摘要
目的:观察宣白承气汤联合机械通气治疗痰热壅肺型慢性阻塞性肺疾病急性加重期(AECOPD)老年患者的临床疗效及对肠道菌群、胃肠黏膜屏障功能的影响。方法:选取2022年1月—2024年6月武义县第一人民医院急诊重症监护病房行机械通气治疗的痰热壅肺型AECOPD老年患者70例为研究对象,按随机数字表法分为对照组、观察组各35例。对照组实施常规西医治疗,观察组在对照组基础上给予宣白承气汤治疗。比较2组临床疗效、肠道菌群、血清胃肠黏膜功能指标[D-乳酸和二胺氧化酶(DAO)]、炎症因子指标[白细胞介素-6(IL-6)、C-反应蛋白(CRP)、降钙素原(PCT)]和不良反应情况。结果:观察组总有效率为94.29%(33/35),对照组为71.43%(25/35),2组比较,差异有统计学意义(P<0.05)。治疗前,2组肠球菌、肠杆菌、乳酸杆菌及双歧杆菌数比较,差异均无统计学意义(P>0.05);治疗后,观察组肠球菌、肠杆菌数均少于对照组(P<0.05),乳酸杆菌、双歧杆菌数均多于对照组(P<0.05)。治疗前,2组D-乳酸、DAO水平比较,差异均无统计学意义(P>0.05);治疗后,观察组D-乳酸、DAO水平均低于对照组(P<0.05)。治疗前,2组IL-6、CRP、PCT水平比较,差异均无统计学意义(P>0.05);治疗后,观察组IL-6、CRP、PCT水平均低于对照组(P<0.05)。观察组不良反应发生率为5.71%(2/35),对照组为22.86%(8/35),组间比较,差异有统计学意义(P<0.05)。结论:宣白承气汤联合机械通气治疗痰热壅肺型AECOPD老年患者疗效肯定,可改善肠道微生态状况和胃肠黏膜功能,下调炎症反应水平,减少不良反应。
Objective:To observe the clinical effect of Xuanbai Chengqi Decoction combined with mechanical ventilation on senior patients with acute exacerbations of chronic obstructive pulmonary disease(AECOPD)of phlegm-heat obstructing the lung type and its effect on intestinal flora and gastrointestinal mucosal barrier function.Methods:A total of 70 senior patients with AECOPD of phlegm-heat obstructing the lung type who underwent mechanical ventilation in the emergency intensive care unit of Wuyi County First People's Hospital from January 2022 to June 2024 were selected as the study subjects.All patients were divided into the control group and the observation group according to the random number table method,with 35 cases in each group.The control group was treated with conventional western medicine,and the observation group was additionally treated with Xuanbai Chengqi Decoction based on the treatment of the control group.The clinical effects,intestinal flora,levels of serum gastrointestinal mucosal function indexes[D-lactic acid and diamino oxidase(DAO)]and inflammatory indexes[interleukin-6(IL-6),C-reactive protein(CRP)and procalcitonin(PCT)]and incidence of adverse reactions were compared between the two groups.Results:The total effective rate was 94.29%(33/35)in the observation group and 71.43%(25/35)in the control group,the difference being significant(P<0.05).Before treatment,there were no differences being found in the comparison of the numbers of Enterococci,Enteric Bacilli,Lactobacilli and Bifidobacterial between the two groups(P>0.05);after treatment,the numbers of Enterococci and Enteric Bacilli in the observation group were less than those in the control group(P<0.05),and the numbers of Lactobacilli and Bifidobacteria were greater than those in the control group(P<0.05).Before treatment,there were no significant differences being found in the comparison of the levels of D-lactic acid and DAO between the two groups(P>0.05);after treatment,the levels of D-lactic acid and DAO in the observation group were lower than those in the control group(P<0.05).Before treatment,there were no significant differences being found in the comparison of the levels of IL-6,CRP and PCT between the two groups(P>0.05);after treatment,the levels of IL-6,CRP and PCT in the observation group were lower than those in the control group(P<0.05).The incidence of adverse reactions was 5.71%(2/35)in the observation group,and that of 22.86%(8/35)in the control group,the difference being significant(P<0.05).Conclusion:Xuanbai Chengqi Decoction combined with mechanical ventilation has a definite curative effect on senior patients with AECOPD of phlegm-heat obstructing the lung type,which can improve the intestinal microecology and the gastrointestinal mucosal function,down-regulate the level of inflammatory responses and reduce the adverse reactions.
作者
朱骏飒
俞骞
王晓明
潘王瑛
ZHU Junsa;YU Qian;WANG Xiaoming;PAN Wangying(Department of Emergency,Wuyi County First People's Hospital,Wuyi Zhejiang 321200,China;Department of Chinese Medicine,Wuyi County First People's Hospital,Wuyi Zhejiang 321200,China)
出处
《新中医》
2025年第12期39-43,共5页
New Chinese Medicine
基金
浙江省医学会临床医学科研专项资金(2023ZYC-B31)。
关键词
慢性阻塞性肺疾病急性加重期
机械通气
宣白承气汤
肠道菌群
黏膜屏障
老年人
Acute exacerbation of chronic obstructive pulmonary disease
Mechanical ventilation
Xuanbai Chengqi Decoction
Intestinal flora
Mucosal barrier
The senior
