| ObjectiveWith the MUC5AC as the breakthrough point, this study observed the clinical curative effect of Tanreqing Injection combined with bronchoalveolar lavage(BAL) surgery in the treatment of CAP patients with phlegm heat obstructing lung type, which on the basis of the routine western medicine therapy. Its impact on the expression of MUC5AC also can be observed. To evaluation the application value of this traditional Chinese and Western medicine therapy comprehensively, which can provide new clinical experience and ideas for treating CAP.MethodsThe study was a randomized controlled trial, which was carried out in the respiratory inpatient of Guangdong Province Traditional Chinese Medical Hospital between January 2015 and January 2016.63 cases was included according to the inclusion criteria. There are one case of each group fall off in the observation process, the shedding rate was 3.2%. Finally,61 cases were divided into 2 groups, the control group (31 cases) and the comprehensive group(30 cases). The control group was given routine western medicine, the comprehensive group was added Tanreqing Injection and BAL. By observing the patients’ changes of traditional Chinese medicine(TCM) symptoms score, clinical pulmonary infection score (CPIS), sputum MUC5AC content, blood White blood cell count(WBC), neutrophil percentage(N%) and C-reactive protein(CRP), we can evaluate the clinical efficacy and safety of the two groups comprehensively.Results1.The baseline conditions:The effective case was 61 cases in this study, the comprehensive group has 30 cases, the control group has 31 cases. The differences of the two groups’ age, gender, nature of work and merger diseases have no statistical significance (P>0.05), and the materials have good comparability.2. The changes of sputum MUC5AC content, blood WBC count and N%:the comparison of two groups respectively exist the statistical significance within groups before and after the treatment (P＜0.05). the comprehensive group had statistical significance comparing with the control group (P＜0.05). The TCM symptoms score, the comparison of two groups respectively exist the statistical significance within groups before and after the treatment (P＜0.05). However, there was no significant difference between two groups (P＞0.05), but there are differences in comparing the two groups after treatment (P＜0.05). Thus the improvement of TCM symptoms score of treatment grouup was superior to control group.3. The changes of CPIS and CRP:the comparison of two groups respectively exist the statistical significance within groups before and after the treatment (P＜0.05). However, there was no statistical significance in comparison of two groups after treatment(P>0.05).4. the comprehensive group’average hospitalization days was 9.43±1.924 days, the control group’the average hospitalization days was 10.74±2.921 days, the comprehensive group can effectively reduce average hospitalization days of the CAP patients comparing the control group(P<0.05).5. The therapeutic effect comparison:the total effective rate of treatment group is 96.7%, the control group effective rate was 77.4%. the comprehensive group is better than that of control group (P< 0.05).6. In the process of the entire study, there were 3 cases of adverse events, which are considered have little to do with intervention measures. There were no significant abnormalities in other signs, such as routine blood, routine stool test, liver function, kidney function in all the patients involved in this test. This result demonstrates that the comprehensive treatment which combined Tanreqing Injection with BAL is safe.Conclusion1. Routine western medicine therapy and the comprehensive treatment combined Tanreqing injection with BAL based on western medicine treatment have a good clinical efficacy in patients with CAP.2. On the basis of the routine western medicine therapy, the comprehensive treatment combined Tanreqing injection with BAL can not only reduce the patients’TCM symptoms score, blood WBC count and neutrophil, but also can improve clinical symptoms and reduce the average hospitalization days. The therapy combined traditional Chinese and western medicine, which clinical curative effect is distinct, is worth widely developing and applying to the clinic. The comprehensive treatment can reduce blood neutrophils and promote the sputum discharge. At the same time, it can change the character of mucus dynamics through reducing the expression of MUC5AC. So it can reduce inflammatory reaction, which improves the patient’s symptoms and signs. This comprehensive treatment is more effective than the routine western medicine treatment, it is safety. |
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