银翘散加减汤联合青霉素治疗化脓性脑膜炎的临床观察

目的观察银翘散加减汤联合青霉素治疗成人化脓性脑膜炎的临床疗效。方法选取60例成人化脓性脑膜炎感染住院患者,随机分为观察组与对照组。对照组单纯给予青霉素治疗,观察组在给予青霉素治疗的基础上额外给予银翘散加减汤。观察并比较2组治疗效果、退热时间、格拉斯评分(GCS)、炎症指标变化以及并发症发生情况等。结果观察组总有效率为83.3%,较对照组的总有效率67.7%有明显提高(P<0.05);与对照组比较,观察组患者退热时间明显缩短,GCS评分明显提高,全血白细胞数(B-WBC)及脑脊液白细胞数(CSF-WBC)均明显降低(P<0.05);治疗前,观察组与对照组血清及脑脊液TNF-α和CRP水平比较差异无统计学意义(P>0.05);与治疗前比较,观察组与对照组治疗后血清、脑脊液TNF-α和CRP水平均明显下降(P<0.05);其中观察组治疗后血清及脑脊液TNF-α水平较对照组明显降低(P<0.05)。结论银翘散加减汤联合青霉素治疗成人化脓性脑膜炎具有显著的疗效,能明显缓解患者发热、意识障碍和炎症因子异常等症状,值得临床进一步推广应用。

Clinical effect of Fructus f orsy thiae decoction combined with penicillin on adult with purulent meningitis

Objective To observe the clinical effect of Fructus forsythiae decoction combined with penicillin on adult with purulent meningitis .Methods 60 patients with adult purulent meningitis infection ,were selected and randomly divided into the observation group and the control group .The control group were simply given penicillin therapy ,while the observation group on the basis of penicillin therapy were given Fructus f orsythiae decoction .The 2 groups of treatment effect ,antifebrile time ,glass scale(GCS) ,in‐flammation index changes and complications were observed and compared .Results The total effective rate of the observation group treatment was 83 .3% ,higher than that of the control group 67 .7% (P<0 .05);compared with the control group ,the patients anti‐febrile time was significantly shortened ,but the GCS score increased significantly .The whole blood leucocyte count(B‐WBC) B and CSF white blood cell count(CSF‐WBC) were significantly reduced(P<0 .05);before the treatment ,the observation group and con‐trol group CSF TNF‐α,CRP levels in serum had no statistical significance(P>0 .05);after the treatment CSF TNF‐αand CRP lev‐els were significantly decreased(P< 0 .05);the observation group after treatment ,the CSF TNF‐αlevel was significantly lower than that of the control group(P<0 .05) .Conclusion Fructus forsythiae decoction with penicillin therapy of adult purulent menin‐gitis has significant therapeutic effect ,which can significantly relieve patients symptoms such as fever ,disturbance of conscious‐ness ,abnormal inflammatory factor ,and is worth of further clinical application .