健脾养肺汤治疗老年肺部感染机械通气患者临床研究

Clinical Study on Jianpi Yangfei Decoction(健脾养肺汤)in Treatment of Elderly Patients with Pulmonary Infection Undergoing Mechanical Ventilation

目的:观察健脾养肺汤治疗老年肺部感染机械通气患者的临床疗效。方法:选取老年肺部感染机械通气患者60例,按随机数字表法分为对照组与治疗组各30例,两组均予以对症治疗,治疗组在此基础上辅以健脾养肺汤治疗。两组均治疗5 d(1个疗程)。比较两组患者治疗前后的血清炎症因子水平、动脉血气指标水平、中医症状评分、临床肺部感染评分(CPIS)、急性生理学和慢性健康状况评价Ⅱ(APACHEⅡ)评分,以及两组患者ICU停留时间和撤机成功率。结果:治疗后,两组患者血清炎症因子水平、动脉血气指标水平、中医症状评分、CPIS、APACHEⅡ评分较治疗前均改善(P<0.01),且治疗组上述指标水平均优于对照组(P<0.05或P<0.01)。治疗组ICU停留时间短于对照组(P<0.01),撤机成功率高于对照组(P<0.05)。结论:在对症治疗的基础上应用健脾养肺汤,可缓解老年肺部感染机械通气患者的临床症状,缩短ICU停留时间,改善预后,其疗效优于单纯对症治疗。

Objective:To observe the clinical efficacy of Jianpi Yangfei Decoction(健脾养肺汤)on elderly patients with pulmonary infection undergoing mechanical ventilation.Methods:A total of 60 elderly patients with pulmonary infection undergoing mechanical ventilation were divided into control group and treatment group by random number table method,with 30 cases in each group.Both the two groups were given symptomatic treatments,and the treatment group was given Jianpi Yangfei Decoction on the basis of the control group.Patients in both groups were treated for 5 days(1 course of treatment).Levels of serum inflammatory factors,levels of arterial blood gas indicators,traditional Chinese medicine(TCM)symptom scores,clinical pulmonary infection score(CPIS),acute physiology and chronic health evaluationⅡ(APACHEⅡ)score,stay time in ICU and weaning success rate were compared.Results:After treatment,the levels of serum inflammatory factors,levels of arterial blood gas indicators,TCM symptom scores,CPIS,APACHEⅡscore of the two groups were improved compared with those before treatment(P<0.01),and the levels of the above indicators of the treatment group were better than those of the control group(P<0.05 or P<0.01).The stay time in ICU of the treatment group was shorter than that of the control group(P<0.01),and the weaning success rate of the treatment group was higher than that of the control group(P<0.05).Conclusions:On the basis of symptomatic treatments,the application of Jianpi Yangfei Decoction can alleviate the clinical symptoms of elderly patients with pulmonary infection undergoing mechanical ventilation,shorten the stay time in ICU,and improve the prognosis.Its efficacy is better than that of symptomatic treatments alone.