目的 基于三证三法、菌毒炎同治理论探讨血必净注射液在治疗重症肺炎感染患者中的临床疗效和安全性.方法 选取2021年1月-2023年12月期间淮南东方医院集团总医院收治的热毒炽盛证合并瘀毒内阻证重症肺炎患者72例,采用随机数字表法分为对照组和治疗组,每组各36例.对照组给予常规西医治疗,包括抗感染治疗、机械通气、化痰、营养治疗等.治疗组在对照组基础上联合使用血必净注射液,均治疗10d.观察比较两组患者临床有效率、不良反应,治疗前后中医证候评分、临床肺部感染评分(Clinical pulmonary infection score,CPIS)、生化指标[C反应蛋白(C-reactive protein,CRP)、降钙素原(Procalcitonin,PCT)]、血气分析[动脉血氧饱和度(Oxygen saturation in arterial blood,SaO2)、(Partial pressure of oxygen in arterial blood,PaO2)]及相关血清炎症因子[肿瘤坏死因子-α(Tumor necrosis factor-α,TNF-α)、白细胞介素-6(Interleukin-6,IL-6)、白细胞介素-8(Interleukin-8,IL-8)]水平.结果 治疗后两组患者CPIS和中医证候评分均较治疗前明显降低,差异有统计学意义(P＜0.01);且治疗组CPIS评分低于对照组,差异有统计学意义(P＜0.05);治疗组中医证候评分与对照组比较,差异无统计学意义(P＞0.05).治疗后两组患者感染生化指标CRP,PCT水平较治疗前明显降低,血气分析指标SaO2水平较治疗前升高,差异有统计学意义(P＜0.01);且治疗组CRP指数水平低于对照组,SaO2水平高于对照组,差异有统计学意义(P＜0.05,P＜0.01).治疗后两组患者血清炎症因子IL-6、IL-8和TNF-α水平较治疗前明显降低,差异有统计学意义(P＜0.01);且治疗组血清炎症因子水平低于对照组,差异有统计学意义(P＜0.05).治疗后治疗组临床总有效率91.67％(33/36)高于对照组77.78％(28/36),差异有统计学意义(P＜0.05).治疗组不良反应事件发生率高于对照组,但差异无统计学意义(P＞0.05).结论 血必净联合西医常规治疗用于热毒炽盛证合并瘀毒内阻证重症肺炎患者,可显著提高临床有效率,改善患者相关临床指标,且安全性良好.
Clinical Efficacy of Xuebijing Injection in Treatment of Patients with Severe Pneu-monia Infection Based on"Three Methods for Three Syndromes"
Objective To explore the clinical efficacy and safety of Xuebijing Injection in the treatment of pa-tients with severe pneumonia infection based on the theory of"simultaneous treatment of bacteria,viruses,and inflamma-tion"and the"three methods for three syndromes"approach.Methods Seventy-two patients with severe pneumonia presenting with the syndrome of heat toxin exuberance combined with internal obstruction of blood stasis toxin syndrome,admitted to Eastern Huainan Hospital Group General Hospital from January 2021 to December 2023,were selected and ran-domly divided into a control group and a treatment group according to a random number table,with 36 cases in each group.The control group received conventional Western medical treatment,including anti-infective therapy,mechanical ventila-tion,phlegm resolving,and nutritional support.The treatment group received Xuebijing Injection in addition to the treatment protocol of the control group,with both groups treated for 10 days.Clinical efficacy,adverse reactions,traditional Chinese medicine(TCM)syndrome scores,clinical pulmonary infection score(CPIS),biochemical markers[C-reactive protein(CRP),procalcitonin(PCT)],blood gas analysis[oxygen saturation in arterial blood(SaO2),partial pressure of oxygen in arterial blood(PaO2)],and serum inflammatory factors[tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),interleukin-8(IL-8)]of the two groups were observed and compared before and after treatment.Results After treat-ment,both groups showed a significant reduction in CPIS and TCM syndrome scores compared to those before treatment(P＜0.01).The CPIS score in the treatment group was lower than that in the control group(P＜0.05).However,there was no statistically significant difference in TCM syndrome scores between the treatment and control groups(P＞0.05).The levels of infection biochemical markers CRP and PCT in both groups were significantly reduced compared to those before treatment,while the SaO2 level in blood gas analysis was significantly increased(P＜0.01).The CRP level in the treatment group was lower than that in the control group,and the SaO2 level was higher than that in the control group(P＜0.05,P＜0.01).After treatment,the serum inflammatory factors IL-6,IL-8,and TNF-α levels in both groups were significantly reduced compared to those before treatment(P＜0.01).The levels of these serum inflammatory factors in the treatment group were lower than those in the control group(P＜0.05).The overall clinical efficacy rate in the treatment group was 91.67％(33/36),higher than 77.78％(28/36)in the control group(P＜0.05).The incidence of adverse reactions in the treatment group was higher than that in the control group,but the difference was not statistically significant(P＞0.05).Conclusion Xuebijing Injection combined with conventional Western treatment for severe pneumonia patients with heat toxin exuberance syndrome combined with internal obstruction of blood stasis toxin syndrome can significantly improve clin-ical efficacy,enhance relevant clinical indicators,and is safe for use.
Three Methods for Three SyndromesSimultaneous Treatment of"Bacteria,Viruses,and Inflamma-tion"Xuebijing InjectionSevere Pneumonia
万方数据
维普
