补阳还五汤治疗老年重症肺炎合并脓毒症的回顾性研究

A retrospective study on treatment of elderly patients with severe pneumonia complicated with sepsis with Buyang Huanwu decoction

中文关键词: 老年  重症肺炎  脓毒症  瘀毒内阻证  补阳还五汤

英文关键词: elderly  severe pneumonia  sepsis  syndrome of internal obstruction by blood stasis and toxins  Buyang Huanwu decoction

中文摘要:

      目的 分析补阳还五汤对老年重症肺炎合并脓毒症瘀毒内阻证患者的临床疗效.方法 选取2020年8月-2023年7月本院重症医学科收治的老年重症肺炎合并脓毒症符合瘀毒内阻证的患者共72例,根据是否服用补阳还五汤分为观察组和对照组,每组36例.比较2组治疗7 d前后白细胞计数(white blood cell count,WBC)、C反应蛋白(C-reactive protein,CRP)、白细胞介素-6(interleukin-6,IL-6)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)水平、序贯器官衰竭评估(sequential organ failure assessment,SOFA)评分、急性生理学及慢性健康状况评分系统Ⅱ(acute physiolo-gy and chronic health evaluation-Ⅱ,APACHE-Ⅱ)评分、中医证候积分,以及2组中医疗效.结果 治疗后,2组WBC、CRP、TNF-α、IL-6水平,APACHE-Ⅱ评分、SOFA评分、中医证候积分较同组治疗前明显下降(P＜0.05),观察组上述指标值均明显低于对照组(P＜0.05);观察组中医疗效明显高于对照组(P＜0.05).结论 在常规治疗基础上,应用补阳还五汤治疗老年重症肺炎合并脓毒症瘀毒内阻证患者,可减轻炎症反应,增强临床疗效,改善患者预后,具有一定的临床应用价值.

英文摘要:

      Objective To analyze the clinical efficacy of Buyang Huanwu decoction in elderly patients with severe pneumonia complicated with sepsis and the syndrome of internal obstruction by blood stasis and toxins.Methods 72 elderly patients with severe pneumonia and sepsis meeting the diagnostic criteria for internal obstruction by blood stasis-toxin syndrome from Intensive Care Unit of this Hospital between August 2020 and July 2023 were enrolled.They were divided into observation group and control group according to whether they took Buyang Huanwu decoction or not,with 36 cases in each group.The levels of white blood cell count(WBC),C-reactive protein(CRP),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),and the scores of Sequential Organ Failure Assessment(SOFA),Acute Physiology and Chronic Health Evaluation Ⅱ(APACHE-Ⅱ)and traditional Chinese medicine(TCM)syndrome before and after 7 days of treatment were compared be-tween the two groups.The therapeutic effects of traditional Chinese medicine were compared between the two groups.Results After treatment,the levels of WBC,CRP,TNF-α,IL-6 and the scores of APACHE-Ⅱ,SOFA and TCM syndrome in both groups decreased significantly compared to before treatment(P＜0.05),and the observation group was significantly lower than the control group(P＜0.05).The therapeutic effect of traditional Chinese medicine in the observation group was significantly higher than that in the control group(P＜0.05).Conclusion On the basis of conventional treatment,the appli-cation of Buyang Huanwu decoction in the treatment of elderly patients with severe pneumonia complicated with sepsis and the syndrome of internal obstruction by blood stasis and toxins can reduce the inflammatory response,enhance the clinical efficacy,and improve the prognosis of patients.It has certain clinical application value.