临床药师参与1例中西医结合治疗肺部感染患者的用药分析

目的:探讨以药物治疗为重点的临床思维,总结药学服务经验。方法:临床药师对1例中西医结合治疗肺部感染患者进行用药分析,根据抗菌药物临床应用指导原则评估抗感染治疗方案,即给予哌拉西林/他唑巴坦联用左氧氟沙星覆盖常见病原体,病情好转后将左氧氟沙星改为阿奇霉素口服治疗;考虑抗生素相关性腹泻,停用静脉抗菌药物,给予甲硝唑0.4 g、tid口服治疗,地衣芽孢杆菌活菌胶囊、双歧杆菌三联活菌胶囊调节肠道菌群,并口服氟康唑200 mg、qd抗真菌治疗;中药以调理脾胃、渗湿止泻为主。结果:患者感染得以控制,腹泻明显好转,出院继续相关治疗。结论:在西医辨病的同时以中医理论为指导进行辨证,可以改善患者的免疫功能和营养状态,从而控制感染、减少复发。

Analysis of Drug Use in a Patient with Pulmonary Infection Treated with Integrated Traditional Chinese and Western Medicine Therapey by Clinical Pharmacists

OBJECTIVE： To discuss the clinical thinking which focuses on drug therapy, and to summarize the experiences of pharmaceutical care. METHODS： Drug use in a patient with pulmonary infection treated with integrated traditional Chinese and western medicine therapy was analyzed by clinical pharmacist and anti-infective plan was evaluated according to principle for clinical use of antibiotics： for common pathogen, piperacillin/tazobactam combined with levofloxacin were given, and oral administration azithromycin replaced levofloxacin if the disease condition was improved; for antibiotics-related diarrhea, intravenous antibiotics was cancelled and metronidazole 0.4 g was given orally, tid; Bacillus licheniformis capsule and Bifid triple viable capsule were used to regulate intestinal flora, and fluconazol 200 mg was given orally as antifungal therapy; TCM was mainly used for regulating spleen and stomach, excreting dampness and stopping diarrhea. RESULTS： The pulmonary infection had been controlled and diarrhea was also improved. The patient received relevant treatment after discharging from the hospital. CONCLUSIONS： Western medicine is combined with TCM theory for disease diagnose can improve immunologic function and nutritional status so as to control the infection and reduce disease reolase.