重症监护病房真菌耐药监测及与中医证型的关系

目的明确重症监护病房(ICU)侵袭性真菌感染的细菌病原学、耐药性及与中医证型的关系,指导临床经验性使用抗菌药物。方法对中国中医科学院广安门医院2006-03—2007-02ICU患者侵袭性感染真菌及其对抗细菌药物的耐药性进行回顾性调查。结果ICU真菌感染主要以念珠菌为主,念珠菌中以白色念珠菌为最多。真菌感染中医辨证以虚实夹杂证最常见,而又以气阴两虚、痰热互结为最多,实证以痰热内结为主。结论依据真菌病原学、抗菌药物敏感性结果及中医证型分布,有效选择中西医疗法,减少新的耐药株的出现,发挥中医优势。

Relationship between drug-resistance of fungi in ICU and syndrome differentiation of TCM

Objective To clarify etiology and drug-resistance of invasive fungus infection and provide and guideline for clinical practice. Methods A retrospective investigation about patients with both fungus infection and antibiotics-tolerance in ICU of Guang An'men Hospital from Mar 2006 to Feb 2007 has been done. Results The main etiology for infection is candida,specially the candida albicans.In TCM syndrome differentiation, fungus infection is corresponding with excessive and deficient mixed pattern, specially the pattern of qi and yin deficiency and phlegm heat retention, while the main excusive syndrome is phlegm heat retention syndrome. Conclusion According to etiology of fungus infection, sensitivity of antibiotics and syndrome differentiation of TCM, treatment with combination of both western and Chinese medicine is applied to avoid the drug-resistance bacteria and demonstrate advantage of TCM.