中西医结合治疗呼吸机相关性肺炎疗效及对感染诊断标志物的影响

目的：观察中西医结合治疗呼吸机相关性肺炎（VAP）的疗效及其对感染诊断标志物 PCT、WBC 及hs-CRP 的影响。方法选取本院重症监护病房（ICU）接受治疗的 VAP 患者72例，随机分为治疗组和对照组，各36例。对照组采用基础治疗加早期足量广谱抗菌药物控制感染，治疗组在对照组治疗基础上加用清肺解毒汤，疗程均为7 d。比较2组用药前后中医证候积分、WBC、血清 PCT、hs-CRP 及临床疗效变化。结果2组治疗前后在中医证候积分、WBC、PCT、hs-CRP 水平方面明显降低，差异具有统计学意义（P ＜0.05），治疗组与对照组治疗后比较差异具有统计学意义（P ＜0.05）；治疗组临床总有效率94.44％，明显高于对照组的72.22％（P ＜0.05）。结论清肺解毒汤联合西药治疗 VAP 能够明显降低中医证候积分及 WBC、PCT、hs-CRP 水平，改善预后。

Lung detoxification soup for treatment of patients with ventilator associated pneumonia

objective To observe the clinical efficacy of lung detoxification soup for treatment of patients with venti-lator associated pneumonia(VAP)and its effects on serum procalcitonin(PCT),high sensitivity C reactive protein (hs-CRP)and white blood cell count(WBC). Methods The 72 cases of patients with anal fistula were divided into the treatment group and the control group,36 cases in each. In the control group,mechanical ventilation,anti-infec-tion,prevention of stress ulcer,early enteral nutrition,early weaning of ventilator and conventional western medicine treatment were given to the patients,while in the treatment group,based on the above conventional treatments in the control group,additionally the lung detoxification soup was given. The therapeutic course was 7 days in both groups. The changes of TCM syndrome integral,levels of serum PCT,hs-CRP and WBC before and after treatment and the clinical efficacy were compared between the two groups. Results After treatment,the TCM syndrome integral,the levels of WBC,serum PCT,hs-CRP were significantly lower than those before treatment in both groups. Compared with the control group,the treatment group after treatment in TCM syndrome integral,WBC,PCT,hs-CRP levels were de-creased(P < 0. 05);the clinical efficiency of the treatment group was significantly higher than that in the control group,with significant difference(P < 0. 05). Conclusion The lung detoxification soup can significantly improve the clinical symptoms,reduce the levels of WBC,serum PCT and hs-CRP in patients of VAP with TCM syndrome of accu-mula of phlegm and heat in lung,to improve the prognosis.