中西药联合对多重耐药铜绿假单胞菌体外抗菌作用研究

Study on the antimicrobial effect of integrated Chinese and western medicine on multi-drug resistant pseudomonas aeruginosa

目的研究中西药联合对多重耐药铜绿假单胞菌(MDR-PA)抗菌作用,为临床中西药联合治疗MDR-PA感染提供依据。方法赤芍、五倍子、野菊花、鱼腥草、小檗碱,煎煮法制备提取液,采用两倍稀释法观察中药对细菌的抑菌效果;采用棋盘格稀释法测定中西药的MIC,通过计算部分联合抑菌指数(FIC)的分布评价中西药联合效果。结果五种中药对MDR-PA有不同程度抑菌作用,五倍子对MDR-PA抑菌作用最强;亚胺培南与小檗碱、头孢他啶与五倍子联合有较好的协同相加作用,协同相加率超过80%。环丙沙星与五种中草药联合显示无关作用;三种抗生素与五种中草药联合均无拮抗作用。结论赤芍、五倍子、野菊花、鱼腥草、小檗碱对MDR-PA有不同程度抑制作用;亚胺培南与小檗碱、头孢他啶与五倍子联合可以增加各自对MDR-PA抗菌作用的敏感性。

Objective To study the antimicrobial effect of integrated Chinese and Western medicine on multi-drug resistant pseudomonas aeruginosa(MDR-PA),and provide the clinical basis for the integrated Chinese and western medicine treatment of MDR-PA infection.Methods Extract liquid from Radix Paeoniae Rubra,Chinese Gall,wild chrysanthemum,Houttuynia cordata,berberine was prepared by decocting method.The antibacterial effect of traditional Chinese medicine on bacteria was observed by double dilution method.The MIC of Chinese and western medicine was determined by checkerboard dilution method.The effect of integrated Chinese and western medicine was evaluated by calculating the distribution of partial fractional inhibitory concentration(FIC).Results Five types of traditional Chinese medicine had different degrees of antibacterial effect on MDR-PA,in which the antibacterial effect of Chinese Gall on MDR-PA was the strongest;imipenem had a favorable synergistic effect with berberine,ceftazidime and Chinese Gall,and the synergistic rate combined was over80%.Ciprofloxacin combined with the five Chinese herbs showed no effect;three types of antibiotics combined with five types of Chinese herbs had no antagonistic effect.Conclusion Radix Paeoniae Rubra,Chinese Gall,wild chrysanthemum,Houttuynia cordata,berberine have different degrees of inhibitory effect on MDR-PA.The combination of imipenem with berberine,ceftazidime and Chinese Gall can increase their susceptibility to antibacterial effect against MDR-PA.