中药灌肠辅助治疗重症肺部感染痰热腑实证临床疗效分析与护理体会  

Analysis of Clinical Effect and Nursing Experience of Chinese Herbal Enema in Adjuvant Treatment for Severe Pulmonary Infection with Phlegm-heat and Fu-organ Excess Syndrome

作　　者：张小燕 季美芬 赵晶 ZHANG Xiaoyan;JI Meifen;ZHAO Jing

机构地区：[1]丽水市人民医院重症监护室

出　　处：《新中医》2019年第12期303-306,共4页New Chinese Medicine

摘　　要：目的:观察中药灌肠辅助治疗重症肺部感染痰热腑实证患者的临床疗效。方法:将80例重症肺部感染痰热腑实证患者随机分为对照组和观察组各40例。2组均给予对症处理,纠正水、电解质及酸碱平衡紊乱,抗感染等常规疗法,观察组加用中药灌肠。2组均连续治疗5天。治疗前后评定CURB-65评分和临床肺部感染评分(CPIS),检测降钙素原(PCT)和C-反应蛋白(CRP)水平,检测动脉血氧分压(PaO2)、二氧化碳分压(PaCO2)、血氧饱和度(SaO2)和氧合指数。结果:治疗后,2组PaO2、SaO2和氧合指数均较治疗前上升,PaCO2均较治疗前下降,差异均有统计学意义(P<0.01)。观察组PaO2、SaO2和氧合指数均高于对照组(P<0.05),PaCO2低于对照组(P<0.05)。2组CURB-65评分和CPIS均较治疗前下降(P<0.01),观察组CURB-65评分和CPIS均低于对照组(P<0.01)。2组PCT和CRP水平均较治疗前下降(P<0.01),观察组PCT和CRP水平均低于对照组(P<0.01)。结论:在常规疗法基础上加用中药灌肠,有助于控制重症肺部感染的炎症情况,改善患者的肺通气/换气功能,使病情能得到进一步的控制。Objective:To observe the clinical effect of Chinese herbal enema in adjuvant treatment for patients with severe pulmonary infection with phlegm-heat and fu-organ excess syndrome.Methods:Divided 80 cases of patients with severe pulmonary infection with phlegm-heat and fu-organ excess syndrome into the control group and the observation group randomly,with 40 cases in each group.Both groups were given symptomatic treatment and routine therapies such as correction of the disorder of water,electrolyte and acid-base,and anti-infection treatment,while the observation group was additionally given the Chinese herbal enema.Both groups received continuous treatment for 5 days.Assessed the scores of CURB-65 and clinical pulmonary infection score(CPIS),detected the levels of procalcitonin(PCT) and C-reactive protein(CRP),and detected the arterial partial pressure of oxygen(PaO2),partial pressure of carbon dioxide(PaCO2),blood oxygen saturation(SaO2) and oxygenation indexes before and after treatment.Results:After treatment,PaO2,SaO2 and oxygenation indexes were all increased and PaCO2 was decreased in the two groups when compared with those before treatment,differences being significant(P <0.01).PaO2,SaO2 and oxygenation indexes in the observation group were higher than those in the control group(P <0.05) and PaCO2 was lower than that in the control group(P <0.05).The scores of CURB-65 and CPIS in the two groups were decreased when compared with those before treatment(P <0.01);the score of CURB-65 and CPIS in the observation group were lower than those in the control group(P <0.01).The levels of PCT and CRP in both groups were decreased when compared with those before treatment(P <0.01),while those in the observation group were lower than those in the control group(P <0.01).Conclusion:The additional application of Chinese herbal enema based on routine therapy can help control the inflammation of severe pulmonary infection,improve the pulmonary ventilation/exchange function of patients,and further control the disease.

关 键 词：重症肺部感染 痰热腑实证 中西医结合疗法 中药灌肠 动脉血气分析 炎症指标 

分 类 号：R248[医药卫生—中医临床基础]