摘要
目的观察小柴胡汤加减治疗ICU老年患者肺部泛耐鲍曼不动杆菌的临床疗效。方法将60例西医诊断为肺部泛耐鲍曼不动杆菌感染,中医辨证为少阳证的患者随机分为对照组与治疗组各30例,两组均使用机械通气。对照组按照《中国鲍曼不动杆菌感染诊治专家共识》进行集束化治疗,采用二联抗生素治疗方案,同时给予对症治疗;治疗组在对照组的基础上给予小柴胡汤加减,疗程均为10 d。观察两组治疗后的临床疗效、病原体清除率、氧合指数、炎症水平(白细胞计数、降钙素原和C反应蛋白)及不良反应,比较两组治疗前后急性生理学和慢性健康状况评分Ⅱ(APACHEⅡ)评分、SOFA评分、机械通气时间、ICU住院时间及28 d死亡率。结果治疗组临床疗效优于对照组(P<0.01),但两组病原体清除率无明显差异(P>0.05)。治疗组的炎症指标、氧合指数较对照组改善明显(P<0.01);治疗组的机械通气时间、ICU住院时间较对照组明显缩短(P<0.01),28 d死亡率两组无明显差异(P>0.05)。结论小柴胡汤加减能降低ICU老年患者肺部泛耐鲍曼不动杆菌感染的炎症指标,改善全身症状及预后。
Objective:To investigate the clinical efficacy of Xiaochaihu Decoction on elderly patients with pulmonary extreme drug resistant acinetobacter baumannii infection in ICU.Methods:A total of 60 cases of pulmonary extreme drug resistant acinetobacter baumannii infection diagnosed by western medicine and syndrome differentiation of Shaoyang syndrome were randomly divided into the control group and treatment group,30 cases in each group.Both groups used ventilator.The control group was treated with cluster therapy according to the Consensus of experts on diagnosis and treatment of acinetobacter baumannii infection in China,and two antibiotic regimens were used;at the same time,symptomatic treatment were given.The treatment group was given Xiaochaihu Decoction on the basis of the control group.Both groups were treated for 10 days.The clinical efficacy,pathogen clearance rate,oxygenation index,inflammation level(WBC count,procalcitonin and C-reactive protein)and adverse reactions of the two groups after treatment were observed,and the acute physiology and chronic health scores before and after treatment were compared between the two groups.The APACHEⅡscore,SOFA score,mechanical ventilation time,ICU hospital stay and 28-day mortality rate were statistically analyzed.Results:The clinical efficacy of the treatment group was better than that of the control group(P<0.01),but there was no significant difference in pathogen clearance between the two groups(P>0.05).The inflammation index and oxygenation index of the treatment group were significantly improved compared with the control group(P<0.01);the mechanical ventilation time and ICU hospitalization time of the treatment group were significantly shorter than those of the control group(P<0.01).There was no significant difference in the 28 day mortality between the two groups(P>0.05).Conclusion:Xiaochaihu Decoction can reduce the inflammatory index of pulmonary extreme resistant Acinetobacter baumannii infection in the elderly,improve the systemic symptoms and prognosis.
作者
肖秋生
马明远
邓梦华
张云海
Xiao Qiusheng;Ma Mingyuan;Deng Menghua;Zhang Yunhai(Foshan Hospital of Traditional Chinese Medicine,Guangdong,Foshan 528000,China)
出处
《中国中医急症》
2021年第5期861-864,共4页
Journal of Emergency in Traditional Chinese Medicine
基金
佛山市医学类科技攻关项目(1920001000871)。
关键词
肺部感染
鲍曼不动杆菌
小柴胡汤
耐药性
炎症指标
Pulmonary infection
Acinetobacter baumanil
Xiaochaihu Decoction
Drug resistance
Inflammatory indicators
