Article(id=1256183409030869614, tenantId=1146029695717560320, journalId=1255847919539208197, issueId=1256183358493679805, articleNumber=null, orderNo=null, doi=10.13193/j.issn.1673-7717.2025.12.042, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=null, receivedDateStr=null, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1777427063351, onlineDateStr=2026-04-29, pubDate=1765296000000, pubDateStr=2025-12-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1777427063351, onlineIssueDateStr=2026-04-29, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1777427063351, creator=13701087609, updateTime=1777427063351, updator=13701087609, issue=Issue{id=1256183358493679805, tenantId=1146029695717560320, journalId=1255847919539208197, year='2025', volume='43', issue='12', pageStart='1', pageEnd='258', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=1, specialIssue=null, createTime=1777427051344, creator=13701087609, updateTime=1777427760067, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1256186331126969089, tenantId=1146029695717560320, journalId=1255847919539208197, issueId=1256183358493679805, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1256186331126969090, tenantId=1146029695717560320, journalId=1255847919539208197, issueId=1256183358493679805, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=231, endPage=235, ext={EN=ArticleExt(id=1256183410687619709, articleId=1256183409030869614, tenantId=1146029695717560320, journalId=1255847919539208197, language=EN, title=Effect of Zijinlong Tablets(紫金龙片)Combined with Intravenous Immunoglobulin in Treatment of Lower Respiratory Tract Infection in The Elderly, columnId=1256183365644968140, journalTitle=Chinese Archives of Traditional Chinese Medicine, columnName=Platform of Provincial Project, runingTitle=null, highlight=null, articleAbstract=
Objective

To investigate the effect of Zijinlong Tablets(紫金龙片)combined with intravenous immunoglobulin in the treatment of lower respiratory tract infection in the elderly.

Methods

Totally 302 elderly patients with lower respiratory tract infections admitted to the hospital from March 2021 to March 2023 were selected and randomly grouped,each with 151 cases.Based on conventional treatment,the control group was given intravenous immunoglobulin,and the study group received Zijinlong Tablets combined with intravenous immunoglobulin.Then the clinicalefficacy,ratio of forced expiratory volume in the firstsecond to forced vital capacity(FEV1/FVC),peak expiratory flow(PEF),maximum voluntary ventilation(MVV),arterial partial pressure of oxygen(PaO2),arterial partial pressure of carbon dioxide(PaCO2),interleukin-6(IL-6),C-reactive protein(CRP),interleukin-1(IL-1),procalcitonin(PCT),immunoglobulin-(Ig)A,IgG,IgM and T-lymphocyte subsets(CD3+,CD4+,CD8+)were compared.

Results

The study group reported a higher overall efficacy rate than the control group(93.38% vs85.43%,P<0.05).An increase in PEF,MVV and FEV1/FVC were observed in all patients after treatment,and the increase was more notable in the study group than those in the controlgroup(P<0.05).An elevation in PaO2 and a decrease PaCO2 were detected in all patients,and both improvements were more remarkable in the study group than those in the control group(P<0.05).After treatment,the levels of IL-6,CRP,IL-1 and PCT showed a decrease in all patients,and the three parameters were all lower in the study group than those in the control group(P<0.05).The levels of IgA,IgG and IgM demonstrated an increase in all patients,and were all larger in the study group than those in the control group(P<0.05).An elevation in CD3+and CD4+and a decrease CD8+were found in all patients,and both improvements were more obvious in the study group than those in the control group(P<0.05).

Conclusion

The application of Zijinlong Tablets combined with intravenous immunoglobulin in the treatment of lower respiratory tract infection in the elderly can effectively improve the pulmonary function and arterial blood gas indexes,attenuate the cellular inflammatory response,ameliorate the body immune function and promote the recovery of the patients.

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目的

观察紫金龙片联合丙种球蛋白治疗老年下呼吸道感染的效果。

方法

选取2021年3月—2023年3月医院收治的302例老年下呼吸道感染患者,随机分为研究组和对照组各151例。两组患者均采用常规治疗,在此基础上,对照组给予丙种球蛋白静脉注射治疗,研究组采用紫金龙联合丙种球蛋白。对比临床疗效、第1秒用力呼气容积与用力肺活量的比值(forced expiratory volume in the first second/forced vital capacity,FEV1/FVC)、呼气峰流速(peak expiratory flow,PEF)、每分钟最大自主通气量(maximal voluntary ventilation,MVV)、动脉血氧分压(arterial partial pressure of oxygen,PaO2)、动脉血二氧化碳分压(partial pressure of arterial blood carbon dioxide,PaCO2)、白细胞介素-6(interleukin-6,IL-6)、C反应蛋白(C-reactive protein,CRP)、白细胞介素-1(interleukin-1,IL-1)、降钙元素(Procalcitonin,PCT)、免疫球蛋白A(immunoglobulin A,IgA)、免疫球蛋白G(immunoglobulin G,IgG)、免疫球蛋白M(immunoglobulin M,IgM)及T细胞亚群(CD3+、CD4+、CD8+)水平进行比较。

