参附注射液辅助治疗重症社区获得性肺炎的回顾性临床研究

Retrospective Clinical Study of the Efficacy of Shenfu Injection in the Adjuvant Treatment of Severe Community-acquired Pneumonia

目的:探讨参附注射液辅助治疗重症社区获得性肺炎的临床疗效和安全性。方法:采用回顾性研究方法,收集2013年1月~2015年12月我院重症医学科(ICU)收治的重症社区获得性肺炎住院患者68例。根据治疗方法分为对照组和参附注射液组各34例。两组患者均给予辅助呼吸、祛痰和抗感染等常规治疗,参附注射液组在常规治疗基础上加用参附注射液60 ml,ivd,qd,疗程14 d。收集两组患者使用抗菌药物情况、气管吸物细菌学检查结果,比较两组患者治疗前、治疗7 d与14 d后的氧合指数、C反应蛋白(CRP)、急性生理与慢性健康评分(APACHEⅡ)、序贯器官衰竭估计评分(SOFA)等指标变化,和治疗7 d、14 d与治疗前各项指标的差值;以及两组总有效率和药品不良反应发生情况。结果:治疗前,参附注射液组氧合指数、CRP、APACHEⅡ评分及SOFA评分等观察指标均明显高于对照组(P<0.05)。两组患者使用抗菌药物情况及气管吸物细菌学检查结果比较,差异无统计学意义(P>0.05)。治疗7 d后,两组患者氧合指数等观察指标差异无统计学意义(P>0.05),治疗14 d后,两组患者氧合指数和CRP差异无统计学意义(P>0.05),APACHEⅡ评分和SOFA评分差异有统计学意义(P<0.05)。两组患者各项观察指标治疗7 d与治疗前的差值比较,氧合指数和CRP差异无统计学意义(P>0.05),APACHEⅡ评分及SOFA评分差异有统计学意义(P<0.05);治疗14 d与治疗前的差值比较,差异均有统计学意义(P<0.05)。参附注射液组总有效率为88.23%,明显高于对照组的67.65%(P<0.05)。治疗期间两组患者均未见明显药品不良反应发生。结论:在常规治疗的基础上联用参附注射液辅助治疗重症社区获得性肺炎,具有一定的临床应用价值。

Objective： To analyze the clinical dlinical efficacy and safety of Shenfu injection in the treatment of severe community- acquired pneumonia. Methods： Totally 68 patients with severe community-acquired pneumonia selected from ICU of our hospital were divided into the control group and Shenfu injection group with 34 cases in each. The basic therapy was adopted in both groups, such as assisted respiration, expectorant and anti-infection, and 60 ml Shenfu injection was additionally used in Shenfu injection group, ivd, qd, and the treatment course was 14 days. The results of bacteriological examination of endotracheal aspirate and the use of antibiotics in the two groups were collected and analyzed. The changes of the oxygenation index, C-reactive protein （ CRP）, APACHE Ⅱ score and SOFA score were compared between the groups before the treatment and after 7-day, 14-day treatment, and the difference values of the above indices before and after the treatment were calculated, and the total effective rate and adverse reactions between the groups were also recorded and compared. Results： The observation indices of Shenfu injection group were higher than those of the control group before the treatment （ P 〈 0.05 ）. After the treatment, the results of bacteriological examination of endotracheal aspirate and the use of antibiotics had no statistical significance between the groups （P 〉 0.05 ）. After the 7-day treatment, the oxygenation index, CRP, APACHE Ⅱ score and SOFA score of the two groups were all better than those before the treatment without statistical difference （ P 〉 0.05 ）. After the 14-day treatment, there was no significant differences in the oxygenation index and CRP between the groups （P 〉 0.05 ）, and the differences in the APACHE Ⅱ score and the SOFA score were statistically significant （ P 〈 0.05 ）. There was no significant differences in the oxygenation index and CRP before the treatment and after the 7-day treatment in both groups, while the differences in the APACHE Ⅱ score and SOFA score were statistically significant （P 〈 0.05）. The differences in all the indices before the treatment and after the 14-day treatment were statistically significant in both groups （ P 〈 0.05 ）. The effective rate was higher in Shenfu injection group than that in the control group （88.23% vs 67.65% ,P 〈0.05 ）. No severe side effects were found during the whole study. Conclusion： The routine therapy combined with Shenfu injection for severe community-acquired pneumonia has beneficial clinical application value.