Clinical Observation On Qingjin Lichang Decoction In Treating Pneumonia (phlegm-heat Obstructing The Lungs) In Patients With Severe Craniocerebral Injur

Objective: The self-made Qingjin Lichang Decoction was used to treat patients with severe traumatic brain injury(s TBI)complicated with pneumonia of phlegm-heat obstructing lung syndrome.The effects of Qingjin Lichang decoction on serum interleukin-6(IL-6),C-reactive protein(CRP),procalcitonin(PCT),white blood cell(WBC)and other inflammatory indexes and related clinical scoring indexes were observed to explore whether it was beneficial to control inflammatory response,improve clinical symptoms and promote the recovery of patients ’ consciousness,and to evaluate the clinical efficacy and safety of the prescription.To provide reference and basis for the clinical application of Qingjin Lichang Decoction combined with western medicine in the treatment of s TBI patients with pneumonia phlegm-heat obstructing lung syndrome.Methods: A prospective randomized controlled clinical study was conducted.From June 2021 to December 2022,86 patients with s TBI complicated with pneumonia of phlegm-heat obstructing lung syndrome were included in the Department of Neurosurgery and Neurological Intensive Care Unit(NICU)of Changsha Hospital of Traditional Chinese Medicine(Changsha Eighth Hospital)in Hunan Province.All patients were divided into observation group and control group by random number table method,43 cases in each group.The control group was treated with conventional western medicine,and the observation group was treated with Qingjin Lichang decoction on the basis of the control group.The patient ’s name,gender,age,long-term smoking history,hypertension,diabetes,coronary heart disease,previous history of lung disease,chest trauma and cerebral hernia,surgery and early mechanical ventilation,and brain injury were recorded.The Glasgow Coma Scale(GCS)scores of the two groups before treatment,7 days,14 days and 21 days after treatment,and the TCM syndrome scores before treatment,14 days and 21 days after treatment were compared.The levels of serum IL-6,CRP,PCT,WBC and Clinical Pulmonary Infection Score(CPIS)were measured before treatment,7 days and 14 days after treatment.The efficacy of TCM syndromes and western medicine in the two groups was evaluated.SPSS26.0 statistical software was used for data analysis to compare the difference between the two groups.Results:(1)Baseline data : Three subjects were lost in each group,and 40 cases were finally completed.There was no significant difference in gender distribution,age,long-term smoking history,hypertension,diabetes,coronary heart disease,past history of lung disease,chest trauma and cerebral hernia,surgery and early mechanical ventilation,and location of craniocerebral injury between the two groups(P>0.05).(2)Observation indexes before treatment : GCS score,TCM syndrome score,modified CPIS score,IL-6,WBC,CRP and PCT were compared between the two groups before treatment,P > 0.05,and there was no significant difference in each index before treatment.(3)GCS score : The GCS scores of the two groups after 7 days,14 days and 21 days of treatment were significantly higher than those before treatment(P < 0.05),while the GCS scores after 14 days and 21 days of treatment were significantly higher in the observation group than in the control group(P<0.05).(4)TCM syndrome score : the scores of the two groups after 14 days and 21 days of treatment were lower than those before treatment(P < 0.05);the scores of the observation group after 14 days and 21 days of treatment were significantly lower than those of the control group(P<0.05).(5)Modified CPIS score : The scores of the two groups after 7 days and 14 days of treatment were lower than those before treatment(P < 0.05);the scores of the observation group were lower than those of the control group after 7 days and 14 days of treatment(P<0.05).(6)IL-6 : The levels of IL-6 in the two groups after 7 days and 14 days of treatment were lower than those before treatment(P<0.05),and the levels of IL-6 in the observation group were significantly lower after 14 days of treatment.(7)WBC,CRP and PCT : The levels of WBC,CRP and PCT in the two groups after 7 days and 14 days of treatment were lower than those before treatment(P <0.05);after 7 days and 14 days of treatment,the levels of the three indicators in the observation group were significantly lower than those in the control group(P<0.05).(8)Efficacy of TCM syndromes : The total effective rate of the observation group was 95.0%,and that of the control group was 80.0%.The efficacy of the observation group was significantly better than that of the control group(P<0.05).(9)Evaluation of western medicine efficacy : The total effective rate of the observation group was 95.00%,and that of the control group was 77.50 %.The curative effect of the observation group was significantly better than that of the control group(P<0.05).Conclusion:(1)Qingjin Lichang Decoction combined with western medicine comprehensive treatment is beneficial to promote the recovery of consciousness of patients with s TBI complicated with pneumonia phlegm-heat obstructing lung syndrome,improve the clinical symptoms,signs and prognosis of patients,and improve the clinical efficacy;(2)Qingjin Lichang Decoction combined with western medicine can effectively reduce the levels of inflammation-related indicators(IL-6,WBC,CRP and PCT)and control the inflammatory response in patients with s TBI complicated with pneumonia of phlegm-heat obstructing lung syndrome.(3)No adverse reactions occurred during the study period in patients treated with Qingjin Lichang Decoction.This prescription has good safety,and its application value can be further evaluated in the later period for clinical promotion.