| Objective:To study the clinical efficacy of Qingfei Prescription combined with Western medicine treatment in patients community acquired pneumonia(CAP)with phlegm and blood stasis syndrome,and to study its mediators regulating inflammation in CAP patients,and to explore the clinical value of Qingfei Prescription in the treatment of CAP.The application significance provides a safer and more effective treatment method and evidence-based medical basis for improving the quality of life of CAP patients.Methods:This study was a randomized,parallel-controlled research,and a total of 108 CAP patients with phlegm and blood stasis syndrome were included in Shanghai Pudong New Area People's Hospital.The patients in the standard case were randomly divided into Treate Group and Control group.The patients in Control group received routine basic treatment.The patients in Treate Group were treated with Qingfei prescription on the basis of the same tranditional basic treatment,and 10 days was a course of treatment.TCM symptom scores were scored on the 1st,2nd,3rd,5th,7th and 10 th day after treatment,and chest computed tomography(CT),pneumonia severity index score(PSI)and relevant laboratory indicators was performed in both groups before and 10 days after treatment.The relevant laboratory indicators included white blood cell count(WBC),neutrophil count 100%(NLCR),erythrocyte sedimentation rate(ESR),drop Procalcitonin(PCT),C-reactive protein(CRP),tumor necrosis factor-?(TNF-?),interleukin-1?(IL-1?),IL-6,IL-8 and immunoglobulin-M(Ig)-M).And the safety indicators were observed during the treatment.Results:(1)There were no remarkable statistically significant differences in the general clinical data of age,gender,course of disease,concurrent disease,smoking and drinking,and conventional antibiotic treatment in western medicine in both groups(P>0.05).(2)After treatment for ten days,in Treate Group the clinical prognosis was cured in 26cases(48.15%),clinically effective in 20 cases(37.04%),and clinically effective in 5cases(9.26%).The total effective rate was 94.44%,which was significantly higher than the control group(P ?0.05).(3)There was no distinct statistically significantdifference in the main syndrome and secondary syndrome scores of TCM in both groups on the first day(P>0.05).On the5 th,7th and the tenth day after treatment,the fever,cough and expectoration scores in the main symptoms of TCM in Treate Group was remarkably decreased compared with that in Control Group with significant difference statistically(P?0.05).On the 5th,7th and day 10 after treatment,thirst,upset,dry stool,short red urine and wet sputum score in the secondary symptoms of TCM in Treate Group were distinctly lower than that in Control Group with significant difference statistically(P?0.05).(4)CT examination results showed that the lung inflammation in the Treate Group was completely absorbed in 28 cases(51.85%),were obviously absorbed in 21 cases(38.89%),and were partially absorbed in 4 cases(7.41%),The total effective rate was98.15%.The inflammation absorption was significantly better than the Control Group with significant difference statistically(P ?0.05).(5)There was no significant difference in PSI score in both groups on the first day(P>0.05).After 10 days of treatment,the PSI score in Treate Group was remarkably lower than that in Control Group,and the difference was statistically significant(P?0.05).(6)There were no significant differences in the level of WBC,NLCR,ESR,PCT and CRP in both groups on the first day(P>0.05).The level of WBC,NLCR,ESR,PCT and CRP in Treate Group were lower than that in Control Group after 10 days of treatment,which showed significant difference(P?0.05).(7)There were no significant differences in the level of TNF-?,IL-1?,IL-6,IL-8 and Ig-M between the two groups on the first day(P>0.05).After 10 days of treatment,The level of TNF-?,IL-1?,IL-6 and IL-8 in Treate Group were significantly lower than that in Control Group,which showed significant difference(P?0.05),and the level of Ig-M in Treate Group was significantly higher than that in Control Group,which showed significant difference(P?0.05).(8)In Treate Group,mild transient nausea/vomiting occurred in 2 patients(3.70%)during the treatment.No adverse reactions such as diarrhea and allergic reaction occurred in the two groups.There were no abnormal changes in liver function,renalfunction and ECG before and after treatment.Conclusion:Qingfei Prescription combined with Western medicine has a good clinical effect on patients with CAP.Qingfei Prescription combined with Western medicine is superior to Western medicine conventional treatment,which can significantly improve the clinical symptoms of patients with TCM,promote the absorption of lung inflammation,significantly reduce PSI,reduce WBC,NLCR,ESR,PCT,and CRP.We can infer that its clinical efficacy may be related to the regulation of TNF-?,IL-1?,IL-6,IL-8 and the elevation of Ig-M. |
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