耐药肺炎克雷伯杆菌肺炎中医证素及证候特点探析

Analysis of syndrome elements and syndrome characteristics of drug-resistant Klebsiella pneumoniae pneumonia

目的探讨耐药肺炎克雷伯杆菌肺炎的中医证素及证候分布特点,为中医辨证用药提供依据。方法收集200例肺炎克雷伯杆菌肺炎住院患者病原学、中医证候特征等临床资料信息,应用SPSS 25.0软件进行统计分析,研究耐药肺炎克雷伯杆菌肺炎患者中医证素及证候特点。结果证素分布上,多重耐药肺炎克雷伯杆菌肺炎患者主要证素为肺与痰。与非产超广谱β-内酰胺酶(extended spectrum beta-lactamases,ESBLs)肺炎克雷伯杆菌肺炎患者相比,产ESBLs肺炎克雷伯杆菌肺炎患者病位证素心神、经络与病性证素闭、气不固的出现频率相对较高,两组差异有统计学意义(P<0.05)。与碳青霉烯类抗生素敏感的肺炎克雷伯杆菌肺炎患者相比,耐碳青霉烯肺炎克雷伯杆菌肺炎患者证素心神、闭的出现频率较高,两组差异有统计学意义(P<0.05)。证候表现上,产ESBLs肺炎克雷伯杆菌肺炎与耐碳青霉烯肺炎克雷伯杆菌肺炎以咳嗽、吐痰、痰黏难咯、舌黯红、苔黄腻、脉细滑为主。结论证素心神、闭与产ESBLs肺炎克雷伯杆菌肺炎和耐碳青霉烯肺炎克雷伯杆菌肺炎相关性较高。高龄老年群体更容易罹患耐药肺炎克雷伯杆菌肺炎,其证候表现进一步印证老年肺炎正气亏虚、热毒炽盛、痰瘀互结之基本病机特点。

Objective To explore the distribution characteristics of traditional Chinese medicine(TCM)syndrome elements and syndromes in cases of drug-resistant Klebsiella pneumoniae pneumonia and to provide a reference basis for its TCM treatment.Methods Collect clinical data from 200 inpatients with Klebsiella pneumoniae pneumonia,including information on etiology and TCM syndrome characteristics.The data will be analyzed using SPSS 25.0 software to investigate the TCM syndrome elements and characteristics in patients with drug-resistant Klebsiella pneumoniae pneumonia.Results The distribution of syndrome elements was analyzed and the results showed that the main syndrome elements in patients with multidrug-resistant Klebsiella pneumoniae pneumonia were lung and sputum.Compared with patients with non-ESBL-producing Klebsiella pneumoniae pneumonia,the frequency of occurrence of disease location syndrome elements(heart and mind),meridians and disease syndrome elements,and qi deficiency was relatively high in patients with ESBL-producing Klebsiella pneumoniae pneumonia,and the difference between the two groups is statistically significant(P<0.05).Additionally,patients with carbapenem-resistant Klebsiella pneumoniae pneumonia had a higher frequency of symptoms,mental state,and closure compared with those who were sensitive to carbapenem antibiotics,and the difference between the two groups was statistically significant(P<0.05).The symptoms associated with ESBL-producing Klebsiella pneumoniae pneumonia and carbapenem-resistant Klebsiella pneumoniae pneumonia were mainly characterized by cough,sputum,sticky sputum,dark red tongue,yellow and greasy fur,and smooth pulse.Conclusion The results showed that syndromes of mind and closure were highly correlated with ESBL-producing Klebsiella pneumoniae pneumonia and carbapenem-resistant Klebsiella pneumoniae pneumonia.The patients in the elderly group were found to be more susceptible to drug-resistant Klebsiella pneumoniae pneumonia,and their symptoms and manifestations further supported the basic pathogenic characteristics of elderly pneumonia,including deficiency of positive qi,hot toxin,and phlegm and blood stasis.