联合用药治疗儿童下呼吸道感染的疗效及安全性探讨

The Curative Effect and Safety Evaluation of Combination Treatment of Children's Lower Respiratory Infection

目的 :探讨联合用药治疗儿童下呼吸道感染的疗效及安全性。方法 :通过医院信息系统(HIS),筛选出2016年2月-2017年2月在濮阳市妇幼保健院儿科住院并确诊为细菌性下呼吸道感染的患儿220例,根据给药方案不同分为治疗组100例和对照组120例,治疗组采用注射用头孢唑肟钠(50 mg/kg,q8h)治疗,对照组采用注射用头孢唑肟钠(同治疗组)联合热毒宁注射液(0.5~0.8 m L/kg,qd)治疗,每天最高剂量不超过10 m L,比较两组临床疗效及不良反应情况。结果:治疗组与对照组临床总有效率分别为91.00%,91.66%,差异无统计学意义(P>0.05)。治疗组检出病原菌93株,经治疗清除病原菌87株,细菌清除率为93.55%;对照组检出病原菌106株,经治疗清除病原菌100株,细菌清除率为94.34%。两组比较差异无统计学意义(P>0.05)。治疗组不良反应发生率为4.00%,对照组为9.17%,两组不良反应发生率比较有统计学意义(P<0.05)。结论 :注射用头孢唑肟钠与热毒宁注射液联合应用应严格遵循中药辨证施治的原则,并对这两种药物联合应用的安全性密切关注。

Objective:To investigate the efficacy and safety of combined drug therapy for children with lower respiratory tract infection. Methods:Through the hospital information system(HIS), 220 children hospitalized in the department of paediatrics in Puyang Maternal and Child Health-care Hospital from February 2016 to February 2017 and diagnosed of bacterial lower respiratory tract infection were screened out, and divided to study group(100 cases) and control group(120 cases) according to different dosing scheme. The treatment of the study group was cefazoxime sodium injection(50 mg/kg, q8 h), while the treatment of the control group was the combined injection of cefazoxime sodium(same with study group) and thermo-toxin(0.5~0.8 m L/kg, qd), the maximum dosage was less than 10 m L. The clinical efficacy and adverse effects were compared. Results:The total clinical efficiency of the treatment group and the control group was 91.00% and 91.66%, respectively, and the difference was not statistically significant(P>0.05). 93 strains of pathogenic bacteria were detected in the treatment group, 87 strains were cleared after the treatment, the bacterial clearance rate was 93.55%. 106 strains were detected in the control group, 100 strains of pathogenic bacteria were cleared after the treatment, and the bacterial clearance was 94.34%. There was no statistically significant difference between the two groups(P>0.05). The incidence of adverse reactions was 4.00% and 9.17% respectively, and the incidence in the two groups was statistically significant(P<0.05). Conclusion:The combine treatment of cefazoxime sodium and thermo-toxin should strictly follow the principle of traditional Chinese medicine dialectical treatment, and the safety of combined treatment of two medicine should be closely monitored.