托毒化痰汤对呼吸机相关性肺炎治疗的影响  

Therapeutic Effect of Detoxification and Expelling Sputum Decoction in Treatment of VAP

作　　者：徐坡[1] 孙腾[1] 朱洪[1] 

机构地区：[1]靖江市中医院,江苏靖江214500

出　　处：《辽宁中医杂志》2015年第2期338-340,共3页Liaoning Journal of Traditional Chinese Medicine

摘　　要：目的:观察托毒化痰汤鼻饲对呼吸机相关性肺炎患者治疗的影响。方法:将76例确诊VAP的患者随机分为实验组和对照组。两组均行气管插管或气管切开,有创呼吸机辅/控通气,脱机采用有创→无创序贯脱机。常规采用非抗生素防治及抗生素治疗策略。实验组在此基础上,加用托毒化痰汤鼻饲,比较两组患者治疗前后白细胞计数、C反应蛋白、临床肺部感染评分(CPIS)、降钙素原(PCT)以及脱机拔管成功率。结果:实验组与对照组相比,在降低患者CPIS、PCT、脱机拔管成功率方面差异有统计学意义(P<0.05),且从各因素与脱机拔管成功与否的ROC曲线来看,CPIS以及PCT的AUC面积分别为0.857、0.819,对预后判断有一定的准确性。结论:托毒化痰汤联合西药中西医结合治疗VAP,效果优于单纯西医治疗组。Objective：To observe the therapeutic effect of Detoxification and Expelling Sputum Decoction by nasal feeding in patients with VAP.Methods：76 patients who were diagnosed as VAP were randomly divided into the experimental group and the control group.Patients in both groups were given endotracheal intubation or tracheotomy and used invasive ventilator to assist / control breathing.Besides,they were conventionally given non-antibiotic prevention treatment and antibiotic treatment.And patients in experimental group,on the basis of those treatments,were given nasal feeding for Detoxification and Expelling Sputum Decoction.And then we compared the results of WBC,CRP,CPIS,PCT and the success rate of extubation in both groups before and after the treatment.Results：The result of the experimental group showed significant difference by statistics in terms of lowering patients＇ CPIS,PCT and increasing extubation（P〈0.05） compared with the control group.And the ROC curve about the connection between various factors and success rate of extubation showed that the AUC area of CPIS and PCT was respectively 0.857 and 0.819,which was referential to some extent in evaluating the prognosis.Conclusion：The therapeutic effect of combination of Detoxification and Expelling Sputum Decoction and western medicine in the treatment of VAP is more preferable.

关 键 词：托毒化痰汤 呼吸机相关性肺炎 中西医结合 降钙素元 

分 类 号：R563.1[医药卫生—呼吸系统]