结果

研究组的总有效率93.38%高于对照组85.43%(P<0.05)。治疗后,两组PEF、MVV、FEV1/FVC上升,研究组高于对照组(P<0.05)。治疗后,两组PaO2上升,PaCO2下降,研究组改善程度优于对照组(P<0.05)。治疗后,两组IL-6、CRP、IL-1、PCT均下降,且研究组更低(P<0.05)。治疗后,两组IgA、IgG、IgM指标上升,研究组高于对照组(P<0.05)。治疗后,两组CD3+、CD4+水平上升,CD8+水平均下降,研究组改善程度优于对照组(P<0.05)。

结论

紫金龙联合丙种球蛋白治疗老年下呼吸道感染能提高临床疗效,改善肺功能及动脉血气指标,控制细胞炎症反应,提高机体免疫能力,促进患者病情康复。

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苗芳(1976-),女,山西太原人,主任医师,博士,研究方向:内分泌。E-mail:
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丘蕾(1976-),女,广东惠阳人,副主任医师,硕士,研究方向:呼吸系统疾病诊治。

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丘蕾(1976-),女,广东惠阳人,副主任医师,硕士,研究方向:呼吸系统疾病诊治。

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articleTitle=丙种球蛋白治疗儿童重症肺炎的临床疗效观察, refAbstract=null), Reference(id=1256183483240690132, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1256183409030869614, doi=null, pmid=null, pmcid=null, year=2018, volume=40, issue=10, pageStart=2117, pageEnd=2121, url=null, language=null, rfNumber=[34], rfOrder=33, authorNames=刘亭, 张煜彬, 陆定艳, journalName=中成药, refType=null, unstructuredReference=刘亭,张煜彬,陆定艳,. 紫金龙氯仿-甲醇组分对脂多糖诱导RAW264. 7细胞炎症的抑制作用[J]. 中成药201840(10):2117-2121., articleTitle=紫金龙氯仿-甲醇组分对脂多糖诱导RAW264. 7细胞炎症的抑制作用, refAbstract=null), Reference(id=1256183484083745240, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1256183409030869614, doi=null, pmid=null, pmcid=null, year=2023, volume=16, issue=25, pageStart=25, pageEnd=28, url=null, language=null, rfNumber=[35], rfOrder=34, authorNames=宁培, journalName=临床合理用药, refType=null, unstructuredReference=宁培. 人免疫丙种球蛋白联合抗生素治疗小儿重症肺炎疗效及对免疫功能的影响[J]. 临床合理用药202316(25):25-28., articleTitle=人免疫丙种球蛋白联合抗生素治疗小儿重症肺炎疗效及对免疫功能的影响, refAbstract=null), Reference(id=1256183485228790246, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1256183409030869614, doi=null, pmid=null, pmcid=null, year=2021, volume=37, issue=5, pageStart=177, pageEnd=181, url=null, language=null, rfNumber=[36], rfOrder=35, authorNames=李玲, 李希, 冯建安, journalName=中药药理与临床, refType=null, unstructuredReference=李玲,李希,冯建安,. 参黄金屏颗粒对肺脾气虚型反复呼吸道感染患儿的临床疗效及相关免疫指标的影响[J]. 中药药理与临床202137(5):177-181., articleTitle=参黄金屏颗粒对肺脾气虚型反复呼吸道感染患儿的临床疗效及相关免疫指标的影响, refAbstract=null), Reference(id=1256183485778244075, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1256183409030869614, doi=null, pmid=null, pmcid=null, year=2023, volume=37, issue=7, pageStart=18, pageEnd=21, url=null, language=null, rfNumber=[37], rfOrder=36, authorNames=王天娇, 王祺, journalName=实用中医内科杂志, refType=null, unstructuredReference=王天娇,王祺. 扶正祛邪法治疗老年社区获得性肺炎[J]. 实用中医内科杂志202337(7):18-21., articleTitle=扶正祛邪法治疗老年社区获得性肺炎, refAbstract=null), Reference(id=1256183486113788400, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1256183409030869614, doi=null, pmid=null, pmcid=null, year=2023, volume=43, issue=12, pageStart=2876, pageEnd=2879, url=null, language=null, rfNumber=[38], rfOrder=37, authorNames=章婵, 娄可, 饶文娇, journalName=中国老年学杂志, refType=null, unstructuredReference=章婵,娄可,饶文娇,. 高流量氧疗辅助丙种球蛋白治疗对老年重症肺炎患者免疫、炎症水平的影响[J]. 中国老年学杂志202343(12):2876-2879., articleTitle=高流量氧疗辅助丙种球蛋白治疗对老年重症肺炎患者免疫、炎症水平的影响, refAbstract=null), Reference(id=1256183487019758074, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1256183409030869614, doi=null, pmid=null, pmcid=null, year=2022, volume=35, issue=11, pageStart=118, pageEnd=120, url=null, language=null, rfNumber=[39], rfOrder=38, authorNames=姜亚男, 张明瑛, journalName=医学信息, refType=null, unstructuredReference=姜亚男,张明瑛. 丙种球蛋白治疗川崎病患儿的效果及对抗血小板聚集相关因子免疫功能的影响[J]. 医学信息202235(11):118-120., articleTitle=丙种球蛋白治疗川崎病患儿的效果及对抗血小板聚集相关因子免疫功能的影响, 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组别例数性别/(例)年龄/(岁)病程/(d)
研究组151787375.65±3.082.28±0.25
对照组151747775.31±2.912.32±0.33
t20.2120.9861.187
P0.6450.3250.236
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两组老年下呼吸道感染患者一般资料比较(

