通腑理肺汤结肠透析联合纤维支气管镜肺泡灌洗对肺炎合并脓毒症患者临床疗效影响

The Clinical Effect of Colon Dialysis with Tongfu Lifei Decoction Combined Fiber Bronchoscope Alveolar Lavage on Treating Patients with Pneumonia Complicated Sepsis

目的:探讨通腑理肺汤结肠透析联合纤维支气管镜肺泡灌洗对肺炎合并脓毒症患者的临床疗效。方法:将90例肺炎合并脓毒症患者按随机数字表达法分为3组,每组30例,第1组为通腑理肺汤结肠透析并纤支镜灌洗肺泡组(治疗组A),第2组为温水结肠透析并纤支镜灌洗肺泡组(治疗组B),第3组为温水结肠透析组(对照组),观察3组患者治疗前后临床疗效以及对中医证候学积分、急性生理学与慢性健康状况评分系统Ⅱ(APACHEⅡ)评分,呼吸机机械通气时间(h),脱机成功率(%),ICU住院时间(d)的影响。结果:治疗组A总有效率93.3%,治疗组B总有效率80%,对照组总有效率50%,3组比较,差异有统计学意义(P<0.05);3组患者治疗前中医证候学积分、APACHEⅡ评分无统计学差异,治疗后中医证候学积分、APACHEⅡ均有所降低,治疗后2周治疗组A显著低于治疗组B及对照组,差异有统计学意义(P<0.05)。3组治疗后呼吸机使用时间(h)、脱机成功率(%)、ICU住院时间(d)明显缩短,治疗2周后与对照组同期比较差异有统计学意义(P<0.05)。结论:通腑理肺汤结肠透析联合纤维支气管镜肺泡灌洗能显著提高患者的临床疗效,改善患者预后。

Objective：To study the influence of colon dialysis with Tongfu Lifei Decoction and combined fiberoptic bronehoscopy alveolar lavage for the clinical efficacy of patients with pneumonia complicated sepsis.Methods： 90 patients with pneumonia complicated sepsis were divided dom number expression 30 cases in each group. The first group was To into three groups according to the ran- ngfulifei Decoction colon dialysis combined fiberoptic bronchoscopy alveolar lavage treatment group （ treatment group （A） ）. The second group was warm water colon dialysis combined fiberoptic bronchoscopy alveolar lavage treatment group （treatment group （B） ）, and the third group was warm water colon dialysis group （ control group）. The clinical efficacy of the patients in the three groups were observed before and after treatment, and the influence on TCM syndrome integral, Acute physiology and chronic health evaluation scoring system II （APACHE II）, mechanical ventilation time （h）, weaning success rate （ % ）, ICU length of stay （d）. Results ： A total efficiency of the treatment group , the treatment group B and the control group were 93.3% , 80% and 50% respectively. The difference of the three groups was statistically significant （P 〈 0. 05 ） ; The TCM Syndrome score and the APACHE Ⅱ were no significant difference before treatment for three groups of patients. The TCM Syndrome score and APACHE Ⅱ decreased after treatment, which was lower in the treatment group A than in the control group and in the treatment groujp B. The difference was statistically significant （ P 〈 0.05 ）. After treatment, the ventilator time （h） weaning success rate（ % ）and ICU length of stay （d） were significantly shorter in the three groups. Compared with the same period in the control group after two weeks of treatment, with statistical significance （ P 〈 0. 05 ）. Conclusion： Colon Dialysis with Tongfu Lifei Decoction combined fiber bronchoscope alveolar lavage can significantly improve the clinical curative effect, and the patient prognosis.