基于伏邪理论的益气透邪方治疗老年多重耐药菌肺炎临床疗效观察  

Clinical efficacy of Yiqi Touxie decoction on elderly multi-drug resistant bacterial pneumonia based on latent pathogenic factor theory

作　　者：王铮[1,2] 苗开辉 董晨 王昱 WANG Zheng;MIAO Kaihui;DONG Chen;WANG Yu

机构地区：[1]甘肃中医药大学,甘肃兰州730000 [2]甘肃中医药大学附属医院,甘肃兰州730000

出　　处：《中医临床研究》2024年第15期63-67,共5页Clinical Journal Of Chinese Medicine

基　　金：甘肃省自然科学基金项目(21JR11RA152);甘肃中医药大学附属医院科研及技术创新基金项目(ZQN2016-15);甘肃中医药大学附属医院科研及技术创新基金青年项目(gzfy-2020-19)。

摘　　要：目的:评价在西医常规治疗基础上加用益气透邪方治疗重症医学科老年多重耐药菌肺炎患者的临床疗效。方法:将2017年2月-2021年10月收治于甘肃中医药大学附属医院重症医学科80例老年多重耐药菌肺炎患者随机分为中药治疗组与对照组,每组40例。对照组予以常规治疗,中药治疗组在常规治疗基础上加用益气透邪方加减,疗程为7 d。记录两组患者治疗前后中医证候积分、C反应蛋白(C-reactive Protein,CRP)、降钙素原(Procalcitonin,PCT)、白细胞介素-6(Interleukin-6,IL-6)、临床肺部感染评分(Clinical Pulmonary Infection Score,CPIS)、氧合指数(P/F)、耐药菌清除率及28 d病死率。结果:中药治疗组与对照组的临床总有效率分别为92.50%(37/40)和70.00%(28/40),中药治疗组疗效优于对照组(P<0.05)。与治疗前相比,两组患者治疗后中医证候积分、CPIS、CRP、PCT、IL-6均较治疗前下降,中药治疗组下降更明显(P<0.05)。与治疗前相比,两组患者P/F均升高,中药治疗组升高更为显著(P<0.05)。耐药菌清除率中药治疗组为37.5%,对照组为27.5%(P>0.05)。两组无显著差异;两组患者28 d病死率无显著差异(P>0.05)。结论:在常规西医治疗基础上运用益气透邪方加减治疗老年耐药菌肺炎能够显著缓解患者临床症状,降低炎症反应,改善氧合指数,临床疗效肯定。Objective:To evaluate the clinical effect of Yiqi Touxie decoction(益气透邪方)on elderly multi-drug resistant bacterial pneumonia in intensive care department based on conventional Western medicine treatment.Methods:A total of 80 elderly patients with multi-drug-resistant bacterial pneumonia admitted to the Department of Intensive Care Medicine,Affiliated Hospital of Gansu University of Chinese Medicine from February 2017 to October 2021 were randomly divided into the TCM treatment group and the control group.The control group was given routine treatment,and the TCM treatment group was supplemented with Yiqi Touxie decoction on the basis of routine treatment,and the course of treatment was 7 days.The TCM syndrome scores,C-reactive protein(CRP),procalcitonin(PCT),interleukin-6(IL-6),clinical pulmonary infection score(CPIS),oxygenation index(P/F),drug resistant bacteria clearance rate and 28 day mortality.in the two groups after treatment were recorded.Results:The total effective rate in the TCM treatment group and the control group were 92.50%(37/40)and 70.00%(28/40),respectively,and the curative effect in the TCM treatment group was better than that in the control group(P<0.05).Compared with those before treatment,TCM syndrome score,CPIS score,CRP,PCT and IL-6 were all decreased in both groups after treatment,and the decrease was more obvious in the TCM treatment group(P<0.05);compared with that before treatment,P/F was increased in both groups,and the improvement was more significant in the TCM treatment group(P<0.05).The clearance rate of drug-resistant bacteria was 37.5%in the TCM treatment group and 27.5%in the control group(P>0.05),and there was no significant difference between the two groups.There was no significant difference in 28 day mortality between the two groups(P>0.05).Conclusion:On the basis of conventional western medicine treatment,the application of modified Yiqi Touxie decoction can significantly alleviate the clinical symptoms,reduce the inflammatory response,improve the oxygenation of p

关 键 词：老年肺炎 益气透邪方 多重耐药菌 中医药治疗 

分 类 号：R256.1[医药卫生—中医内科学]