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组别例数性别/(例)年龄/(岁)病程/(d)
研究组151787375.65±3.082.28±0.25
对照组151747775.31±2.912.32±0.33
t20.2120.9861.187
P0.6450.3250.236
), ArticleFig(id=1256183440353932243, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1256183409030869614, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数痊愈显效有效无效总有效
研究组15180(52.98)48(31.79)13(8.61)10(6.62)141(93.38)
对照组15164(42.38)50(33.11)15(9.93)22(14.57)129(85.43)
χ25.033
P0.025
), ArticleFig(id=1256183440995660762, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1256183409030869614, language=CN, label=表2, caption=

两组老年下呼吸道感染患者临床疗效比较

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数痊愈显效有效无效总有效
研究组15180(52.98)48(31.79)13(8.61)10(6.62)141(93.38)
对照组15164(42.38)50(33.11)15(9.93)22(14.57)129(85.43)
χ25.033
P0.025
), ArticleFig(id=1256183442094568418, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1256183409030869614, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数PEF/(L/min)MVV/(L/min)FEV1/FVC/(%)
治疗前治疗后治疗前治疗后治疗前治疗后
研究组151286.49±35.68358.13±39.74a61.62±7.5487.44±8.70a54.39±7.0966.23±8.12a
对照组151287.10±34.27330.85±36.35a60.98±7.7378.28±8.89a54.02±7.1159.41±8.27a
χ20.1526.2240.7289.0490.4537.231
P0.8800.0000.4670.0000.6510.000
), ArticleFig(id=1256183442602079212, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1256183409030869614, language=CN, label=表3, caption=

两组老年下呼吸道感染患者肺功能比较(

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数PEF/(L/min)MVV/(L/min)FEV1/FVC/(%)
治疗前治疗后治疗前治疗后治疗前治疗后
研究组151286.49±35.68358.13±39.74a61.62±7.5487.44±8.70a54.39±7.0966.23±8.12a
对照组151287.10±34.27330.85±36.35a60.98±7.7378.28±8.89a54.02±7.1159.41±8.27a
χ20.1526.2240.7289.0490.4537.231
P0.8800.0000.4670.0000.6510.000
), ArticleFig(id=1256183443445134329, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1256183409030869614, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数PaO2PaCO2
治疗前治疗后治疗前治疗后
研究组15153.46±5.7788.93±8.54a55.23±6.6330.07±6.38a
对照组15153.18±6.0273.28±8.77a55.41±6.9043.75±6.84a
χ20.41315.7100.23117.972
P0.6800.0000.8170.000
), ArticleFig(id=1256183444283994124, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1256183409030869614, language=CN, label=表4, caption=

