标题：升降散加减治疗重症肺炎(痰热壅肺型)的效果及对炎症因子和外周血T淋巴细胞群的影响

      作者：强卫平 1，付成保 2，官蜀均 3    1.西安中医脑病医院内科，陕西 西安 710038；2.西安中医脑病医院脑病科，陕西 西安 710000；3.西安存济妇产医院中医科，陕西 西安 710000

      卷次： 2023年34卷14期

      【摘要】 目的 探讨升降散加减治疗重症肺炎(痰热壅肺型)的效果及对炎症因子和外周血T淋巴细胞群的影响。方法 选取2019年1月至2022年6月西安中医脑病医院收治的80例重症肺炎(痰热壅肺型)患者进行研究，按随机数表法分为观察组和对照组各40例。对照组患者采取常规西医治疗，观察组患者在对照组治疗的基础上联合升降散加减治疗，两组患者均治疗两周。治疗结束后，比较两组患者的治疗效果、症状缓解时间，以及治疗前后的炎症因子[C反应蛋白(CRP)、肿瘤坏死因子-α (TNF-α)、白细胞介素-6 (IL-6)和白细胞介素-10 (IL-10)]、外周血T淋巴细胞群[CD3+、CD4+、CD8+及CD4+/CD8+]水平；同时比较两组患者治疗期间的不良反应发生情况。结果 观察组患者的治疗总有效率为95.00%，明显高于对照组的80.00%，差异有统计学意义(P<0.05)；治疗后，观察组患者的发热、咳嗽、咳痰、气短及胸闷缓解时间分别为(4.26±0.61) d、(7.59±1.01) d、(6.14±1.06) d、(4.16±0.81) d、(5.99±0.53) d，明显短于对照组的(6.44±1.34) d、(10.25±1.56) d、(9.11±1.55) d、(6.27±1.89) d、(8.27±1.71) d，差异均有统计学意义(P<0.05)；治疗后，观察组患者的CRP、TNF-α、IL-6水平分别为(41.99±9.11) mg/L、(1.05±0.23) pg/mL、(23.33±6.54) ng/mL，明显低于对照组的(48.79±10.23) mg/L、(1.55±0.34) pg/mL、(27.71±7.06) ng/mL，IL-10水平为(15.78±0.34) pg/mL，明显高于对照组的(10.74±0.37) pg/mL，差异均有统计学意义(P<0.05)；治疗后，观察组患者的CD3+、CD4+、CD4+/CD8+水平分别为(71.92±8.03)%、(54.38±4.73)%、2.79±0.29，明显高于对照组的(62.18±7.83)%、(47.19±5.37)%、1.78±0.28，CD8+水平为(21.47±3.02)%，明显低于对照组的(28.29±3.74)%，差异均有统计学意义(P<0.05)；观察组患者的不良反应总发生率为10.00%，略高于对照组的7.50%，但差异无统计学意义(P>0.05)。结论 升降散加减联合西医常规治疗重症肺炎(痰热壅肺型)能明显改善患者的炎症因子水平和外周血T淋巴细胞群水平，治疗效果良好，具有临床应用价值。
      【关键词】 重症肺炎；痰热壅肺型；升降散；疗效；炎症因子；免疫功能；外周血T淋巴细胞群
      【中图分类号】 R563.1 【文献标识码】 A 【文章编号】 1003—6350（2023）14—1993—05

Efficacy of modified Shengjiang Powder in the treatment of severe pneumonia (phlegm-heat blocking lung type)and its impact on inflammatory factors and peripheral blood T lymphocyte group.
QIANG Wei-ping 1, FUCheng-bao 2, GUAN Shu-jun 3. 1. Department of Internal Medicine, Xi'an Traditional Chinese Medicine EncephalopathyHospital, Xi'an 710038, Shaanxi, CHINA; 2. Department of Encephalopathy, Xi'an Traditional Chinese MedicineEncephalopathy Hospital, Xi'an 710000, Shaanxi, CHINA; 3. Department of Traditional Chinese Medicine, Xi'an CunjiMaternity Hospital, Xi'an 710000, Shaanxi, CHINA
【Abstract】 Objective To explore the efficacy of modified Shengjiang Powder in the treatment of severe pneu-monia (phlegm-heat blocking lung type) and its impact on inflammatory factors and peripheral blood T lymphocytegroup.Methods A study was conducted on 80 patients of severe pneumonia (phlegm heat obstructing lung type) admittedto Xi'an Traditional Chinese Medicine Encephalopathy Hospital from January 2019 to June 2022. The patients were ran-domly divided into an observation group and a control group according to random number table method, each with 40 cas-es. Patients in the control group received routine western medicine treatment, while those in the observation group re-ceived modified Shengjiang Powder on the basis of the control group. Both groups were treated for 2 weeks. After treat-ment, the treatment effectiveness and symptom relief time were compared between the two groups, as well as the levels ofinflammatory factors such as C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), and inter-leukin-10 (IL-10), peripheral blood T lymphocyte populations such as CD3+, CD4+, CD8+, and CD4+/CD8+ before and af-ter 2 weeks of treatment. The adverse reactions during treatment between the two groups were compared. Results The to-tal effective rate of patients in the observation group was 95.00%, which was significantly higher than 80.00% in the con-trol group (P<0.05). The remission time of fever, cough, expectoration, shortness of breath, and chest tightness in the ob-servation group were (4.26±0.61) d, (7.59±1.01) d, (6.14±1.06) d, (4.16±0.81) d, (5.99±0.53) d, which were significantlyshorter than (6.44±1.34) d, (10.25±1.56) d, (9.11±1.55) d, (6.27±1.89) d, (8.27±1.71) d in the control group (P<0.05). Af-ter treatment, the CRP, TNF-α, and IL-6 levels in the observation group were (41.99±9.11) mg/L, (1.05±0.23) pg/mL,and (23.33±6.54) ng/mL, which were significantly lower than (48.79±10.23) mg/L, (1.55±0.34) pg/mL, and (27.71±7.06) ng/mL in the control group; the IL-10 level in the observation group was (15.78±0.34) pg/mL, which was signifi-cantly higher than (10.74±0.37) pg/mL in the control group; the differences were statistically significant (P<0.05). Af-ter treatment, the levels of CD3 + , CD4 + , CD4 +/CD8 + in the observation group were (71.92±8.03)%, (54.38±4.73)%,2.79±0.29, which were significantly higher than (62.18±7.83)%, (47.19±5.37)%, 1.78±0.28 in the control group; the lev-els of CD8+ in the observation group was (21.47±3.02)%, which was significantly lower than (28.29±3.74)% in the con-trol group; the differences were statistically significant (P<0.05). The total incidence of adverse reactions in the observa-tion group was 10.00%, which was slightly higher than 7.50% in the control group (P>0.05). Conclusion ModifiedShengjiang Powder combined with routine western medicine in the treatment of severe pneumonia (phlegm-heat block-ing lung type) can significantly improve the levels of inflammatory factors and peripheral blood T lymphocyte group inpatients, with good therapeutic effects and high clinical application value.
      【Key words】 Severe pneumonia; Phlegm-heat blocking lung type; Shengjiang Powder; Efficacy; Inflammatoryfactors; Immunity; Peripheral blood T lymphocyte group