耐药菌肺炎中医证候分布及演变规律文献研究

Literature Study on Distribution and Evolution of Traditional Chinese Medicine Syndromes of Drug-resistant Pneumonia

目的基于文献探讨耐药菌肺炎的中医证候分布及演变规律,为临床诊治及证候研究提供参考。方法检索知网、万方、维普数据库中涉及耐药菌肺炎证候的文献,并筛选文献,建立Excel数据库,统计各证候分布比例及其演变规律。结果共检索出159篇,最终纳入19篇;其中医证候分布前五依次为痰热蕴肺、气阴亏虛、邪在肺卫、热陷心包、肺胃热炽;其演变规律从第一天以痰热壅肺证为主,逐渐演变以气阴亏虚证为主;耐药菌以铜绿假单胞菌、鲍曼不动杆菌、肺炎克雷白杆菌、金黄色葡萄球菌、大肠埃希菌为主,感染菌株以革兰阴性杆菌为主。结论耐药菌肺炎的中医证候前期以邪实证为主,以痰热蕴肺多见,随着病情的缓解及进展,后期逐渐转为本虚症为主,以气阴亏虛为主;可能耐药菌或者抗生素容易伤及人体气阴。

Objective To explore the distribution and evolution of traditional Chinese medicine syndromes of drug-resistant pneumonia based on literature, so as to provide reference for clinical diagnosis, treatment and syndrome research.Methods The literaturerelated to the syndrome of drug-resistant bacteria pneumonia in CNKI, Wanfang and VIP databases were searched, and the literaturewas screened to establish Excel database, and the distribution ratio and evolution rule of each syndrome were counted.Results A total of 159 papers were retrieved and 19 were included.The top five traditional Chinese medicine syndromes were phlegm-heat accumulation of the lung, deficiency of Qi and Yin, evil in the lung, heat entrapment of the pericardium, and heat burning of the lung and stomach.The evolution rule of the syndrome was mainly phlegm-heat obstructing the lung on the first day, and gradually evolved to bethe deficiency of Qi and Yin.The drug-resistant bacteria were pseudomonas aeruginosa, Acinetobacter baumannii, Klebsiella pneumoniae, Staphylococcus aureus, Escherichia coli, and the infection strain was mainly gram-negative bacteria.Conclusion The traditional Chinese medicine syndromes of drug-resistant pneumonia are mainly manifested by evils in the early stage, and phlegm-heat accumulating in the lung is more common.With the remission and progress of the disease, it gradually turns to the main deficiency syndrome in the later stage, mainly due to the deficiency of Qi and Yin. Medicinal bacteria or antibiotics can easily damage the body’s Qi and Yin.