基于伏邪理论的清透法对ICU耐药菌肺部感染患者耐药菌清除率及脱机成功率的影响

Effects of clearing-expelling method based on Fu-Xie theory on clearance rate of drug-resistance bacteria and successful rate of ventilator weaning in ICU pulmonary infection patients with drug-resistance bacteria

目的分析ICU耐药菌肺部感染且接受机械通气治疗患者的临床资料,客观评价基于伏邪理论的清透法的临床价值。方法釆用回顾性研究方法,分析2012年1月1日—2013年12月31日中国中医科学院广安门医院ICU符合耐药菌肺部感染诊断且机械通气的患者112例,在常规治疗基础上,按是否服用清透法方药,分为治疗组58例和对照组54例。观察时间为7天和14天,比较2组患者血C-反应蛋白含量(CRP)、血小板(PLT)、耐药病原菌清除率、机械通气时间及脱机成功率等指标的变化。结果 2组治疗第7、14天后CRP、PLT比较差异有统计学意义(P<0.01);治疗组耐药病原菌清除率79.3%,对照组59.2%;2组机械通气时间及脱机成功率比较差异均有统计学意义(P<0.01)。结论基于伏邪理论的清透法可提高ICU耐药菌肺部感染且机械通气患者的耐药菌清除率,改善其机体炎症反应及凝血功能,从而降低机械通气时间,提高脱机成功率。

Objective To analyze the clinical data of patients who underwent ventilator with drug-resistant pulmonary infection in ICU,so as to objectively evaluate the clinical value of clearing-expelling method based on Fu-Xie theory. Methods By retrospective study method,112 patients who met the diagnosis of drug-resistant pulmonary infection and received ventilator in ICU from January1 st,2012 to December 31 st,2013 in Guang＇anmen Hospital were analyzed. All the cases were divided into a treatment group（ 58cases） and a control group（ 54 cases） according to whether they were treated with clearing-expelling method. The observation period was 7 and 14 days. Levels of C-reactive protein,platelet,clearance rate of drug-resistant pathogen,the mechanical ventilation time and the successful rate of ventilator weaning were compared between groups. Results The differences of CRP and PLT after 7 days and14 days in two groups were statistically significant（ P〈0. 01）. The clearance rate of drug-resistant pathogenic bacteria was 79. 3% in the treatment group and 59. 2% in the control group. Compared between the mechanical ventilation time and successful rate of ventilator weaning,the differences were statistically significant（ P〈0. 01）. Conclusion The clearing-expelling method based on Fu-Xie theory could increase the clearance rate of drug-resistance bacteria and improve the body＇s inflammatory response and coagulation function,leading to a lower duration of mechanical ventilation and more successful rate of ventilator weaning.