宣肺固金汤治疗卒中相关性肺炎痰热蕴肺证的疗效及预后的影响因素分析  

Effect of Xuanfei Gujin Decoction on Stroke-associated Pneumonia with Phlegm-Heat Obstructing the Lungs and Analysis of Prognostic Factors

作　　者：李小童 李霏[1] LI Xiaotong;LI Fei(Department of Integrated Traditional Chinese and Western Medicine,Anyang District Hospital,Puyang Henan 455000,China)

机构地区：[1]濮阳市安阳地区医院中西医结合科,河南安阳455000

出　　处：《临床研究》2025年第5期125-128,共4页Clinical Research

摘　　要：目的探讨卒中相关性肺炎(SAP)痰热蕴肺证患者给予宣肺固金汤的疗效及预后的影响因素。方法选取2020年7月至2023年6月濮阳市安阳地区医院收治的SAP痰热蕴肺证患者共计80例,所有患者均给予宣肺固金汤治疗,观察临床疗效,根据预后分为预后良好组(70例)和预后不良组(10例),并进行单因素分析与多因素Logistic回归分析以明确预后的影响因素。结果80例SAP痰热蕴肺证患者中,显效32例(40.00%),有效38例(47.50%),无效10例(12.50%);预后不良组年龄≥60岁、多重耐药菌感染、多肺叶病变、白蛋白(Alb)水平<35 g/L、合并基础疾病≥2种、未及时排痰、疾病程度重度、无生活自理能力、气管切开、合并呼吸困难的患者占比与预后良好组相比更高,差异均有统计学意义(P<0.05);多因素Logistic回归分析结果显示,年龄≥60岁(OR=2.157)、多重耐药菌感染(OR=1.803)、多肺叶病变(OR=3.568)、Alb水平<35 g/L(OR=2.334)、合并基础疾病≥2种(OR=2.519)、未及时排痰(OR=1.836)、疾病程度重度(OR=3.481)、无生活自理能力(OR=6.263)、气管切开(OR=6.769)、合并呼吸困难(OR=8.174)是影响宣肺固金汤对SAP痰热蕴肺证预后的影响因素,差异均有统计学意义(P<0.05)。结论宣肺固金汤治疗SAP痰热蕴肺证患者具有一定疗效,但可能受到年龄、多重耐药菌感染、多肺叶病变、Alb水平、合并基础疾病、未及时排痰、疾病程度重度、无生活自理能力、气管切开、合并呼吸困难因素影响,需要重点关注。Objective To explore the therapeutic effects of Xuanfei Gujin Decoction on patients with Stroke-associated pneumonia(SAP)and phlegm-heat obstructing the lungs,and to analyze the factors influencing prognosis.Methods A total of 80 patients with SAP and phlegm-heat obstructing the lungs admitted to Anyang Regional Hospital from July 2020 to June 2023 were selected.All patients received treatment with Xuanfei Gujin Decoction.Clinical efficacy was observed,and patients were categorized into a good prognosis group(70 cases)and a poor prognosis group(10 cases)based on their outcomes.Univariate analysis and multivariate logistic regression analysis were conducted to identify prognostic factors.Results Among the 80 patients with SAP and phlegm-heat obstructing the lungs,32 patients(40.00%)exhibited significant efficacy,38 patients(47.50%)showed efficacy,and 10 patients(12.50%)were ineffective.In comparison to the good prognosis group,the poor prognosis group had a higher proportion of patients aged≥60 years,with multidrug-resistant bacterial infections,multiple lung lobe involvement,albumin(Alb)levels<35 g/L,two or more comorbidities,delays in expectoration,severe disease severity,lack of self-care ability,tracheostomy,and respiratory distress,with all differences being statistically significant(P<0.05).The results of multivariate logistic regression analysis indicated that age≥60 years(OR=2.157),multidrug-resistant bacterial infection(OR=1.803),multiple lung lobe involvement(OR=3.568),Alb levels<35 g/L(OR=2.334),two or more comorbidities(OR=2.519),delays in expectoration(OR=1.836),severe disease severity(OR=3.481),lack of self-care ability(OR=6.263),tracheostomy(OR=6.769),and respiratory distress(OR=8.174)were significant factors affecting the prognosis of Xuanfei Gujin Decoction treatment for SAP with phlegm-heat obstructing the lungs(P<0.05).Conclusion Xuanfei Gujin Decoction exhibits therapeutic efficacy for patients with SAP and phlegm-heat obstructing the lungs;however,its effects may be influenced by factors s

关 键 词：脑卒中 感染性肺炎 宣肺固金汤 预后 影响因素 

分 类 号：R742[医药卫生—神经病学与精神病学]