健脾益肺化痰中药治疗呼吸机相关性肺炎的临床研究

目的探讨健脾益肺化痰中药雾化吸人治疗呼吸机相关性肺炎（VAP）的临床疗效。方法将82例VAP患者随机分为两组，每组41例。对照组采用西医常规治疗，治疗组在西医常规治疗基础上采用健脾益肺化痰中药雾化吸入，比较两组患者治疗第5天血清CRP及PCT水平及治疗后PaO2／FiO2、CPIS评分，并比较两组患者机械通气时间、抗生素应用时间及ICU治疗时间。结果治疗前两组患者PaO2／FiO2、CPIS评分和血清CRP、PCT水平及中医症候评分差异无统计学意义（P〉0．05），治疗第5天两组患者血清CRP、PCT水平指标均下降，治疗组低于对照组，差异有统计学意义（P〈0．05）；治疗后两组患者PaO2／FiO2较治疗前升高，治疗组高于对照组，CPIS评分较治疗前降低，治疗组低于对照组（P〈0．05），中医症候评分两组均下降，治疗组低于对照组（P〈0．05）；治疗组机械通气时间、抗生素应用时间及ICU治疗时间均低于对照组，差异均有统计学意义（P〈0．05）。结论健脾益肺化痰中药雾化吸入联合西药治疗VAP疗效优于单纯西药治疗，且安全性好，有临床推广价值。

Clinical study on strengthening the spleen and the lung huatan decoction in the treatment of ventilator-associated pneumonia

Objective To investigate the clinical curative effect of Strengthening the spleen and the lung Huatan De- coction with atomization inspiration in the treatment of ventilator-associated pneumonia （VAP）. Methods A total of 82 patients with VAP were randomly divided into two groups, 41 cases in the control group were given routine western medicine, 41 cases in the treatment group were treated with Strengthening the spleen and the lung Huatan Decoction with atomization inspiration based on the conventional western medicine, compared serum CRP and PCT levels on 5th day, and compared PaOJFiO2 and CPIS scores and Traditional Chinese medicine （TCM） symptom scores of patients in two groups after treatment, and compared mechanical ventilation time, antibiotic treatment time and the length of treat- ment in ICU of patients between the two groups. Results Compared PaOJFiO2, CPIS scores, serum CRP, PCT levels of patients before treatment, there was no statistically difference （P 〉0.05）, serum CRP, PCT levels of the patients in two groups decreased on 5th day after treatment, the treatment group was lower than the control group, the differences were statistically significant （P 〈0.05）; PaO2/FiO2 of the patients in the two groups after treatment increased than before treatment, the treatment group was higher than the control group, CPIS scores decreased than before treatment, the treatment group was lower than the control group （P 〈0.05）. TCM symptom scores decreased in both. groups, the treat- ment group was lower than the control group （P 〈0.05）; Mechanical ventilation time, antibiotic treatment time and the length of treatment in ICU of patients in the treatment group were lower than those of the control group, the differences were statistically significant（P 〈0.05）. Conclusion Strengthening the spleen and the lung Huatan Decoction with atom- ization inspiration combined with western medicine in the treatment of VAP is better than that only with western, and the security is good, it is worth the clinical promotion.