吕晶，刘昱材，赵志国．卒中相关性肺炎研究进展 [J]．湖南中医杂志， 2017 ， 33 ( 2 ): 147 - 152 .

高佳，王颖．中医药治疗卒中相关性肺炎研究概况 [J]．中医药临床杂志， 2017 ， 29 ( 11 ): 1794 - 1797 .

吴江莹，刘晓新．从肺脾论治卒中相关性肺炎的中医临床思路 [J]．天津中医药， 2012 ， 29 ( 6 ): 559 - 561 .

宋苹，张溪，姚怀国．卒中相关性肺炎的中医症状及证型特征 [J]．实用医学杂志， 2018 ， 34 ( 9 ): 1557 - 1560 .

黄璐，张月娟，廖若夷，等．中医药辅助治疗卒中相关性肺炎的Meta分析 [J]．湖南中医药大学学报， 2016 ， 36 ( 1 ): 81 - 84 .

胡旭明，高美慧，鲍琪，等．卒中相关性肺炎病原菌分析及血清降钙素原的临床诊疗价值 [J]．中华医院感染学杂志， 2018 ， 28 ( 3 ): 344-347，351 .

李兰英，余青云，谭杰，等． PCT及IFN- γ 在卒中相关性肺炎中的水平变化及诊断价值 [J]．实用医药杂志， 2017 ， 34 ( 8 ): 681 - 683 .

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