千金苇茎汤合定喘汤联合支气管肺泡灌洗治疗痰热阻肺型重症肺炎伴肺不张患者的疗效及对血清IL-10、IFN-γ水平的影响OA

Objective To observe the therapeutic effect of Qianjin Weijing Decoction combined with Dingchuan Decoction and bronchoalveolar lavage(BAL)on patients with severe pneumonia complicated with atelectasis of phlegm-heat obstructing the lung pattern and its effect on serum interleukin-10(IL-10)and interferon-γ(IFN-γ).Methods Ninety-four patients with severe pneumonia complicated with atelectasis of phlegm-heat obstructing the lung pattern admitted to the Department of Critical Care Medicine of South Campus of Gaozhou Hospital of Traditional Chinese Medicine from February 2023 to February 2025 were selected and randomly divided into control group and observation group by random number table method,with 47 cases in each group.Both groups received conventional treatment such as anti-infection,antipyretic,expectorant and nutritional support.On this basis,the control group was treated with BAL,and the observation group was treated with BAL combined with Qianjin Weijing Decoction and Dingchuan Decoction,with a course of 2 weeks.The disappearance time of symptoms such as atelectasis,fever,cough and pulmonary rales was compared between the two groups.The changes of Traditional Chinese Medicine(TCM)syndrome scores,blood gas analysis indexes[partial pressure of carbon dioxide(PaCO2),arterial partial pressure of oxygen(PaCO2),oxygen saturation(SaO2)]and inflammatory factors(IL-10,IFN-γ)were observed before and after treatment,and the clinical efficacy and safety of the treatment regimens were evaluated.Results(1)In terms of efficacy:after 2 weeks of treatment,the total effective rate was 95.74%(45/47)in the observation group and 82.98%(39/47)in the control group.Intergroup comparison(by chi-square test)showed that the efficacy of the observation group was significantly superior to that of the control group(P＜0.05).(2)In terms of symptom disappearance time:compared with the control group,the disappearance time of atelectasis,fever,cough and pulmonary rales in the observation group was significantly shortened(P＜0.001).(3)In terms of TCM syndrome scores:after treatment,the TCM syndrome scores in both groups were decreased compared with those before treatment(P＜0.001),and the reduction degree in the observation group was significantly superior to that in the control group(P＜0.001).(4)In terms of blood gas analysis indexes:after treatment,the levels of PaO2 and SaO2 in both groups were increased compared with those before treatment(P＜0.05),while the PaCO2 level was decreased(P＜0.05).The increase degrees of PaO2 and SaO2 and the decrease degree of PaCO2 in the observation group were significantly superior to those in the control group(P＜0.05 or P＜0.01).(5)In terms of inflammatory factors:after treatment,the serum IL-10 level in both groups was increased compared with that before treatment(P＜0.05),while the serum IFN-γ level was decreased(P＜0.05).The increase degree of serum IL-10 and the decrease degree of serum IFN-γ in the observation group were significantly superior to those in the control group(P＜0.001).(6)In terms of safety:during treatment,the total incidence of adverse reactions was 14.89%(7/47)in the observation group and 10.64%(5/47)in the control group,with no statistically significant difference between the two groups(P＞0.05).Conclusion Qianjin Weijing Decoction combined with Dingchuan Decoction as adjuvant therapy for BAL in patients with severe pneumonia complicated with atelectasis of phlegm-heat obstructing the lung pattern can significantly relieve disease symptoms,promote the recovery of pulmonary lesions,reduce pulmonary inflammatory response,improve pulmonary function,and correct blood gas abnormalities,with favorable overall efficacy.