两组老年下呼吸道感染患者血气指标比较(

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数PaO2PaCO2
治疗前治疗后治疗前治疗后
研究组15153.46±5.7788.93±8.54a55.23±6.6330.07±6.38a
对照组15153.18±6.0273.28±8.77a55.41±6.9043.75±6.84a
χ20.41315.7100.23117.972
P0.6800.0000.8170.000
), ArticleFig(id=1256183445005414422, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1256183409030869614, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数IL-6/(pg/mL)CRP/(mg/L)IL-1/(pg/mL)PCT/(ng/mL)
治疗前治疗后治疗前治疗后治疗前治疗后治疗前治疗后
研究组15187.57±8.1235.28±3.06a26.36±7.4315.24±5.71a157.47±15.8650.38±5.25a2.53±0.971.71±0.74a
对照组15187.73±8.5946.67±4.41a26.01±7.5219.63±6.20a157.69±15.0764.47±6.81a2.58±0.932.06±0.88a
χ20.16626.0750.4076.4000.12420.1360.4573.741
P0.8680.0000.6840.0000.9020.0000.6480.000
), ArticleFig(id=1256183445525508130, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1256183409030869614, language=CN, label=表5, caption=

两组老年下呼吸道感染患者炎症因子比较(

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数IL-6/(pg/mL)CRP/(mg/L)IL-1/(pg/mL)PCT/(ng/mL)
治疗前治疗后治疗前治疗后治疗前治疗后治疗前治疗后
研究组15187.57±8.1235.28±3.06a26.36±7.4315.24±5.71a157.47±15.8650.38±5.25a2.53±0.971.71±0.74a
对照组15187.73±8.5946.67±4.41a26.01±7.5219.63±6.20a157.69±15.0764.47±6.81a2.58±0.932.06±0.88a
χ20.16626.0750.4076.4000.12420.1360.4573.741
P0.8680.0000.6840.0000.9020.0000.6480.000
), ArticleFig(id=1256183446372757548, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1256183409030869614, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数IgAIgGIgM
治疗前治疗后治疗前治疗后治疗前治疗后
研究组1511.37±0.292.48±0.39a7.34±0.9212.87±1.22a1.05±0.331.71±0.36a
对照组1511.39±0.232.07±0.28a7.36±1.089.37±1.14a1.07±0.271.46±0.32a
χ20.66410.4940.17325.7580.5766.378
P0.5070.0000.8630.0000.5650.000
), ArticleFig(id=1256183447173869625, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1256183409030869614, language=CN, label=表6, caption=

两组老年下呼吸道感染患者免疫球蛋白水平比较(

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数IgAIgGIgM
治疗前治疗后治疗前治疗后治疗前治疗后
研究组1511.37±0.292.48±0.39a7.34±0.9212.87±1.22a1.05±0.331.71±0.36a
对照组1511.39±0.232.07±0.28a7.36±1.089.37±1.14a1.07±0.271.46±0.32a
χ20.66410.4940.17325.7580.5766.378
P0.5070.0000.8630.0000.5650.000
), ArticleFig(id=1256183448339886145, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1256183409030869614, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数CD3+CD4+CD8+
治疗前治疗后治疗前治疗后治疗前治疗后
研究组15156.71±3.0867.33±5.14a32.04±3.2243.25±4.58a33.82±2.5722.03±1.52a
对照组15156.75±3.2662.91±3.55a32.11±3.2038.56±3.45a34.18±2.6128.26±3.18a
χ20.1108.6950.19010.0511.20821.720
P0.9130.0000.8500.0000.2280.000
), ArticleFig(id=1256183449656897612, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1256183409030869614, language=CN, label=表7, caption=

两组老年下呼吸道感染患者T细胞亚群水平比较(

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数CD3+CD4+CD8+
治疗前治疗后治疗前治疗后治疗前治疗后
研究组15156.71±3.0867.33±5.14a32.04±3.2243.25±4.58a33.82±2.5722.03±1.52a
对照组15156.75±3.2662.91±3.55a32.11±3.2038.56±3.45a34.18±2.6128.26±3.18a
χ20.1108.6950.19010.0511.20821.720
P0.9130.0000.8500.0000.2280.000
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紫金龙片联合丙种球蛋白治疗老年下呼吸道感染疗效观察
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丘蕾 , 苗芳
中华中医药学刊 | 省级项目平台 2025,43(12): 231-235
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中华中医药学刊 | 省级项目平台 2025, 43(12): 231-235
紫金龙片联合丙种球蛋白治疗老年下呼吸道感染疗效观察
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丘蕾, 苗芳
作者信息
  • 山西省人民医院,山西 太原 030012
  • 丘蕾(1976-),女,广东惠阳人,副主任医师,硕士,研究方向:呼吸系统疾病诊治。

通讯作者:

