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1.辽宁中医药大学,沈阳 110847
2.大连市中医医院,辽宁 大连 116013
3.辽宁中医药大学 附属医院,沈阳 110032
刘浩,博士,主治医师,从事呼吸危重症工作,Tel:0411-82681738,E-mail:hua_yu430@163.com
* 曲妮妮,博士,主任医师,从事呼吸病学工作,Tel:024-31961603,E-mail:21653160@qq.com
收稿日期:2021-03-26,
网络出版日期:2021-10-27,
纸质出版日期:2021-12-20
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刘浩,曲妮妮.痰热清注射液联合西药治疗老年多重耐药菌肺炎患者的临床疗效[J].中国实验方剂学杂志,2021,27(24):125-130.
LIU Hao,QU Ni-ni.Clinical Efficacy of Tanreqing Injection Combined with Western Medicine in Treatment of Pneumonia Caused by Multi-drug Resistant Bacteria in Elderly Patients[J].Chinese Journal of Experimental Traditional Medical Formulae,2021,27(24):125-130.
刘浩,曲妮妮.痰热清注射液联合西药治疗老年多重耐药菌肺炎患者的临床疗效[J].中国实验方剂学杂志,2021,27(24):125-130. DOI: 10.13422/j.cnki.syfjx.20212495.
LIU Hao,QU Ni-ni.Clinical Efficacy of Tanreqing Injection Combined with Western Medicine in Treatment of Pneumonia Caused by Multi-drug Resistant Bacteria in Elderly Patients[J].Chinese Journal of Experimental Traditional Medical Formulae,2021,27(24):125-130. DOI: 10.13422/j.cnki.syfjx.20212495.
目的
2
观察痰热清注射液联合西药对老年多重耐药菌肺炎患者的临床疗效。
方法
2
将2018年12月至2020年12月就诊于大连市中医医院重症病房的140例属痰热壅肺型老年多重耐药菌肺炎患者通过随机数字表法分为观察组(70例)和对照组(70例),对照组予常规西药治疗,观察组予常规西药联合痰热清注射液治疗,疗程均为7 d。记录两组患者治疗前后中医证候临床总疗效、中医证候总积分、临床肺部感染评分(CPIS)和耐药菌清除率等主要疗效指标,体温恢复及咳嗽缓解时间,降钙素原(PCT),C反应蛋白(CRP),白细胞计数(WBC),白细胞介素-6(IL-6),白细胞介素-8(IL-8)和氧分压(PO
2
)等次要疗效指标。
结果
2
观察组和对照组的中医疗效总有效率分别为90.00%(63/70)和75.70%(53/70),观察组疗效更佳(
Z
=-2.147,
P
<
0.05)。与本组治疗前比较,两组治疗后CPIS及中医证候总积分均显著下降(
P
<
0.01);且观察组下降更显著(
P
<
0.01)。观察组耐药菌清除率为67.1%(47/70),明显优于对照组的48.6%(34/70),差异有统计学意义(
χ
2
=4.951,
P
<
0.05)。观察组咳嗽、发热缓解时间均低于对照组(
P
<
0.01)。与本组治疗前比较,两组治疗后PCT,CRP,WBC,IL-6及IL-8水平均显著下降,PO
2
水平显著上升(
P
<
0.01);且观察组各项炎症指标和PO
2
水平改善均显著优于对照组(
P
<
0.01)。
结论
2
痰热清注射液联合西药治疗老年多重耐药菌肺炎患者临床疗效显著,可显著控制感染,减轻炎症损伤,改善耐药菌清除率,提高患者氧合,缓解临床症状,值得临床推广应用。
Objective
2
To observe the clinical effect of Tanreqing injection combined with western medicine on pneumonia caused by multi-drug resistant bacteria (MDRB) in elderly patients.
Method
2
A total of 140 MDRB-induced pneumonia inpatients with the syndrome of phlegm-heat obstructing lung in the intensive care unit (ICU) of Dalian Hospital of Traditional Chinese Medicine from December 2018 to December 2020 were divided into an observation group (70 cases) and a control group (70 cases)) according to the random number table method. The patients in the control group received conventional treatment by western medicine, and those in the observation group received conventional treatment by western medicine combined with Tanreqing injection. The course of treatment was 7 days. The main efficacy indexes of the two groups before and after treatment were recorded,including the total clinical efficacy of traditional Chinese medicine (TCM) syndrome,total TCM syndrome score,clinical pulmonary infection score (CPIS), and the clearance rate of MDRB. Secondary efficacy indexes included temperature recovery and cough remission time,procalcitonin (PCT),C-reactive protein (CRP),white blood cell count (WBC),interleukin-6 (IL-6),interleukin-8 (IL-8), and oxygen partial pressure (PO
2
).
Result
2
The total effective rates of the observation group and the control group were 90.00% (63/70) and 75.70% (53/70),respectively,and the observation group had superior curative efficacy (
Z
=-2.147,
P
<
0.05). After treatment,CPIS and total TCM syndrome scores in both groups decreased compared with those before treatment,and the decrease was more significant in the observation group (
P
<
0.01). The clearance rate of MDRB in the observation group was 67.1% (47/70),superior to 48.6% (34/70) in the control group (
χ
2
=4.951,
P
<
0.05). The temperature recovery and cough remission time in the observation group was shorter than that in the control group (
P
<
0.01). After treatment,the levels of PCT,CRP,WBC,IL-6, and IL-8 in both groups were reduced compared with those before treatment,while the levels of PO
2
increased (
P
<
0.01). The improvement of various inflammatory indexes and the PO
2
level in the observation group was better than that in the control group (
P
<
0.01).
Conclusion
2
The clinical efficacy of Tanreqing injection combined with western medicine in the treatment of MDRB-induced pneumonia in elderly patients is significant,which can control infection,reduce inflammatory damage,improve the clearance rate of MDRB and PO
2
,and alleviate clinical symptoms. It is worthy of clinical application.
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