清金化痰汤加减汤辅助治疗痰热蕴肺型呼吸机相关性肺炎患者疗效及对炎性因子急性生理与慢性健康评分临床肺部感染评分的影响  

Effect of modified Qingjin Huatan decoction on inflammatory factors,ApacheⅡscore and CPIS score in patients with ventilator-associated pneumonia with phlegm heat accumulation in the lung

作　　者：张丽 张斌 Zhang Li;Zhang Bin(Department of Critical Care Medicine,Zhoushan City Hospital of Traditional Chinese Medicine,Zhoushan,Zhejiang316000,China)

机构地区：[1]舟山市中医院重症医学科,浙江舟山316000

出　　处：《中国药物与临床》2024年第8期477-481,共5页Chinese Remedies & Clinics

摘　　要：目的分析痰热蕴肺型呼吸机相关性肺炎(VAP)患者联合清金化痰汤加减汤辅助治疗对炎性因子、急性生理与慢性健康(APACHEⅡ)评分和临床肺部感染(CPIS)评分的影响。方法回顾性分析2019年2月至2021年4月浙江省舟山市中医院重症医学科收治入院的95例痰热蕴肺型VAP患者临床资料,根据不同治疗方案,将其分为常规组(45例)和联合组(50例)。常规组采用抗感染等常规对症治疗,联合组在常规组的基础上联合清金化痰汤加减汤辅助治疗。比较2组疗效以及治疗前后炎性因子和血气分析指标水平、APACHEⅡ评分和CPIS评分。结果联合组总有效率(90%)高于常规组(69%)(P<0.05);治疗2个月后,2组C反应蛋白(CRP)和降钙素原(PCT)水平以及APACHEⅡ评分和CPIS评分均低于治疗前(P<0.05),联合组低于常规组(P<0.05);治疗2个月后,2组动脉血氧分压(PaO_(2))和氧合指数(OI)高于治疗前(P<0.05),联合组高于常规组(P<0.05);2组动脉血二氧化碳分压(PaCO_(2))水平低于治疗前(P<0.05),联合组低于常规组(P<0.05)。结论痰热蕴肺型VAP患者联合清金化痰汤加减汤辅助治疗可加强肺功能,同时降低炎性因子水平、APACHEⅡ评分和CPIS评分,可在临床推广应用。Objective To analyze the effects of adjuvant treatment with modified Qingjin Huatan Decoction on inflammatory factors,acute physiology and chronic health(APACHEⅡ)score and clinical pulmonary infection(CPIS)in patients with ventilator-associated pneumonia(VAP)with phlegm heat accumulating in the lung.Methods A retrospective analysis was conducted on the clinical data of 95 patients with phlegm heat accumulation lung type VAP admitted to the Department of Critical Care Medicine at Zhoushan City Hospital of Traditional Chinese Medicine in Zhejiang Province from February 2019 to April 2021.They were divided into the conventional group(n=45)and the combination group(n=50)based on different treatment plans.The conventional group received routine symptomatic treatment such as anti-infection,while the combined group received adjuvant treatment with modified Qingjin Huatan Decoction on the basis of the conventional group.Compare the efficacy of the two groups,as well as the levels of inflammatory factors and blood gas analysis indicators,APACHEⅡscore,and CPIS score before and after treatment.Results The total effective rate of the combined group(90%)was significantly higher than that of the routine group(69%)(P<0.05);After 2 months′treatment,the levels of C-reactive protein(CRP)and(PCT),APACHEⅡscore and CPIS score in the two groups were significantly lower than those before the treatment(P<0.05),and those in the combined group were significantly lower than those in the routine group(P<0.05);After 2 months′treatment,the levels of PaO_(2) and OI in the two groups were significantly higher than those before the treatment(P<0.05),and those in the combined group were significantly higher than those in the routine group(P<0.05).The index level of arterial blood carbon dioxide partial pressure(PaCO_(2))in the two groups was significantly lower than that before the treatment(P<0.05),and that in the combined group was significantly lower than that in the routine group(P<0.05).Conclusion The adjuvant treatment of modified

关 键 词：清金化痰汤 炎性因子 痰热壅肺 肺炎 呼吸机相关性 治疗效果 急性病生理学和长期健康评价 CPIS评分 

分 类 号：R259[医药卫生—中西医结合]