苗芳(1976-),女,山西太原人,主任医师,博士,研究方向:内分泌。E-mail:
Effect of Zijinlong Tablets(紫金龙片)Combined with Intravenous Immunoglobulin in Treatment of Lower Respiratory Tract Infection in The Elderly
Lei QIU, Fang MIAO
Affiliations
  • Respiratory Department of Shanxi Provincial People's Hospital,Taiyuan 030012,Shanxi,China
出版时间: 2025-12-10 doi: 10.13193/j.issn.1673-7717.2025.12.042
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目的

观察紫金龙片联合丙种球蛋白治疗老年下呼吸道感染的效果。

方法

选取2021年3月—2023年3月医院收治的302例老年下呼吸道感染患者,随机分为研究组和对照组各151例。两组患者均采用常规治疗,在此基础上,对照组给予丙种球蛋白静脉注射治疗,研究组采用紫金龙联合丙种球蛋白。对比临床疗效、第1秒用力呼气容积与用力肺活量的比值(forced expiratory volume in the first second/forced vital capacity,FEV1/FVC)、呼气峰流速(peak expiratory flow,PEF)、每分钟最大自主通气量(maximal voluntary ventilation,MVV)、动脉血氧分压(arterial partial pressure of oxygen,PaO2)、动脉血二氧化碳分压(partial pressure of arterial blood carbon dioxide,PaCO2)、白细胞介素-6(interleukin-6,IL-6)、C反应蛋白(C-reactive protein,CRP)、白细胞介素-1(interleukin-1,IL-1)、降钙元素(Procalcitonin,PCT)、免疫球蛋白A(immunoglobulin A,IgA)、免疫球蛋白G(immunoglobulin G,IgG)、免疫球蛋白M(immunoglobulin M,IgM)及T细胞亚群(CD3+、CD4+、CD8+)水平进行比较。

结果

研究组的总有效率93.38%高于对照组85.43%(P<0.05)。治疗后,两组PEF、MVV、FEV1/FVC上升,研究组高于对照组(P<0.05)。治疗后,两组PaO2上升,PaCO2下降,研究组改善程度优于对照组(P<0.05)。治疗后,两组IL-6、CRP、IL-1、PCT均下降,且研究组更低(P<0.05)。治疗后,两组IgA、IgG、IgM指标上升,研究组高于对照组(P<0.05)。治疗后,两组CD3+、CD4+水平上升,CD8+水平均下降,研究组改善程度优于对照组(P<0.05)。

结论

紫金龙联合丙种球蛋白治疗老年下呼吸道感染能提高临床疗效,改善肺功能及动脉血气指标,控制细胞炎症反应,提高机体免疫能力,促进患者病情康复。

下呼吸道感染  /  老年  /  紫金龙  /  丙种球蛋白  /  炎症
Objective

To investigate the effect of Zijinlong Tablets(紫金龙片)combined with intravenous immunoglobulin in the treatment of lower respiratory tract infection in the elderly.

Methods

Totally 302 elderly patients with lower respiratory tract infections admitted to the hospital from March 2021 to March 2023 were selected and randomly grouped,each with 151 cases.Based on conventional treatment,the control group was given intravenous immunoglobulin,and the study group received Zijinlong Tablets combined with intravenous immunoglobulin.Then the clinicalefficacy,ratio of forced expiratory volume in the firstsecond to forced vital capacity(FEV1/FVC),peak expiratory flow(PEF),maximum voluntary ventilation(MVV),arterial partial pressure of oxygen(PaO2),arterial partial pressure of carbon dioxide(PaCO2),interleukin-6(IL-6),C-reactive protein(CRP),interleukin-1(IL-1),procalcitonin(PCT),immunoglobulin-(Ig)A,IgG,IgM and T-lymphocyte subsets(CD3+,CD4+,CD8+)were compared.

Results

The study group reported a higher overall efficacy rate than the control group(93.38% vs85.43%,P<0.05).An increase in PEF,MVV and FEV1/FVC were observed in all patients after treatment,and the increase was more notable in the study group than those in the controlgroup(P<0.05).An elevation in PaO2 and a decrease PaCO2 were detected in all patients,and both improvements were more remarkable in the study group than those in the control group(P<0.05).After treatment,the levels of IL-6,CRP,IL-1 and PCT showed a decrease in all patients,and the three parameters were all lower in the study group than those in the control group(P<0.05).The levels of IgA,IgG and IgM demonstrated an increase in all patients,and were all larger in the study group than those in the control group(P<0.05).An elevation in CD3+and CD4+and a decrease CD8+were found in all patients,and both improvements were more obvious in the study group than those in the control group(P<0.05).

