| As the development of the society, ageing of the population becomes increasingly severe and diseases in the elderly should be thought highly of. Pneumonia is one of the main causes which lead to death of the older. The incidence rate of pneumonia in the elderly is much higher than that of young adults. So, the diagnosis and treatment of pneumonia in the elderly has become a tough problem in our work.The essay reviewed the diagnosis and treatment development of Chinese medicine of pneumonia in the elderly. On the basis of summarizing my tutor's experience on pneumonia in the elderly, the assay pioints out that the six exogenous factors are the etiological factors of pneumonia in the elderly while the healthy qi deficiency is the fundamental cause of it. Deficiency of both qi and yin remains all along the course of it. Phlegm and stasis of blood is not only the pathological product of the disease but also the important etiological factor. So, supplementing qi and nourishing yin and clearing lung and eliminating phlegm should be the main principle of treatment of pneumonia in the elderly.In clinical observation, in order to investigate the therapeutic effect of Radix Astragali and Flos Lonicerae composition on pneumonia in the elderly and to establish the principle of treatment of supplementing qi and nourishing yin and clearing lung and eliminating phlegm, 61 qualified patients was enrolled according to the diagnostic criteria of both Chinese medicine and western medicine. They were randomly divided into two groups, i.e. the treatment group and control group. Clinical Observation Scale of Pneumonia in the Elderly and Syndrome Scale of Pneumonia in the Elderly were established and symptoms, signs and laboratory examinations were recorded in detail. In addition, serum levels of IL-2,IL-6,TNF-αwere detected before and after treatment. The study shows that there is no significant difference between two groups in therapeutic effect of the disease(P>0.05). But in therapeutic effect of syndrome, the treatment group is superior than the control group (P<0.05). As for symptoms alleviation, the therapeutic effect of the treatment group is much better than the control group on cough, stethocatharsis , thirst, shortness of breath, lassitude (P<0.05). But there seems no difference between the two groups when panting and chest distress are reffered(P>0.05). The serum level of CRP,IL-2,IL-6,TNF-αdecrease significantly after treatment in both groups(P<0.001) and there is significant difference between the two groups in difference of CRP and IL-6 (P<0.05).In the experiment part, the technique of serum pharmacology was adopted to investigate the bacteriostasis effect of Radix Astragali and Flos Lonicerae composition in vitro. It demonstrates that the composition can inhibit the growth of some bacteria in vitro. However, its effect is weaker than that of ceftazidime, especially on Gram-negative bacteria. As for Staphylococcus epidermidis, the composition is superior to ceftazidime. Comparing with the other three groups, Radix Astragali and Flos Lonicerae composition combining with ceftazidime shows the strongest effect on these bacteria. It indicates that although the effect of Chinese herbs alone on bacteria is quite weak, it can strengthen the effect of antibiotics on bacteira.In a word, the mehod of supplementing qi and nourishing yin and clearing lung and eliminating phlegm is one of the main principles of treatment of pneumonia in the elderly. Radix Astragali and Flos Lonicerae composition can inhibit the growth of some bacteria in vitro and has some advantages in improving symdorme, alleviating symptoms, decreasing serum levels of mediators of inflammation. |
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