肺肠同治法辅助治疗呼吸机相关性肺炎(肺热腑实证)临床研究  

Clinical Efficacy of“Lung-intestinal Treatment”Method for Adjuvant Treatment of Ventilator-associated Pneumonia(Syndrome of Lung Heat and Fu-viscera Excess)

作　　者：姜家龙 楼黎明[2] 胡丹丹[2] 颜一琴 Jiang Jialong;Lou Liming;Hu Dandan;Yan Yiqin(Zhejiang University of Chinese Medicine,Zhejiang,Hangzhou 310053,China;不详)

机构地区：[1]浙江中医药大学,浙江杭州310053 [2]浙江中医药大学附属第三医院,浙江杭州310005

出　　处：《中国中医急症》2023年第2期242-244,255,共4页Journal of Emergency in Traditional Chinese Medicine

基　　金：浙江省中医药科技计划项目(2021ZB164,2021ZZ018);教育部产学合作协同育人项目(202101160020)。

摘　　要：目的观察肺肠同治法辅助治疗呼吸机相关性肺炎(VAP)(肺热腑实证)的临床疗效。方法选取浙江中医药大学附属第三医院呼吸与危重症医学科及ICU住院VAP患者56例,采用随机数表法分为对照组与治疗组各28例。对照组予西医常规治疗,治疗组在对照组的基础上加用肺肠同治方,疗程10 d,观察两组患者炎症相关指标[C反应蛋白(CRP)、降钙素原(PCT)、白细胞计数(WBC)、肝素结合蛋白(HBP)、白细胞介素-6(IL-6)]、便秘症状及疗效积分、中医证候积分、体征积分、临床肺部感染评分(CPIS)、退热时间、抗生素疗程及病程等。结果与本组治疗前比较,对照组治疗后各项炎症指标、CPIS评分、中医证候(发热、咳嗽、口干欲饮)与体征积分及总分改善(P<0.05);便秘症状及疗效积分与中医证候(咯痰、腹胀便秘)积分无明显变化(P>0.05)。治疗组治疗后各项炎症指标,便秘症状及疗效积分,CPIS评分,中医证候(发热、咳嗽、口干欲饮、腹胀便秘)与体征积分及总分均改善(P<0.05),中医证候(咯痰)积分无明显变化(P>0.05)。组间比较,治疗组在炎症指标(CRP、WBC、HBP、IL-6)、便秘症状及疗效积分、CPIS评分、中医证候(咳嗽、口干欲饮、腹胀便秘)积分及总分改善优于对照组(P<0.05),抗生素疗程及病程较对照组减少(P<0.01);两组治疗后PCT、中医证候(发热、咯痰)积分、体征积分及退热时间比较,差异无统计学意义(P>0.05)。结论肺肠同治方联合西医常规治疗,能更加有效地改善患者临床症状,抑制炎症反应,疗效优于单纯西医治疗。Objective:To observe the clinical efficacy of“lung-intestinal treatment”method for adjuvant treatment of ventilator-associated pneumonia(VAP)(syndrome of lung heat and fu-viscera excess).Methods:A total of 56 patients with VAP hospitalized in the Department of Respiratory and Critical Care Medicine and ICU of the Third Affiliated Hospital of Zhejiang University of Chinese Medicine were enrolled and divided into the control group and treatment group by random number table method,28 cases in each group.The control group was treated with conventional western medicine,and the treatment group was added with lung-intestinal treatment on the basis of the control group.The treatment course was 10 days.The inflammation-related indexes[C-reactive protein(CRP),procalcitonin(PCT),white blood cell count(WBC),heparin-binding protein(HBP),interleukin-6(IL-6)],constipation symptoms and efficacy points,TCM symptom points,sign scores,clinical pulmonary infection scores(CPIS),antipyretic time,antibiotic course and course of the disease were observed.Results:Compared with before treatment,the control group had improvement in the inflammatory indexes,CPIS score,TCM symptoms(fever,cough,dry mouth)and total scores after treatment(P<0.05),but there was no significant change in the symptoms and efficacy of constipation or the TCM symptoms(sputum cough,bloating and constipation)(P>0.05).After treatment,the inflammatory indexes,constipation symptoms and efficacy points,CPIS score,TCM symptoms(fever,cough,dry mouth,bloating and constipation)and total scores were all improved in the treatment group(P<0.05),but there was no significant change in TCM symptoms(sputum production)(P>0.05).Compared with the control group,the treatment group had significantly improved the inflammatory indexes(CRP,WBC,HBP,IL-6),constipation symptoms and efficacy scores,CPIS scores,TCM symptoms(cough,dry mouth,bloating and constipation)and total scores(P<0.05),and the course of antibiotics and disease course were reduced compared with the control group(P<0.01),wh

关 键 词：呼吸机相关性肺炎 中医疗法 肺肠同治 临床观察 

分 类 号：R563.1[医药卫生—呼吸系统]