Conclusion

The application of Zijinlong Tablets combined with intravenous immunoglobulin in the treatment of lower respiratory tract infection in the elderly can effectively improve the pulmonary function and arterial blood gas indexes,attenuate the cellular inflammatory response,ameliorate the body immune function and promote the recovery of the patients.

lower respiratory tract infection  /  elderly  /  Zijinlong Tablets(紫金龙片)  /  immunoglobulin  /  inflammation
丘蕾, 苗芳. 紫金龙片联合丙种球蛋白治疗老年下呼吸道感染疗效观察. 中华中医药学刊, 2025 , 43 (12) : 231 -235 . DOI: 10.13193/j.issn.1673-7717.2025.12.042
Lei QIU, Fang MIAO. Effect of Zijinlong Tablets(紫金龙片)Combined with Intravenous Immunoglobulin in Treatment of Lower Respiratory Tract Infection in The Elderly[J]. Chinese Archives of Traditional Chinese Medicine, 2025 , 43 (12) : 231 -235 . DOI: 10.13193/j.issn.1673-7717.2025.12.042
下呼吸道感染主要以支气管、气管及肺部的感染为主,由多种病原微生物引起,是人类常见的感染性疾病之一[1-2]。飞沫传播是下呼吸道感染的主要形式,临床症状表现为发热、咳嗽及咯痰[3]。由于老年人生理机能的退化,免疫防御功能降低,老年人下呼吸道感染发病率较普通人更高[4]。若不及时诊治,易累及多个脏腑器官,导致病情发展迅速,常合并诸多并发症,如支气管扩张、缺氧性中毒性脑病、败血症等,对生命健康造成严重威胁[5]。临床上针对下呼吸道感染主要采用一般疗法和以抗病毒、抗菌为主的药物治疗,其中左氟沙星等抗生素为常用药[6]。但由于老年人器官功能的衰退,对抗生素治疗易敏感性不足,产生耐药性[7]。因此,探索针对老年人下呼吸道感染更高效的治疗方法是必需的。丙种球蛋白是一种含有人体所需多种抗体,存在于血液中的蛋白质,能使机体抵抗力得到提升,从而预防感染[8]。在治疗呼吸道相关疾病方面,丙种球蛋白疗效显著,可促进肺功能的康复,改善相关临床症状[9-10]。紫金龙为罂粟壳紫金龙属植物,现代药理学研究表明,其活性成分有消炎、抗菌、镇痛之功[11],但临床上使用紫金龙治疗呼吸道感染的研究较少。因此,本研究对紫金龙联合丙种球蛋白治疗老年下呼吸道感染的临床效果进行探讨。
选取2021年3月—2023年3月本院收治的302例老年下呼吸道感染患者。诊断标准:符合中华中医药学会内科分会[12]制定标准。纳入标准:(1)符合相关诊断标准,年龄60-85岁;(2)无其他免疫及血液系统疾病;(3)未合并严重脏器功能损害;(4)临床资料信息完整;(5)患者及家属对研究内容知情,自愿签署知情同意书。排除标准:(1)上呼吸道感染;(2)合并有先天性肺部疾病;(3)对治疗所使用的相关药物过敏;(4)心、肝、肾等重要器官功能障碍或器官严重衰竭;(5)凝血功能障碍;(6)存在精神障碍,自主意识不清晰,沟通异常。
将老年下呼吸道感染的患者以随机数法分为研究组和对照组各151例。两组一般资料比较差异无统计学意义(P>0.05)。见表1
两组患者入院后根据个人身体状况,均给予常规抗菌、抗炎、调节水电解质紊乱等治疗。对照组给予丙种球蛋白(上海莱士血液制品股份有限公司,S20013054)静脉注射,0.4 g/次,1次/d;研究组在此基础上加用紫金龙片(天津中新药业集团股份有限公司,Z20010064)进行口服,2片/次,2次/d。两组持续治疗7 d。
痊愈:临床症状基本消失;显效:临床症状改善明显;有效:临床症状有所好转;无效:临床症状无明显改善或加重。
