中西医联合用药治疗脑梗死患者肺部感染的疗效分析

Efficacy of Chinese and western medicine therapy in treatment of cerebral infarction patients complicated with pulmonary infections

目的了解中西医联合用药治疗脑梗死患者肺部感染的疗效,为中医院脑病科病区预防控制医院感染提供参考。方法选取2008年1月-2013年6月脑病科收治的脑梗死合并肺部感染患者231例,将其随机分为治疗组126例和对照组105例;两组均给予相同的常规治疗手段,治疗组加用中药汤剂治疗,观察两组的临床症状改善时间、药物不良反应,检测T淋巴细胞亚群指标,治疗3个疗程后评价治疗效果。结果治疗组的咳嗽、咳痰液、发热、湿啰音的改善时间均显著低于对照组(t=0.485、0.619、0.449、0.540,P<0.05),对照组治疗3个疗程后的CD4+和CD4+/CD8+比值显著高于治疗前(t=0.656、0.570,P<0.05);治疗组治疗3个疗程后的CD4+和CD4+/CD8+比值显著高于治疗前,CD8+显著低于治疗前(t=0.479、0.619、0.653,P<0.05);治疗组治疗3个疗程后的CD4+和CD4+/CD8+比值显著高于对照组(t=0.607、0.524,P<0.05);治疗3个疗程后,治疗组的总有效率96.8%,显著高于对照组(χ2=4.056,P<0.05);对照组的药物不良反应发生率7.6%,治疗组的药物不良反应发生率7.1%,差异无统计学意义。结论中西医联合用药治疗脑梗死患者肺部感染具有较高的疗效,不增加不良反应的发生,具有较高的临床推广价值。

OBJECTIVE To understand the efficacy of Chinese and western medicine therapy in treatment of the cerebral infarction patients complicated with pulmonary infections so as to provide guidance for prevention and control of nosocomial infections in the ward of encephalopathy department.METHODS A total of 231 cerebral infarction patients complicated with pulmonary infections who were treated in the department of encephalopathy from Jan2008 to Jun 2013 were enrolled in the study and randomly divided into the treatment group with 126 cases and the control group with 105cases;both groups were treated with the same conventional therapy,and the treatment group was given additional traditional Chinese medicine decoction;the time of improvement of clinical symptoms and the drug-induced adverse events were observed and compared between the two groups,the indicators of T lymphocytes subsets were detected,and the therapeutic effect was evaluated after three treatment courses.RESULTS The time of improvement of the cough,expectoration,fever,and moist rales of the treatment group was significantly shorter than that of the control group（t=0.485,0.619,0.449,0.540,P〈0.05）.The CD4^＋and CD4^＋/CD8^＋of the control group were significantly higher after the three treatment courses than before the treatment（t=0.656,0.570,P〈0.05）;the CD4^＋and CD4^＋/CD8^＋of the treatment group were significantly higher after the three treatment courses than before the treatment,while the CD8^＋was significantly lower after the three treatment courses than before the treatment（t=0.479,0.619,0.653,P〈0.05）;after the three treatment courses,the CD4^＋and CD4^＋/CD8^＋of the treatment group were significantly higher than those of the control group（t=0.607,0.524,P〈0.05）.After the three treatment courses,the total effective rate of treatment of the treatment group was 96.8%,significantly higher than that of the control group（χ^2=4.056,P〈0.05）.The incidence rate of drug-induced adverse events was 7.6%in the control group,7.1%in the treatment group,there was no significant difference.CONCLUSION The Chinese and western medicine combination therapy can achieve good effect on treatment of the cerebral infarction patients complicated with pulmonary infections,without the increase of incidence of the adverse events,and it is worthy to be promoted in the hospital.