西医常规治疗联合清气凉营汤鼻饲对急诊呼吸机相关性肺炎患者炎症反应、肺功能及中医证候评分的影响

Effect of routine treatment of western medicine combined with nasal feeding of qingqi liangying decoction on inflammatory reaction,pulmonary function and TCM syndrome score in emergency patients with ventilator-associated pneumonia

目的探讨西医常规治疗联合清气凉营汤鼻饲对急诊呼吸机相关性肺炎患者炎症反应、肺功能及中医证候评分的影响。方法选取急诊呼吸机相关性肺炎(中医辨证为气营两燔证)患者100例,随机分为试验组和对照组。试验组予常规西医治疗结合清气凉营汤鼻饲治疗,对照组予常规西医治疗。比较2组患者治疗后疗效、中医症候评分、C反应蛋白(CRP)、降钙素原(PCT)及白细胞计数(WBC)、肺活量(VC)、最大自主分钟通气量(MVV)和1 s用力呼气容积(FEV_1)的水平。结果与治疗前比较,2组患者治疗后的中医证候总积分、舌象、脉象、症状及体征积分均显著下降(P<0.05),且对照组显著高于试验组(P<0.05)。与治疗前比较,2组患者治疗后的MVV、VC及FEV_1均显著增高(P<0.05),且对照组显著低于试验组(P<0.05)。与治疗前比较,2组患者治疗后的PCT、CRP水平均显著降低(P<0.05),WBC显著升高(P<0.05),且试验组显著优于对照组(P<0.05)。结论清气凉营汤鼻饲联合西医常规治疗具有抑制炎症反应、提高疗效、减低中医证候评分、改善肺功能等优势。

Objective To explore the effect of western medicine combined with qingqi liangying decoction by nasal feeding on the inflammatory reaction,pulmonary function and TCM syndrome score in emergency patients with ventilator-associated pneumonia.Methods A total of 100 emergency patients with ventilator-associated pneumonia(TCM differentiation as syndrome of flaring heat in qifen and yingfen)were selected and randomly divided into control group and experimental group.The experimental group was treated with routine western medicine and qingqi liangying decoction by nasal feeding,while the control group was given routine treatment of western medicine.The curative effect,TCM symptom score,C reactive protein(CRP),procalcitonin(PCT),white blood cell count(WBC),vital capacity(VC),the largest independent minute ventilation(MVV)and forced expiratory volume(FEV 1)were compared.Results Compared with before treatment,the total score of TCM syndrome,tongue image,pulse condition,symptoms and signs scores of the two groups after treatment significantly decreased(P<0.05),and the indexes of control group were significantly higher than the experimental group(P<0.05).Compared with before treatment,the MVV,VC and FEV 1 of the two groups after treatment significantly increased(P<0.05),and the indexes of control group were significantly lower than the experimental group(P<0.05).Compared with before treatment,the levels of PCT and CRP in the two groups after treatment significantly decreased(P<0.05),WBC significantly increased(P<0.05),and the indexes of experimental group were significantly better than the control group(P<0.05).Conclusion Qingqi liangying decoction by nasal feeding combined with western medicine can inhibit the inflammation,improve the curative effect,reduce the TCM syndrome score and improve lung function.