人参败毒散加减联合西药治疗重症肺炎患者多重耐药菌感染的临床效果

Clinical effect of modified Renshen Baidu powder combined with western medicine in the treatment of severe pneumonia patients with multi-drug resistant bacteria infection

目的观察人参败毒散加减联合西药治疗重症肺炎患者多重耐药菌(MDRB)感染的临床效果。方法收集2020年1月至2022年7月成都中医药大学附属医院全科医学科收治的重症肺炎MDRB感染130例患者的临床资料进行回顾性研究。根据是否联用人参败毒散将患者分为观察组和对照组,各65例。对照组采用常规西药治疗,观察组在对照组基础上给予人参败毒散加减治疗。比较2组患者治疗2周后临床疗效及治疗前后中医证候积分、临床肺部感染评分(CPIS)、血气分析指标[动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))、氧合指数]、炎症反应指标[白细胞计数(WBC)、C反应蛋白(CRP)、降钙素原]水平及不良反应发生率。结果观察组治疗后总有效率高于对照组[92.3%(60/65)比80.0%(52/65)](P<0.05)。治疗后,2组患者中医证候积分及CPIS均低于治疗前,且观察组均低于对照组(均P<0.05)。治疗后,2组患者PaO_(2)、氧合指数均高于治疗前,PaCO_(2)、WBC、CRP、降钙素原水平均低于治疗前,且观察组改善更明显(均P<0.05)。2组不良反应发生率比较,差异无统计学意义(P=0.676)。结论人参败毒散加减联合西药治疗重症肺炎患者MDRB感染临床效果明确,能显著控制感染,抑制肺部炎症反应,提高氧合指数,改善肺功能,缓解临床症状。

Objective To observe the clinical effect of modified Renshen Baidu powder combined with western medicine in the treatment of severe pneumonia patients with multi-drug resistant bacteria(MDRB)infection.Methods From January 2020 to July 2022,a retrospective study was conducted on the clinical data of 130 severe pneumonia patients with MDRB infection who were admitted to the Department of General Medicine,Hospital of Chengdu University of Traditional Chinese Medicine.Patients were divided into observation group and control group according to whether Renshen Baidu powder was used in combination,with 65 cases in each group.The control group was treated with conventional western medicine,and the observation group was treated with Renshen Baidu powder on the basis of control group.The clinical effect on the patients 2 weeks after treatment and the levels of traditional Chinese medicine syndrome score,clinical pulmonary infection score(CPIS),blood gas analysis indexes[partial pressure of arterial oxygen(PaO_(2)),partial pressure of arterial carbon dioxide(PaCO_(2)),oxygenation index],and inflammatory response indexes[white blood cell count(WBC),C-reactive protein(CRP),procalcitonin]before and after treatment and the incidence of adverse reactions were compared between the two groups.Results The total effective rate in the observation group was significantly higher than that in the control group after treatment[92.3%(60/65)vs 80.0%(52/65)](P<0.05).After treatment,the traditional Chinese medicine syndrome score and CPIS in both groups were lower than those before treatment,and those in the observation group were lower than those in the control group(all P<0.05).After treatment,PaO_(2) and oxygenation index in both groups were higher than those before treatment,levels of PaCO_(2),WBC,CRP and procalcitonin were lower than those before treatment,and the improvement in the observation group was more obvious(all P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P=0.676).Conclusion The clinical effect of Renshen Baidu powder combined with western medicine on the treatment of severe pneumonia patients with MDRB infection is clear.It can significantly control infection,inhibit pulmonary inflammatory reaction,improve oxygenation and lung function and alleviate clinical symptoms.