采用湖南医翼健康科技有限公司提供的肺功能仪对两组患者治疗前后的第1秒用力呼气容积与用力肺活量的比值(forced expiratory volume in the first second/forced vital capacity,FEV1/FVC)、呼气峰流速(peak expiratory flow,PEF)及每分钟最大自主通气量(maximal voluntary ventilation,MVV)进行测定。
采用雷度米特(苏州)医疗科技有限公司提供的血气分析仪测定患者治疗前后的动脉血氧分压(arterial partial pressure of oxygen,PaO2)及动脉血二氧化碳分压(partial pressure of arterial blood carbon dioxide,PaCO2)。
采用酶联免疫吸附法(ELISA)检测患者治疗前后血清中白细胞介素-1(interleukin-1,IL-10)、C反应蛋白(C-reactive protein,CRP)、降钙元素(Procalcitonin,PCT)及白细胞介素-6(interleukin-6,IL-6),试剂盒由北京普恩光德生物科技开发有限公司提供。
检测患者治疗前后免疫球蛋白A(immunoglobulin A,IgA)、免疫球蛋白G(immunoglobulin G,IgG)、免疫球蛋白M(immunoglobulin M,IgM)水平,仪器为深圳市盛信康科技有限公司提供的全自动生化分析仪。
采用湖南唯公生物科技有限公司提供的流式细胞仪检测治疗前后患者的CD3+、CD4+、CD8+水平。
采用SPSS 20.0进行统计分析。计量资料以()表示,以t检验,计数资料以(%)表示,以χ2检验,记P<0.05为差异有统计学意义。
研究组的总有效率93.38%高于对照组85.43%(P<0.05)。见表2
治疗后,两组PEF、MVV、FEV1/FVC上升,研究组高于对照组(P<0.05)。见表3
治疗后,两组PaO2上升,PaCO2下降,研究组改善程度优于对照组(P<0.05)。见表4
治疗后,两组IL-6、CRP、IL-1、PCT下降,研究组更低(P<0.05)。见表5
治疗后,两组IgA、IgG、IgM指标均上升,研究组高于对照组(P<0.05)。见表6
治疗后,两组CD3+、CD4+水平均上升,CD8+水平均下降,且研究组改善程度优于对照组(P<0.05)。见表7
随着年龄的增长,老年人机体功能发生退化,自身免疫防御功能降低,导致呼吸道黏膜发生萎缩,分泌及咽喉的防御功能下降,与常人相比,更易受到病毒的侵袭,发生呼吸道相关疾病[13-15]。受上述因素影响,老年人在发生下呼吸道感染后,下呼吸道内的分泌物发生潴留,黏稠度高,难以排出,治疗难度更大[16-17]。若不及时对老年人下呼吸道感染进行诊治,容易造成肺功能损伤,引发呼吸衰竭等多种并发症[18]。针对下呼吸道感染,临床上多采用抗病毒、抗炎药物进行治疗,如左氧氟沙星、青霉素等;但由于老年人的生理特性,常规治疗起效更慢,需要花费的时间更长,易反复发作,且由于抗生素滥用导致耐药性增加[19-20]。中西医结合可能是提升患者治疗效果的有效方式。老年下呼吸道感染属于中医“感冒”“咳嗽”“虚证”等范畴,病机为卫外功能薄弱、营卫失和、肺脾肾三脏不足、外感六淫之邪等,可通过扶正补虚、温阳化气、解热散表、宣肺化痰等方法治疗。黄芪补肺固表、白术补气健脾、桂枝发汗解肌、太子参止咳平喘,被广泛用于下呼吸道感染治疗,但对感冒风寒引起的头疼、身痛及肺部炎症作用不明。因此,对于老年下呼吸道感染患者改善肺功能、抑制炎症、调节免疫的药物治疗方案需要进一步探索。
丙种球蛋白是一种免疫调节剂,具有多种免疫活性,可以调节免疫失调,抑制炎症反应,提高机体的抗感染能力,在治疗呼吸道及肺部相关疾病上疗效较好[21-22]。紫金龙为罂粟壳植物紫金龙的根,味辛、苦,性凉,有毒,归肝、肾、胃经,能够镇静止痛、消炎止血[23-24]。现代研究表明,紫金龙具有多种生物活性,其中对心血管和平滑肌作用明显[25]。但临床上使用紫金龙治疗肺部疾病的研究较少,因此本研究以相关文献为理论基础,对紫金龙联合丙种球蛋白治疗老年下呼吸道感染的效果进行观察与探讨。
本研究结果显示,与对照组相比,研究组的总有效率更高,PEF、MVV、FEV1/FVC水平较高,提示紫金龙联合丙种球蛋白治疗可以提高临床疗效,改善患者肺功能。其原因为:丙种球蛋白的主要成分为IgG,通过静脉注射进入体内可以提高患者血清中抗体水平,中和病理性抗体;此外,丙种球蛋白在体内还能够调节因感染造成的免疫缺陷,增强免疫细胞功能,抑制补体介导造成的免疫损害,减少病原体的侵袭,从而使机体抵抗力增强,肺功能得到提升,患者临床症状缓解[26-27]。现代药理研究学表明,从紫金龙中提取出的活性成分普罗托品可以松弛平滑肌,从而增强肺部的纤毛运动,溶解黏液,促进患者分泌物的排出[28]。PaO2是动脉血浆中物理溶解的氧分子所产生的分压,PaCO2指标代表血浆中溶解的二氧化碳量,可以对呼吸系统的酸碱平衡状态进行显示,同时能反映肺泡通气的效率[29]。通过对PaO2与PaCO2指标的监控,可以了解患者的通气状态,判断预后情况。治疗后,两组PaO2均上升,PaCO2均下降,且研究组改善程度优于对照组,表明联合治疗能通过促进肺功能的恢复,使患者体内缺氧状态得到改善,患者氧合作用得到加强,从而促进动脉血气指标得到改善[30]
