世界中医药

目的：探讨痰热清用于治疗胸外科术后患者的临床疗效，及其对血清TNF-α、IL-6、IL-8等炎性细胞因子的影响。方法：选择本院胸外科2014年2月至2015年12月诊治的90例胸外科术后（肺癌术后48例，食管癌术后42例）的患者作为研究对象，采用随机数字表法随机分为2组，每组各45例。对照组给予西医常规的抗感染方案行抗感染治疗。观察组则在对照组的基础上加用痰热清注射液治疗，于术后即给予痰热清20 mL静脉滴注治疗，连续治疗7 d。观察2组的临床疗效。同时采用ELISA方法检测2组患者血清中治疗前及治疗后TNF-α、IL-6、IL-8含量的变化。结果：经治疗后，观察组的临床疗效优于对照组，差异有统计学意义（P<0.05）；2组患者治疗后白细胞、中性粒细胞的含量均有所下降，差异均具有统计学意义（P<0.05）；白细胞、中性粒细胞下降明显低于对照组，差异均具有统计学意义（P<0.05）；观察组气道分泌物有效清除率、肺部感染发生率等优于对照组，差异均具有统计学意义（P<0.05）；2组患者血清中治疗后TNF-α、IL-6、IL-8的含量均有所下降，差异均具有统计学意义（P<0.05）；而观察组的下降程度较对照组更为明显，差异均具有统计学意义（P<0.05）。结论：胸外科术后即使用痰热清注射液联合抗生素抗感染治疗更能有效地改善胸外科术后患者的临床症状，并能降低其血清中TNF-α、IL-6、IL-8等炎性细胞因子的含量，说明痰热清注射液发挥抑制机体炎性反应，改善临床症状，可能与之通过抑制组织中TNF-α、IL-6、IL-8等炎性反应因子的生成或释放进入血清，降低血清中炎性细胞因子的含量有关，但其具体机制仍需后期进一步深入探讨。

English Summary:

To evaluate the clinical efficacy of Tanreqing in the treatment of thoracic surgery patients, and its effect on serum TNF-α, IL-6, IL-8 and other inflammatory cytokines. Methods:Ninety patients who had thoracic surgery in the hospital from February 2014 to December 2015 (postoperative lung cancer, 48 cases of esophageal cancer after 42 cases) were selected as research objects and randomly divided into two groups, with 45 cases in each group. The control group received conventional anti-infective western medicine treatment, while the observation group additionally took 20 mL Tanreqing injection treatment by intravenous injection, immediately after the surgery and treated for 7 days. The clinical efficacy of the two groups was observed. Changes in serum TNF-α, IL-6, IL-8 content before and after the treatment were tested by ELISA in the two groups. Results:After treatment, clinical efficacy of the observation group was much better than that of the control group and the difference was statistically significant (P<0.05). Contents of WBC and neutrophil declined in both the two groups, showing statistically significant differences (P<0.05). Leukocytes and neutrophils decreased more significant in the observation group, indicated that the difference was statistically significant (P<0.05). The effective clearance of airway secretions and pulmonary infection rate of the observation group were superior to those of the control group, with statistically significant differences (P<0.05). TNF-α, IL-6, IL-8 levels in serum were decreased after the treatment in both groups, showing that the differences were statistically significant (P<0.05). The declination in the observation group was more remarkable, with statistically significant differences (P<0.05). Conclusion:Tanreqing combined with anti-infective therapy immediately for patients who just had thoracic surgery is likely to be more effective in improving the clinical symptoms and may reduce the content of inflammatory cytokines, including TNF-α, IL-6, IL-8, etc. This indicated that Tanreqing may have the effect of suppressing body’s inflammatory response and improving clinical symptoms, which may be related to the inhibition to generation or release of inflammatory factors, such as TNF-α, IL-6, IL-8 and even entering serum, as well as the reduction of inflammatory cytokines serum levels. Its exact mechanism still needs to be further discussed.

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