| Objective:To investigate the clinical effect of modified Qingjin Huatan Decoction on apoplexy-related pneumonia of phlegm-heat obstructing lung type.Method:A total of 60 patients diagnosed with stroke-related pneumonia of phlegm-heat obstructing lung type and meeting the inclusion criteria were selected from the Department of Encephalopathy and Critical Care Medicine of Gansu Hospital of Traditional Chinese Medicine from December 2021 to December 2022 and randomly divided into control group and treatment group,with 30 cases in each group.The control group was given routine treatment.On the basis of the control group,the treatment group was given supplemented Qingjin Huatan decoction orally or nasal feeding.The changes of white blood cell count(WBC),procalcitonin(PCT),ratio of neutrophils to lymphocytes(NLR),cell levels of CD4~+,CD8~+,ratio of CD4~+/CD8~+,pneumonia infection score(CPIS),total TCM syndrome score and individual scores of the two groups were compared before treatment and 10 days after treatment.Routine stool,liver and kidney function,electrocardiogram,etc.were recorded as safety observation indexes,and adverse reactions and treatment measures were recorded during treatment.SPSS25.0 was used for statistical analysis.Results:1.Comparison of baseline data:Age,gender,combined underlying diseases,stroke type and severity,and smoking were compared between the two groups,showing no statistical significance(P>0.05).2.Comparison of observational indicators:(1)Comparison of inflammatory indicators:there was no statistical significance in WBC,PCT and NLR between the two groups before treatment(P>0.05),indicating comparability;After 10 days of treatment,WBC,PCT and NLR in both groups were lower than before treatment,and the reduction in the treatment group was more obvious than that in the control group,with statistical significance(P<0.05).(2)Comparison of immune indicators:Before treatment,there was no statistical significance in the levels of CD4~+,CD8~+and the ratio of CD4~+/CD8~+between the two groups(P>0.05),which was comparable;After 10 days of treatment,CD4~+and CD4~+/CD8~+in 2 groups were higher than before treatment,and the increase in treatment group was more obvious than that in control group,with statistical significance(P<0.05).The level of CD8~+in 2 groups was lower than before treatment,and the treatment group was more significantly lower than the control group,the difference was statistically significant(P<0.05).(3)Comparison of scale scores:Before treatment,there was no statistical significance in CPIS scores,total TCM syndrome scores and individual scores between the two groups(P>0.05),which was comparable;After 10 days of treatment,the CPIS score,the total score of TCM syndrome and the score of each single syndrome of the two groups were lower than before treatment,and the score of fever,cough,sputum volume,sputum color quality,sputum singing and wheezing in the treatment group was significantly improved than that of the control group,with statistical significance(P<0.05).3.Evaluation of efficacy:The evaluation criteria of efficacy were established according to the reduction rate of TCM syndrome points.The total effective rate of the treatment group was83.3%and that of the control group was 70%,and the total efficacy of the treatment group was superior to the control group,with statistical significance(P<0.05).4.Safety evaluation:During the observation period,there were no obvious abnormalities in routine bowel movements,liver and kidney function,and electrocardiogram in the two groups.Mild gastrointestinal adverse reactions occurred in 2 patients in the treatment group and 1patient in the control group,which were resolved by themselves without special treatment.Conclusions:Modified Qingjin Huatan Decoction combined with conventional Western medicine treatment can effectively improve the clinical symptoms of SAP patients,reduce inflammation and improve immune suppression.The clinical efficacy is obviously better than conventional treatment alone,and has high safety. |
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