Clinical study of ambroxol hydrochloride combined with Xuebijing injection for treatment of elderly patients with severe pneumonia / 中国中西医结合急救杂志

ABSTRACT

Objective To investigate the therapeutic effect of ambroxol hydrochloride combined with Xuebijing injection for treatment of elderly patients with severe pneumonia. Methods A total of 60 patients with severe pneumonia admitted to the Third Affiliated Hospital of Soochow University from January 2015 to December 2016 were enrolled, and they were divided into an observation group and a control group by random number table method, 30 cases in each group. Both groups were given routine treatment of antibiotics, nutritional support, oxygen aspiration, spasmolysis and phlegm reduction therapies. etc. On the basic conventional treatment, the patients of the control group were treated with 300 mg ambroxol hydrochloride added into 100 mL normal saline for intravenous (IV) drip, twice a day; on the basis of treatment of control group, the patients in the observation group additionally were treated with 50 mL Xuebijing injection added into 100 mL normal saline for IV drip, twice a day. After treatment for 14 days, the curative effect was observed. Before and after treatment, the changes of immune function, inflammatory factors, respiratory mechanics, blood gas indexes and clinical efficacy were observed in the two groups. Results Compared with those before treatment, levels of the CD3+, CD4+ and CD4+/CD8+, arterial oxygen satuation (SaO2), arterial partial pressure of oxygen (PaO2) and oxygenation index (PaO2/FiO2) in the two groups after treatment were significantly increased, while CD8+, interleukin-6 (IL-6), C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), airway platform pressure (Pplat), peak inspiratory pressure (PIP), mean airway pressure (mPaw) and airway resistance (Raw) and arterial partial pressure of carbon dioxide (PaCO2) were decreased significantly after treatment in the two groups (all P < 0.05), the levels of immune indexes CD3+, CD4+, CD4+/CD8+, SaO2, PaO2 and PaO2/FiO2 after treatment in the observation group were significantly higher than those in the control group [CD3+ 0.69±0.05 vs. 0.60±0.04, CD4+ 0.40±0.04 vs. 0.35±0.03, CD4+/CD8+ 1.84±1.10 vs. 1.41±0.79, SaO2 0.96±0.04 vs. 0.91±0.05, PaO2 (mmHg, 1 mmHg =0.133 kPa) 97.71±10.03 vs. 74.68±8.14, PaO2/FiO2 (mmHg) 361.87±20.01 vs. 258.95±17.54, all P < 0.05], meanwhile the CD8+, IL-6, CRP, TNF-α, Pplat, PIP, mPaw, Raw and PaCO2 were significantly lower than those of the control group [CD8+ 0.23±0.03 vs. 0.30±0.05, IL-6 (pg/L) 97.48±8.14 vs. 144.51±12.67, CRP (mg/L) 31.26±4.85 vs. 68.97±7.02, TNF-α (mg/L) 16.07±1.80 vs. 21.85±2.64, Pplat (cmH2O, 1 cmH2O = 0.098 kPa) 12.23±1.57 vs. 15.97±1.91, PIP (cmH2O) 23.26±3.07 vs. 28.09±3.10, mPaw (cmH2O) 8.54±0.54 vs. 9.39±1.30, Raw (cmH2O·L-1·s-1) 6.74±1.12 vs. 9.29±1.55, PaCO2 (mmHg) 36.44±4.13 vs. 47.07±5.35, all P < 0.05]. After treatment, the effective rate of the observation group was significantly higher than that of the control group [90.00% (27/30) vs. 63.33% (19/30), P < 0.05]. Conclusions Using ambroxol hydrochloride combined with Xuebijing injection for treatment of elderly patients with severe pneumonia can promote their immune function, reduce the inflammatory factors, improve respiratory mechanics and blood gas index levels, thus the combined therapy can elevate the clinical therapeutic effect for treatment of senile severe pneumonia.