清热宣肺汤直肠滴注在ICU卒中相关性肺炎的应用及效果评价  

Clinical Application and Effect of Qingre Xuanfei Decoction Proctoclysis on Stroke Associated Pneumonia

作　　者：章昕[1] 蔡玲[1] 王秋雁[1] 

机构地区：[1]杭州市中医院重症监护室,浙江杭州310007

出　　处：《中华中医药学刊》2014年第8期1871-1874,共4页Chinese Archives of Traditional Chinese Medicine

基　　金：国家重点基础研究发展计划(973计划)项目(2013CB601209)

摘　　要：目的：探讨清热宣肺汤直肠滴注在ICU卒中相关性肺炎的应用效果。方法：将ICU卒中相关性肺炎患者78例,随机分为实验组和对照组,每组各39例,对照组在利尿、降低颅压、抗感染、神经营养治疗基础上,联合醒脑静静滴辅助治疗,醒脑静20mL加0.9%生理盐水250mL静滴qd,实验组在对照组相同治疗基础上,采用清热宣肺汤直肠滴注,中药煎剂500mL缓慢直肠滴注,保留20～30min,每日1次,两组均10d为1疗程,治疗前后检测2组感染参数包括CRP、白细胞（WBC）、NT-proBNP含量等指标,并对临床治疗结果进行分析。结果：实验组治疗1疗程后CRP、NT-proBNP含量为（11.53±0.98）mg/L、（648.42±9.36）ng/L;白细胞（WBC）平均为（5.27±0.29）109/L;对照组CRP、NT-proBNP含量为（19.64±1.73）mg/L、（667.13±8.92）ng/L;白细胞（WBC）平均为（8.49±0.37）109/L;两组治疗后感染参数、c反应蛋白均呈降低趋势,实验组较对照组明显降低（P〈0.05）;实验组体温恢复正常时间、WBC恢复正常时间、肺部湿罗音消失时间分别为：（4.81±0.42）d、（5.42±0.53）d、（4.71±0.29）d;实验组与对照组比较,临床症状明显改善（t=3.843,P〈005;t=2981,P〈0.05;t=2.058,P〈0.05）;实验组临床治愈率为92.31%;对照组临床治愈率为61.54%,两组具有显著性差异（χ2=6.822,P〈0.05）。其中实验组预后良好占87.18%,对照组预后良好占61.54%,与对照组相比较,实验组预后明显优于对照组,具有显著性差异（χ2=2.891,P〈0.05;χ2=2.058,P〈0.05）。结论：清热宣肺汤直肠滴注可以明显改善肺炎感染症状,治疗卒中相关性肺炎,能够提高临床治愈率,可以在临床推广。Objective：To investigate the effect of Qingre Xuanfei Decoction Rectoclysis on stroke associated pneumonia. Methods ：78 cases of patients with stroke associated pneumonia were randomly divided into experimental group and control group, 39 cases in each group. The control group beside the routine treatment, combined with Xingnaojing injection,20 mL in O. 9% physiological saline for intravenous infusion of 250 mL once a day. The experimental group added Qingre Xuanfei Decoction 500 mL for proctoelysis,retention for 20 -30min,once a day. 10 days was a course of treatment. The infection parameters of the two groups were detected before and after treatment, including CRP, white blood cell （ WBC）, NT - proBNP content index, and the clinical outcome were analyzed. Results ： In the experimental group after a course of treatment, CRP and content of NT - proBNP were （ 11.53 ± 0.98 ） mg/L, （648.42 ± 9.36 ） ng/L; white blood cell （ WBC ） was （5.27 ±0.29） 10-9/L. In control group, CRP and the content of NT - proBNP were （19.64 ± 1.73） mg/L, （667.13 ±8.92） ng/L;thin white cell （WBC） was （8.49± 0. 37） 10^-9/L;parameter,infection in two groups after treatment of C reactive protein decreased and the experimental group was significantly lower than the control group （ P 〈 0.05 ）. The experiment group＇ s temperature returned to normal time, WBC to restore the normal time,lung wet rales dis- appearance time were （ 4.81 ± 0.42） d, （ 5.42 ±0.53 ） d, （4.71 ± 0.29） d. Compared with the control group, the clini-cal symptoms improved significantly （ t = 3. 843, P 〈 0.05 ; t = 2.981, P 〈 0.05 ; t = 2. 058, P 〈 0.05 ）. The experiment group＇ s cure rate was 92.31% and that of the control group was 61.54%. The two groups had significant difference （X2 =6. 822,P 〈0.05）. In the experimental group,good prognosis was 87.18% and in the control group,it was 61.54%. Compared with the control group, the experimental group prognosis was better with significant diff

关 键 词：清热宣肺汤 直肠滴注 卒中相关性肺炎 感染参数 预后 

分 类 号：R563.1[医药卫生—呼吸系统]