针刺联合大承气汤灌肠对重症肺炎患者肺部感染控制窗的影响

Effects of Acupuncture Combined with Dachengqi Decoction Enema on Pulmonary Infection Control Window of the Patients with Severe Pneumonia

目的观察针刺联合大承气汤灌肠对重症肺炎患者肺部感染控制窗以及机械通气时间的影响。方法将重症肺炎患者62例随机分为治疗组与对照组各31例,分别使用针刺足三里联合大承气汤灌肠治疗与单纯西药治疗。比较两组患者中医证候评分(TCMSS)、感染控制窗时间、机械通气时间、抗生素疗程、住院时间、二重感染发生率以及各组患者降钙素原(PCT)、C反应蛋白(CRP)等指标的差异。结果治疗组与对照组在抗生素疗程、感染控制窗时间、机械通气时间方面差异有统计学意义(P<0.05);但两组在住院时间、二重感染发生率方面差异无统计学意义(P>0.05)。两组治疗后中医证候评分较治疗前下降,治疗组优于对照组(P<0.05);两组治疗后PCT、CRP水平差异有统计学意义(P<0.05)。结论使用针刺足三里联合大承气汤灌肠治疗重症肺炎患者较单纯西药相比,明显改善患者中医证候评分,缩短机械通气时间和抗生素疗程。

Objective： To observe the effects of acupuncture combined with Dachengqi Decoction enema on pulmonary infection control window and mechanical ventilation time of the patients with severe pneumonia.Methods： 62 patients of severe pneumonia were randomly divided into two groups： the treatment group were treated with acupuncture at Zusanli and Dachengqi Decoction enema once a day combined with Western medicine. The control group were only treated with Western medicines. Two groups of patients were compared in TCM symptom score（TCMSS）,infection control window time（PCIW）,mechanical ventilation time,antibiotic treatment course,hospitalization time,double infection incidence and the difference of calcitonin（PCT） and C-reactive protein（CRP） in each group. Results： There were significant differences between the treatment group and the control group in the course of antibiotic treatment,the time of infection control window,and the time of mechanical ventilation（P〈0.05）. However,there was no statistical difference between the two groups in the time of hospitalization and the incidence of double infection（P〈0.05）. The score of TCM syndrome in the two groups was lower than that before the treatment. That of the treatment group was better than that of the control group,and the difference was statistically significant（P〈0.05）. The levels of PCT and CRP in the two groups were statistically different after treatment（P〈0.05）. Conclusion： Compared with only Western medicine,the acupuncture at Zusanli combined with Dachengqi Decoction enema on severe pneumonia patients can obviously improve the score of TCM syndrome,and shorten the time of mechanical ventilation and the course of antibiotics.