小青龙汤辅助治疗呼吸机相关性肺炎的疗效观察  

Clinical observation on therapeutic effect of Xiaoqinglong decoction for supplementary treatment of patients with ventilator associated pneumonia

作　　者：朱海云[1,2] 阚建英[2] 曹书华[3] 

机构地区：[1]天津中医药大学,天津300193 [2]天津市中医药研究院附属医院,天津300120 [3]天津市第一中心医院,天津300192

出　　处：《中国中西医结合急救杂志》2016年第5期472-474,共3页Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care

摘　　要：目的：探讨小青龙汤辅助治疗呼吸机相关性肺炎（VAP）患者的临床疗效。方法回顾性分析2011年7月至2014年12月在天津市中医药研究院附属医院住院治疗的中医辨证为外寒内饮型的VAP患者33例，按治疗方法不同分为中药小青龙汤治疗组（观察组18例）和一般治疗组（对照组15例）。对照组给予抗感染、化痰止咳、保护胃黏膜和器官功能、营养支持、预防褥疮及血栓形成等一般治疗；观察组在一般治疗基础上加用小青龙汤（组成：麻黄15 g，桂枝15 g，细辛15 g，干姜15 g，芍药15 g，半夏15 g，五味子15 g，灸甘草10 g）鼻饲，每次150 mL、每日2次。两组患者分别于治疗前及治疗3 d、7 d观察体温变化，取外周血检测白细胞计数（WBC）及C-反应蛋白（CRP）水平的变化；并记录患者临床疗效。结果两组患者治疗前体温、WBC及CRP比较差异均无统计学意义；治疗后两组各项指标均较治疗前显著下降，并随治疗时间延长呈持续下降趋势；以观察组治疗后体温和WBC下降更为显著，7 d表现出统计学意义〔体温（℃）：36.5±0.6比37.0±0.8， WBC（×109/L）：6.7±3.0比8.9±2.5，均P＜0.05〕，但观察组和对照组CRP差异无统计学意义（mg/L：3 d为73.7±20.5比61.5±18.4；7 d为27.2±10.5比23.5±9.1，P＞0.05）。治疗后7 d观察组总有效率高于对照组〔83.3%（15/18）比80.0%（12/15）〕，但差异无统计学意义（P＞0.05）。结论小青龙汤可减轻VAP患者炎症反应，改善临床症状。ObjectiveTo investigate the therapeutic effect of Xiaoqinglong decoction for supplementary treatment of patients with ventilator-associated pneumonia （VAP）.Methods Thirty-three VAP patients with syndrome of traditional Chinese medicine （TCM） as interior retention of phlegm and exopathic cold admitted to Affiliated Hospital of Tianjin Academy of Traditional Chinese Medicine （TCM） from July 2011 to December 2014 were enrolled, and their historical data were retrospectively analyzed. According to the difference in treatment methods, the patients were divided into TCM treatment Xiaoqinglong decoction group （observation group, 18 cases） and general treatment group （control group, 15 cases）. The patients in both groups were given conventional western medicine treatment, including anti-infection, phlegm elimination and cough relieve, protection of gastric mucosa and organ function, nutritional support, prevention of bedsore and thrombosis, etc. Additionally, the patients in TCM treatment group were given Xiaoqinglong decoction （drug composition： herba ephedrae 15 g, ramulus cinnamomi 15 g, herba asari 15 g, rhizoma zingiberis 15 g, chinese peony 15 g, rhizoma pinelliae 15 g, fructus schisandrae 15 g, radix glycyrrhizae preparata 10 g） for nasal feeding, once 150 mL, twice a day, once every 7 days. The changes in body temperature were observed before and 3 days and 7 days after treatment, and peripheral blood was collected for determination of white blood cell count （WBC） and C-reactive protein （CRP） level in the two groups. Comprehensive therapeutic effects of the patients in both groups were recorded.Results There were no significant differences in body temperature, WBC and CRP before treatment between the two groups. After treatment, the above parameters in both groups were significantly lower than those before treatment, and they showed a decrease tendency with time prolongation. The decrease in body temperature and WBC in observation group was more obvious than those of control grou

关 键 词：小青龙汤 呼吸机相关性肺炎 疗效观察 

分 类 号：R563.1[医药卫生—呼吸系统]