痰热清治疗慢性阻塞性肺疾病合并肺部感染的疗效  

Effect of Tanreqing on treatment of chronic obstructive pulmonary disease complicated with pulmonary infection

作　　者：陈苗[1] 张洁[2] 陈思 李玉[1] 郭佳林 CHEN Miao;ZHANG Jie;CHEN Si;LI Yu;GUO Jia-lin(Jiaozuo People's Hospital,Jiaozuo,Henan 454100,China)

机构地区：[1]焦作市人民医院呼吸与危重症医学科,河南焦作454100 [2]焦作市人民医院干部病房,河南焦作454100 [3]焦作市中医院西药房,河南焦作454100

出　　处：《中华医院感染学杂志》2021年第10期1466-1469,共4页Chinese Journal of Nosocomiology

基　　金：中国宋庆龄基金会呼吸疾病临床研究公益基金定向基金资助项目(2018MZFT-174)。

摘　　要：目的探讨痰热清注射液治疗慢性阻塞性肺疾病(COPD)合并肺部感染的疗效.方法选取2017年1月-2019年12月焦作市人民医院收治的COPD合并肺部感染患者154例为研究对象,分析感染病原菌分布特点,并按照随机数字表法分为研究组和对照组各77例.两组均给予COPD急性发作的常规治疗,在此基础上研究组给予痰热清注射液,治疗14 d.比较两组疗效、痰液病原菌清除率、血清正五聚蛋白3(PTX3)和降钙素原(PCT)水平差异,观察两组患者不良反应.结果研究组治疗总有效率为93.51%,高于对照组的83.12%(P<0.05);痰培养共分离出病原菌154株,其中革兰阴性菌116株占75.32%,革兰阳性菌38株占24.68%;治疗7 d和14 d时,研究组痰液病原菌清除率为62.34%和97.40%,高于对照组的45.45%和88.31%(P<0.05).治疗后,两组患者血清PTX3、PCT水平均下降(P<0.05),且研究组血清PTX3、PCT水平低于对照组(P<0.05).两组患者不良反应发生率分别为11.69%和10.39%,无统计学意义.结论COPD合并肺部感染以革兰阴性菌感染为主,痰热清注射液有助于提高病原菌清除率,减轻机体炎症反应,增加临床疗效.OBJECTIVE To explore the effect of Tanreqing injection on treatment of chronic obstructive pulmonary disease(COPD)complicated with pulmonary infection.METHODS A total of 154 COPD patients complicated with pulmonary infection who were treated in the Jiaozuo People′s Hospital from Jan 2017 to Dec 2019 were recruited as the study subjects and were randomly divided into the study group and the control group,with 77 cases in each group.The distribution of pathogens was observed,both groups were given conventional therapy for acute attack of COPD,the study group was given additional Tanreqing injection for 14 days.The curative effect,clearance rates of pathogens in sputum,serum pentraxin 3(PTX3)and procalcitonin(PCT)were compared between the two groups,and the adverse reactions in the two groups of patients were observed.RESULTS The total effective rate of treatment of the study group was 93.51%,significantly higher than 83.12%of the control group(P<0.05).Totally 154 strains of pathogens were isolated from sputum specimens,116(75.32%)of which were gram-negative bacteria,and 38(24.68%)were gram-positive bacteria.The clearance rates of pathogens in sputum of the study group were respectively 62.34%and 97.40%after the treatment for 7 and 14 days,significantly higher than 45.45%and 88.31%of the control group(P<0.05).The levels of serum PTX3 and PCT of the two groups of patients were significantly reduced after the treatment(P<0.05),and the levels of serum PTX3 and PCT of the study group were lower than those of the control group(P<0.05).The incidence rates of adverse reactions of the two groups of patients were 11.69%and 10.39%,respectively,and there was no significant difference.CONCLUSION The patients with gram-negative bacteria infections are dominant among the COPD patients complicated with pulmonary infection.Tanreqing injection may raise the clearance rate of pathogens,alleviate the inflammatory response and boost the clinical curative effect.

关 键 词：慢性阻塞性肺疾病 肺部感染 痰热清注射液 五聚蛋白3 降钙素原 

分 类 号：R563[医药卫生—呼吸系统]