在下呼吸道感染的发病过程中,炎症因子水平也随着病情发生变化。IL-1、IL-6均为常见促炎因子,在免疫应答中发挥着重要作用,可以促进炎症反应和抗体的产生;CRP是人体受到炎症刺激或感染后生成的一种蛋白质,是发生下呼吸道感染的重要标志物之一[31]。PCT为降钙素的无激素前肽,当机体处于异常状态时,释放的PCT会明显增加,因此PCT可对全身炎症的活跃程度进行反映[32]。通过对IL-6、CRP、IL-1及PCT的水平高低检测,可了解肺部炎症程度。本研究结果中,两组IL-6、CRP、IL-1、PCT均下降,且研究组较对照组下降更多,表明联合治疗与单纯静脉注射丙种球蛋白相比,能够进一步使患者的免疫功能得到改善,从而使机体的免疫环境得到平衡,肺部炎症反应减轻。其原因为:丙种球蛋白能够对患者机体的免疫功能进行调节,通过对巨噬细胞及单核巨噬细胞相应活性与能力的增强,减少炎症因子的释放,从而控制机体炎症反应[33]。同时,现代药理学研究表明,从紫金龙中提取出的活性成分氯仿-甲醇组分也具有抗炎的功效,通过降低促炎细胞因子水平,抑制细胞炎症[34]
血清中免疫球蛋白以IgA、IgG、IgM最为常见,其指标可以对人体的体液免疫功能进行评估。当人体受到病毒或细菌感染,免疫系统产生大量免疫球蛋白,与病原体或异物相结合,形成免疫复合物,参与对抗病原菌和病毒的过程[35]。T淋巴细胞具有细胞免疫功能,发育成熟后,可以通过淋巴或血液循环到达全身免疫器官,从而发挥免疫作用。在T淋巴细胞分类中,CD3+、CD4+、CD8+为重要免疫细胞,与患者病情发展密切相关,可对机体细胞的免疫功能进行反映[36]。本研究中,研究组在治疗后免疫球蛋白IgA、IgM、IgG水平及T淋巴细胞CD3+及CD4+水平均上升,T淋巴细胞CD8+水平下降,且改善优于对照组,提示紫金龙联合丙种球蛋白治疗可能提高老年人的免疫功能。其原因为:丙种球蛋白可以通过促进免疫球蛋白的分泌,使机体的体液免疫功能进一步得到增强,从而病原体的清除率提升,消灭病原体所用时间更短,病情能够得到更好控制[37-38]。同时丙种球蛋白可对免疫细胞数目进行负反馈,调节其恢复正常水平,使患者机体免疫系统恢复平衡[39]。紫金龙在治疗肿瘤方面有较好疗效,其片剂可以抑制肿瘤的转移与复发,因此紫金龙联合丙种球蛋白在提高免疫力方面可能有协同作用[40]。然而紫金龙的药理机制尚未明确,临床不良反应未知,研究不足之处需进一步探讨。
综上所述,紫金龙联合丙种球蛋白治疗老年下呼吸道感染能提高临床疗效,改善肺功能及动脉血气指标,控制细胞炎症反应,提高机体免疫能力,促进患者病情康复。
  • 山西省应用基础研究计划项目(1901D111434)
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doi: 10.13193/j.issn.1673-7717.2025.12.042
  • 首发时间:2026-04-29
  • 出版时间:2025-12-10
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山西省应用基础研究计划项目(1901D111434)
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    山西省人民医院,山西 太原 030012

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苗芳(1976-),女,山西太原人,主任医师,博士,研究方向:内分泌。E-mail:
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2种不同金属材料的力学参数

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种数
Number of
species
占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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