中西医结合治疗产超广谱β-内酰胺酶细菌感染相关性肺炎的临床观察

The clinical contrast research of the treatment of traditional Chinese medicine combined with western ;medicine for ESBLs bacterial infection associated pneumonia

目的：探讨中西医结合治疗产超广谱β-内酰胺酶（ESBLs）细菌感染相关性肺炎的临床疗效。方法收集80例产ESBLs细菌感染相关性肺炎患者，根据随机数字表法，将其分为对照组（西药常规治疗）和观察组（中西医结合治疗），每组40例，比较两组临床症状及体征消失时间及住院时间、痰细菌学培养结果，以及两组的临床疗效。结果与对照组相比，观察组患者咳嗽消失时间[（6．5±1．3）d比（8．2±1．5）d， t＝4.38，P＜0．05]、发热消失时间[（5．1±1．2）d比（6．8±1．4）d，t＝4．19，P＜0．05]、肺部啰音消失时间[（6.2±1．3）d比（7．8±1．6）d，t＝4．27，P＜0．05]及住院时间[（9．1±1．3）d比（11．8±1．6）d，t＝5．06，P＜0．05]均明显缩短；与对照组相比，观察组痰肺炎克雷伯菌（25．0％比8．0％，χ2＝4．30，P＜0．05）和大肠埃希菌（70．0％比60.0％，χ2＝4．75，P＜0．05）转阴率明显增高；与对照组相比，观察组患者治疗的显效率明显提高（92．5％比75．0％，χ2＝4．50，P＜0．05）。结论中西医结合治疗能够提高对产ESBLs细菌感染相关性肺炎的临床疗效，提高痰细菌转阴率，值得临床推广。

Objective To study the clinical efficacy of the treatment of traditional Chinese medicine combined with western medicine for extended -spectrum β-lactamase （ESBLs ） bacterial infection associated pneumonia.Methods 80 patients with ESBLs bacterial infection associated pneumonia in our hospital from January 2015 to June 2016 were randomized into the control group （western medicine routine treatment）and the observation group （treatment of traditional Chinese medicine combined with western medicine）according to the random number method,40 patients in each group.The disappearance time of clinical symptoms and signs and hospitalization time, sputum culture results,and the clinical efficacy of treatment in the two groups were compared.Results Compared with the control group,the disappearance time of cough[（6.5 ±1.3）d vs （8.2 ±1.5）d],t=4.38,P〈0.05],fever [（5.1 ±1.2）d vs （6.8 ±1.4）d,t=4.19,P〈0.05],pulmonary rales[（6.2 ±1.3）d vs （7.8 ±1.6）d,t=4.27,P〈0.05]and the hospitalization time[（9.1 ±1.3）d vs （11.8 ±1.6）d,t=5.06,P〈0.05]were significantly reduced in the observation group.Compared with the control group,the negative rates of pneumonia klebsiella （25.0% vs 8.0%,χ2 =4.30,P〈0.05）and Escherichia coli （70.0%vs 60.0%,χ2 =4.75,P〈0.05）in sputum were obviously increased in the observation group.Compared with the control group,the markedly effective rate of treatment was significantly improved in the observation group（92.5%vs 75.0%,χ2 =4.50,P〈0.05）.Conclusion The treatment of traditional Chinese medicine combined with western medicine can significantly increase the clinical efficacy of ESBLs bacterial infection associated pneumonia,improve the negative rates of sputum bacteria,and it is worthy of clinical promotion.