Effect of Qingfei Tongfu Decoction on the lung function, score of TCM syndrome and levels of inflammatory factors in patients with severe pneumonia differentiated as syndrome of obstruction of phlegm-heat in lung
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摘要:目的 探讨清肺通腑汤对重症肺炎痰热壅肺证患者肺功能、中医证候积分和炎症因子水平的影响。方法 选取80例重症肺炎痰热壅肺证患者, 随机分为对照组与观察组各40例。对照组采用常规治疗，观察组在常规治疗的基础上采用清肺通腑汤治疗。比较2组治疗前后中医证候积分(发热、咳嗽、气促等)，肺功能指标[用力肺活量(FVC)、第1秒用力呼气容积(FEV1)、每分钟最大通气量(MVV)]和炎症因子[白细胞计数(WBC)、C反应蛋白(CRP)、白细胞介素-6(IL-6)]水平。结果 治疗2周后, 2组发热、咳嗽、气促积分均显著低于治疗前(P < 0.05), 且观察组显著低于对照组(P < 0.05)。治疗2周后, 2组FVC、FEV1、MVV均显著高于治疗前(P < 0.05), 且观察组显著高于对照组(P < 0.05)。治疗2周后, 2组WBC、CRP、IL-6均显著低于治疗前(P < 0.05), 且观察组显著低于对照组(P < 0.05)。结论 重症肺炎痰热壅肺证采用中医清肺通腑汤治疗安全有效，可改善患者症状，抑制炎性反应，增强肺功能，促进患者康复。Abstract:Objective To explore the effect of Qingfei Tongfu Decoction on the lung function, score of TCM syndrome and levels of inflammatory factors in patients with severe pneumonia differentiated as syndrome of obstruction of phlegm-heat in lung.Methods Totally 80 patients with severe pneumonia differentiated as syndrome of obstruction of phlegm-heat in lung were randomly divided into control group and observation group, with 40 cases in each group. The control group was treated with conventional treatment, while the observation group was treated with Qingfei Tongfu Decoction on the basis of conventional treatment. The scores of TCM syndromes (fever, cough, shortness of breath, etc.), lung function indexes[forced vital capacity (FVC), forced expiratory volume in one second (FEV1), maximum ventilation volume (MVV) per minute] and inflammatory factors [white blood cell count (WBC), C reactive protein (CRP), interleukin-6 (IL-6)] before and after treatment were compared between the two groups.Results After 2 weeks of treatment, the scores of fever, cough and shortness of breath in both groups were significantly lower than those before treatment (P < 0.05), and the observation group was significantly lower than the control group (P < 0.05). After 2 weeks of treatment, FVC, FEV1 and MVV of the two groups were significantly higher than those before treatment (P < 0.05), and the observation group was significantly higher than the control group (P < 0.05). After 2 weeks of treatment, WBC, CRP and IL-6 levels in both groups were significantly lower than those before treatment (P < 0.05), and the observation group was significantly lower than the control group (P < 0.05).Conclusion Qingfei Tongfu Decoction is effective in treatment of patients with severe pneumonia differentiated as syndrome of obstruction of phlegm-heat in lung, which can improve the symptoms of patients, inhibit inflammatory response, enhance lung function, and promote rehabilitation of patients.
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表 1 2组治疗前后中医证候积分比较(x±s)
分 组别 发热 咳嗽 气促 治疗前 治疗2周后 治疗前 治疗2周后 治疗前 治疗2周后 对照组(n=40) 2.45±0.31 1.04±0.25* 2.37±0.30 1.10±0.26* 2.36±0.29 1.06±0.24* 观察组(n=40) 2.50±0.33 0.81±0.21*# 2.35±0.28 0.85±0.23*# 2.37±0.30 0.84±0.21*# 与治疗前比较, *P < 0.05; 与对照组比较, #P < 0.05。 
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表 2 2组治疗前后肺功能指标比较(x±s)
组别 FVC/L FEV1/% MVV/(L/min) 治疗前 治疗2周后 治疗前 治疗2周后 治疗前 治疗2周后 对照组(n=40) 1.21±0.45 1.89±0.57* 48.97±7.64 56.03±8.19* 57.81±8.12 72.16±10.49* 观察组(n=40) 1.19±0.47 2.23±0.64*# 49.91±7.58 64.25±9.56*# 58.04±8.10 86.47±12.06*# FVC: 用力肺活量; FEV1: 第1秒用力呼气容积; MVV: 每分钟最大通气量。与治疗前比较, *P < 0.05; 与对照组比较, #P < 0.05。
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表 3 2组治疗前后炎症因子水平比较(x±s)
组别 WBC/(×109/L) CRP/(mg/L) IL-6/(pg/mL) 治疗前 治疗2周后 治疗前 治疗2周后 治疗前 治疗2周后 对照组(n=40) 19.26±4.12 12.65±3.24* 141.67±25.36 70.97±9.02* 67.12±8.74 51.30±6.79* 观察组(n=40) 19.08±4.23 7.46±2.89*# 140.72±25.17 40.37±7.08*# 66.98±8.81 23.05±5.28*# WBC: 白细胞计数; CRP: C反应蛋白; IL-6: 白细胞介素-6。与治疗前比较, *P < 0.05; 与对照组比较, #P < 0.05。
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