Abstract: Objective　To study the clinical application effect of Qilianhua Jiedu pill combined with traditional Chinese medicine ointment in the treatment of pneumonia. Methods　A total of 126 pneumonia patients admitted to Jiamusi Hospital of Traditional Chinese Medicine from September 2019 to September 2021 were selected as the treatment objects. The patients were numbered according to the order of admission and were randomly divided into an observation group and a control group, with 63 cases in each group. In the control group, there were 31 males and 32 females, aged (48.39±10.18) years; in the observation group, there were 36 males and 27 females, aged (46.96±10.22) years. The control group was treated with traditional Chinese medicine ointment, and the observation group was treated with Qilianhua Jiedu pill and traditional Chinese medicine ointment. The clinical efficacy, symptom subsidence time, inflammatory factors levels, immune function indexes levels, and treatment safety were evaluated and compared between the two groups. t test was used for the measurement data and χ² test was used for the count data. Results　The total effective rate of the observation group was 92.06% (58/63), which was higher than that of the control group [77.78% (49/63)], with a statistically significant difference (χ²=5.020, P=0.025). After treatment, the subsidence time of fever, cough, soreness, and pulmonary rales in the observation group were (2.09±0.56) d, (3.27±0.90) d, (4.18±0.90) d, and (5.38±1.16) d, respectively, which were shorter than those in the control group [(2.86±0.79) d, (4.15±0.94) d, (5.47±0.98) d, and (6.29±1.32) d], with statistically significant differences (all P<0.05). Before treatment, there were no statistically significant differences in the levels of inflammatory factors and T lymphocyte subsets between the two groups (all P>0.05). After treatment, the levels of C-reactive protein (CRP), interleukin (IL)-6, and tumor necrosis factor (TNF)-α in the observation group were (12.41±3.02) mg/L, (39.32±4.94) ng/L, and (53.99±5.87) ng/L, respectively, which were lower than those in the control group [(15.42±4.10) mg/L, (43.76±5.31) ng/L, and (58.45±6.84) ng/L], with statistically significant differences (all P<0.05). After treatment, the levels of CD3⁺, CD4⁺, and CD4⁺/CD8⁺ in the observation group were (53.98±5.83)%, (54.87±5.61)%, and (1.94±0.35), respectively, which were higher than those in the control group [(48.76±5.47)%, (50.19±5.35)%, and (1.67±0.32)], and the level of CD8⁺ was (28.15±3.04)%, which was lower than that in the control group [(30.87±3.09)%], with statistically significant differences (all P<0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups (χ²=0.321, P=0.571). Conclusion　Qilianhua Jiedu pill combined with traditional Chinese medicine ointment has a significant curative effect in the treatment of pneumonia, which can inhibit the expressions of inflammatory factors in the body and improve the patients' immunity, with mild adverse reactions.

Key words: Pneumonia, Application of traditional Chinese medicine ointment, Qilianhua Jiedu pill, Clinical efficacy, Inflammatory factors, Immunity

摘要： 目的　研究探讨芪莲花解毒丸联合中药膏敷贴治疗肺炎的临床应用效果。方法　选取2019年9月至2021年9月佳木斯市中医院收治的126例肺炎患者为治疗对象，按患者入院顺序进行编号并作为分组依据，随机分为观察组和对照组，各63例。对照组男31例、女32例，年龄（48.39±10.18）岁，以中药膏敷贴治疗；观察组男36例、女27例，年龄（46.96±10.22）岁，以芪莲花解毒丸联合中药膏敷贴治疗。评估比较两组患者的临床疗效、症状消退时间、炎症因子水平、免疫功能指标水平、治疗安全性。计量资料采用t检验，计数资料采用χ²检验。结果　观察组总有效率为92.06%（58/63），高于对照组77.78%（49/63），差异有统计学意义（χ²=5.020，P=0.025）。治疗后观察组发热、咳嗽、酸痛、肺部湿啰音消退时间分别为（2.09±0.56）d、（3.27±0.90）d、（4.18±0.90）d、（5.38±1.16）d，均短于对照组的（2.86±0.79）d、（4.15±0.94）d、（5.47±0.98）d、（6.29±1.32）d，差异均有统计学意义（均P<0.05）。治疗前，两组肺炎患者炎症因子水平、T淋巴细胞亚群水平比较，差异均无统计学意义（均P>0.05）。治疗后，观察组C反应蛋白（CRP）、白细胞介素（IL）-6、肿瘤坏死因子（TNF）-α水平分别为（12.41±3.02）mg/L、（39.32±4.94）ng/L、（53.99±5.87）ng/L，均低于对照组的（15.42±4.10）mg/L、（43.76±5.31）ng/L、（58.45±6.84）ng/L，差异均有统计学意义（均P<0.05）。治疗后，观察组CD3⁺、CD4⁺、CD4⁺/CD8⁺分别为（53.98±5.83）%、（54.87±5.61）%、（1.94±0.35），均高于对照组的（48.76±5.47）%、（50.19±5.35）%、（1.67±0.32），而CD8⁺为（28.15±3.04）%，低于对照组（30.87±3.09）%，差异均有统计学意义（均P<0.05）。两组肺炎患者不良反应发生率比较，差异无统计学意义（χ²=0.321，P=0.571）。结论　芪莲花解毒丸联合中药膏敷贴治疗肺炎的疗效显著，抑制机体炎症因子表达，改善患者免疫力，不良反应较轻。

关键词: 肺炎, 中药膏敷贴, 芪莲花解毒丸, 临床疗效, 炎症因子, 免疫功能