犀角地黄汤加味通过清除IL-6和TNF-α改善重症肺炎机械通气患者的炎症反应机制研究Modified Xijiao Dihuang Decoction Improves the Inflammatory Response of Mechanically Ventilated Patients with Severe Pneumonia by Eliminating IL-6 and TNF-α
唐霞,邓太兵,梅馨芳
摘要(Abstract)：
目的 探究犀角地黄汤加味通过清除白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)改善重症肺炎机械通气患者炎症反应的作用机制。方法 患者80例随机分为对照组与研究组各40例。对照组采用常规治疗措施，研究组在对照组的基础上口服犀角地黄汤加味。两组患者均于治疗前及治疗2周后，采集全血标本进行检测，并进行临床疗效评估。结果 治疗后，两组外周血Th1和Th17含量均较治疗前明显降低（P <0.05），而Th2和Treg含量明显升高（P <0.05）；且治疗后研究组外周血Th1、Th17含量低于对照组（P <0.05），同时Th2、Treg含量明显高于对照组（P <0.05）。两组患者血清白细胞介素-4(IL-4)、γ干扰素（IFN-γ）、IL-6、TNF-α、白细胞介素-17(IL-17)、超敏C反应蛋白（hs-CRP）、降钙素原（PCT）水平均较治疗前降低（P <0.05），同时血清TGF-β水平升高（P <0.05）；且研究组血清IL-6、TNF-α、IL-17、hs-CRP、PCT水平低于对照组（P <0.05）。两组患者APACHEⅡ评分、CPIS、PSI评分均较治疗前显著降低（P <0.05），且研究组患者低于对照组（P <0.05）。研究组患者平均ICU住院时间、机械通气时间、呼吸机相关性肺炎发生率以及肺部湿啰音、肺部致密影等临床症状恢复时间均短于对照组（P <0.05）。结论 犀角地黄汤联合西医常规治疗可以通过清除IL-6、TNF-α等炎性介质改善重症肺炎机械通气患者的临床症状，缩短机械通气时间。
关键词(KeyWords)： 重症肺炎;机械通气;IL-6;TNF-α;犀角地黄汤加味;炎症反应
基金项目(Foundation): 四川省卫生健康委员会普及应用项目（20PJ310）
作者(Author): 唐霞,邓太兵,梅馨芳
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