清开灵联合抗生素治疗老年COPD感染临床分析

Clinical Analysis of Qingkailing Combined Medication Treatment of Elderly Patients with COPD Infection

目的:探讨分析清开灵联合抗生素治疗老年慢性阻塞性肺病(COPD)患者合并感染的疗效优越性。方法:按随机数字表法将我院60例COPD患者分为抗生素组30例,根据病原菌结果确定给予敏感抗生素单一治疗;清开灵组30例,给予敏感菌抗生素基础上加用清开灵,分别于治疗前1 d和治疗14 d后第2天评价2组患者的急性生理与慢性健康、呼吸困难量表评分及其临床疗效、细菌感染率比较,同时采集患者空腹静脉检测血清中CRP浓度及肺功能测定FEV1/FVC(%)指标的变化。结果:2组患者治疗前APACHEⅡ评分、呼吸困难评分比较差异无统计学意义;治疗14 d后与抗生素单一治疗组比较,清开灵组APACHEⅡ评分与呼吸困难评分均有显著性降低(t=-9.326,P=0.000 VS t=-18.04,P=0.001);与治疗前比较,清开灵组与抗生素组的CRP范围均呈极显著降低或显著性降低(t=5.341,P=0.000 VS t=1.186,P=0.024),2组患者的FEV1/FVC(%)均较治疗前显著性升高(t=-4.712,P=0.0052VS t=-1.020,P=0.0421);在治疗14 d的临床疗效评定中,2组间比较差异无统计学意义(χ2=2.445,P=0.105),但2治疗组显效率存在显著性差异,清开灵组显示出疗效的优越性(χ2=5.5445,P=0.018);另外,清开灵联合用药组在抗感染及预后方面体现极显著优越性(χ2=5.455,P=0.02)。结论:清开灵联合抗生素应用可以有效纠正老年COPD患者各临床指标,可控制治疗过程中的细菌感染,避免耐药性发生的同时改善其临床症状特征。

Objective： Analysis the advantage of Qingkailing combined antibiotic therapy in elderly COPD patients with infection. Methods： 60 cases in our hospital were randomly divided into antibiotics group（ 30 patierts） and COPD group（ 30patients）,determine a single treatment or not by according to results of pathogenic bacteria sensitive to antibiotics;Qingkailing group of 30 patients received antibiotics on the basis of susceptible plus Qingkailing. Before treatment and 14 days after treatment the next day evaluation comparing the two groups of patients with Acute Physiology and Chronic Health,dyspnea scores and clinical efficacy, bacterial infection; simultaneous acquisition of fasting venous serum CRP concentrations in lung function test changes in FEV1/FVC（ %） indicators. Results： Two groups of patients before treatment APACHE Ⅱ score,dyspnea score compared with no significant difference; After treatment,14 d,compared with antibiotic monotherapy group,Qingkailing group APACHE Ⅱ score and dyspnea scores were significantly decreased（ t =- 9. 326,P = 0. 000 VS t =- 18. 04,P = 0. 001）; compared with before treatment,CRP range Qingkailing group and antibiotic group showed significantly lower or significantly lower（ t = 5. 341,P = 0. 000 VS t = 1. 186,P = 0. 024）,the two groups of patients with FEV1/FVC（ %） than before treatment has increased significantly（ t =- 4. 712,P = 0. 0052 VS t =- 1. 020,P = 0. 0421）; in the treatment of 14 d clinical assessment of efficacy,the two groups had no significant difference（ χ^2= 2. 445,P = 0. 105）,but the two treatment groups was efficient there are significant differences Qingkailing group showed efficacy superiority（ χ^2= 5. 5445,P = 0. 018）; addition,the combined group Qingkailing reflects a significant advantage in terms of resistance to infection and prognosis（ χ^2= 5. 455,P = 0. 02）. Conclusion： Qingkailing combined antibiotics can effectively correct the various clinical parameters in elderly patients with COPD,also can control the course of treatment of bacterial infections,prevent the occurrence of drug resistance while improving the clinical symptoms characteristic,has a significant effect.