摘要
目的:观察清金化痰汤联合西医治疗呼吸机相关性肺炎痰热壅肺证患者的临床肺部感染评分(CPIS)、降钙素原(PCT)指标的影响。方法:选择2010年3月—2012年2月收入上海市岳阳医院急诊医学科病房的67例呼吸机相关性肺炎痰热壅肺证患者,随机分为治疗组34例和对照组33例,两组患者均予西医规范治疗,治疗组在西医规范治疗基础上加服清金化痰汤,每日2次,每次200 mL,两组患者疗程均为7天。观察治疗前后的患者中医证候评分、临床疗效、临床肺部感染评分(CPIS),检测并记录治疗前后血清CRP、PCT水平变化,进行统计学分析。结果:经治疗两组患者的临床肺部感染评分及体温、白细胞计数、胸部X线评分均有所改善(P<0.05),治疗组患者体温、气道分泌物两项指标改善情况优于对照组,差异有统计学意义(P<0.05);经治疗两组患者CPIS、PCT水平均较前下降(P<0.05),治疗组比对照组下降明显,差异有统计学意义(P<0.05)。结论:在西医规范治疗基础上,清金化痰汤能够降低临床肺部感染评分,提高治疗有效率,可能与其降低患者血清急性反应蛋白(CRP)、降钙素原(PCT)水平有关。
Objective：To observe the clinical effect of Qingjin Huatan Decoction in treatment of patients with ventilator associ- ated pneumonia （VAP） of retention of heat - phlegm and to discuss the curative effects on the pneumonia as well as its potential intervention mechanisms. Methods ：We conducted a prospective case - control study on 70 patients with ventilator associated pneu- monia in the emergency ward during March 2010 to February 2012. The 70 patients were randomly divided into the management group which consisted of 34 patients and the control group which consisted of 36 patients. The management group received routine western medicine therapy combining Qingjin Huatan Decoction by oral or nasal feeding for 7 days, and the other one only received routine western medicine therapy. On the first day before starts of treatment and day 7 after the treatment, we recorded clinical pul- monary infection score, assayed all patients＇serum concentration of CRP, simultaneously assayed serum PCT. All data was statisti- cally analyzed by SPSS 15.0 for windows. Results：There was no significant difference（P 〉0. 05 ） in all patients with CPIS score and temperature,white blood cells, microbiological analysis among the total before treatment. After seven days treatment, the level of CPIS score and temperature,white blood cells, hematopneie index, airway secretion, Chest X - ray, microbiological analysis in all patients were declined significantly（ P 〈 0. 05 ）. The CPIS score and the condition of fever and airway secretion were improved more in the management group than those in the control group （ P 〈 0.05 ）. There was no significant difference in the level of PCT. After seven days treatment, the level of PCT was declined significantly in the management group （ P 〈 0. 05 ）. Conclusion ： Qingjin Huatan Decoction combined routine western medicine could significantly improve the condition of retention of heat - phlegm and could reduce CPIS and PCT, which suggests that Qingjin Huatan Decoction could relieve the pulmonary inflammation. The curative effects may be carried on through significantly reducing the levels of PCT and sTEAM - 1 in the serum.
出处
《辽宁中医杂志》
CAS
2013年第8期1606-1608,共3页
Liaoning Journal of Traditional Chinese Medicine
基金
上海市卫生局2009年度青年科研项目资助项目
关键词
降钙素原
临床肺部感染评分
呼吸机相关性肺炎
procalcitonin
clinical pulmonary infection score
ventilator associated pneumonia
