益气活血通督法对创伤后颈髓损伤患者肺部感染控制窗和炎症因子的影响  

Influence of the Benefiting Qi and Promoting Blood Circulation Method for Dredging Governor Channel on Pulmonary Infection Control Window and Inflammatory Factors in Patients with Cervical Spinal Cord Injury after Trauma

作　　者：焦瑞娜 王凤英 杨铁柱 Jiao Ruina;Wang Fengying;Yang Tiezhu(Luoyang Orthopedic Traumatological Hospital of Henan Province(Henan Province Orthopedic Hospital),Henan,Luoyang 471002,China)

机构地区：[1]河南省洛阳正骨医院,河南省骨科医院,河南洛阳471002

出　　处：《中国中医急症》2021年第5期805-808,共4页Journal of Emergency in Traditional Chinese Medicine

基　　金：河南省中医药科学研究专项课题(2019ZY1029)。

摘　　要：目的观察益气活血方对创伤后颈髓损伤患者肺部感染控制窗和炎症因子的影响。方法患者72例随机分为治疗组与对照组。对照组采用西医常规治疗,治疗组在此基础上加用益气活血方。观察两组患者肺部感染控制窗、抗生素使用疗程、机械通气时间、ICU住院日和二重感染率;治疗前和治疗后7、14 d中医证候评分(发热、咳嗽、胸闷、痰量)、急性生理与慢性健康Ⅱ(APACHEⅡ)评分、临床肺部感染(CPIS)评分、白细胞计数(WBC)、降钙素原(PCT)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)的变化,评价临床疗效。结果治疗7、14 d,两组患者中医证候评分、APACHEⅡ和CPIS评分、相关炎症指标(WBC、PCT、TNF-α、IL-6)均显著降低(P<0.05),两组同时间点对比,治疗组改善更加明显(P<0.05);治疗组肺部感染控制窗时间和抗生素疗程明显短于对照组(P<0.05),且临床疗效也优于对照组(P<0.05)。结论益气活血方辅助治疗创伤后颈髓损伤肺部感染患者,可有效控制炎症反应,改善临床症状,疗效显著。Objective:To observe the influence of the benefiting qi and promoting blood circulation method for dredging governor channel on pulmonary infection control window and inflammatory factors in patients with cervical spinal cord injury after trauma.Methods:A total of 72 patients were randomly divided into the treatment group and control group.Patients of the control group were treated with conventional western medicine,and the treatment group was treated with Yiqi Huoxue Decoction on this basis.The control window of pulmonary infection,the course of antibiotics,the time of mechanical ventilation,the days of ICU stay and the rate of secondary infection were observed in the two groups.The scores of TCM syndromes before and after treatment at 7,14 days after treatment,clinical efficacy,and changes in APACHEⅡscore,CPIS score,white blood cell count,procalcitonin,tumor necrosis factor-α(TNF-α),and IL-6 were recorded and compared between the two groups.Results:After 7 days and 14 days of treatment,the APACHEⅡand CPIS scores,and related inflammation indicators(WBC,PCT,TNF-α,IL-6)were significantly reduced in the two groups(P<0.05).Comparing the two groups at the same time point,the treatment group improved more significantly(P<0.05).The pulmonary infection control window and the course of antibiotics in the treatment group were significantly shorter than those in the control group(P<0.05),and the clinical efficacy was also better than that in the control group(P<0.05).Conclusion:Yiqi Huoxue Decoction assisting in the treatment of patients with post-traumatic cervical spinal cord injury and pulmonary infection can effectively control the inflammatory response and improve the clinical symptoms with significant curative effect.

关 键 词：颈髓损伤 肺部感染 益气活血方 益气活血通督法 中医药治疗 

分 类 号：R563.1[医药卫生—呼吸系统]