清肺化痰汤雾化联合西药治疗呼吸机相关性肺炎随机平行对照研究

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[目的]观察清肺化痰汤雾化联合西药治疗呼吸机相关性肺炎疗效。[方法]使用随机平行对照方法,将80例住院患者按抛硬币法简单随机分为两组。对照组40例亚胺培南-西司他丁钠+0.9%100m L生理盐水,12h/次,静滴;氨溴索,30mg/次,2次/d,雾化吸入。治疗组40例清肺化痰汤(川贝母、桔梗、瓜蒌、半夏制、桑白皮各15g,知母、苏子、黄芩、杏仁各10g,甘草5g),1剂/d,水煎100m L,雾化吸入治疗,雾化速度为5m L/min,2次/d;西药治疗同对照组。连续治疗10d为1疗程。观测临床症状、体温、APACHE评分、白细胞计数、PCT、不良反应。治疗1疗程,判定疗效。[结果]治疗组痊愈11例,显效13例,有效12例,无效4例,总有效率90.00%。对照组痊愈7例,显效11例,有效11例,无效11例,总有效率72.50%。治疗组疗效优于对照组(P<0.05)。相关指标两组均有改善(P<0.01),治疗组改善优于对照组(P<0.01)。[结论]清肺化痰汤雾化联合西药治疗呼吸机相关性肺炎疗效满意,无严重不良反应,值得推广。 [Objective] To observe the therapeutic effect of Qingfei Huatan Decoction combined with western medicine on ventilator-associated pneumonia. [Methods] Using randomized parallel control method, 80 inpatients were randomly divided into two groups according to the coin-tossing method. In the control group, 40 patients were given imipenem-cilastatin sodium and 0.9% 100m L normal saline, intravenously for 12 hours, ambroxol, 30mg / time, twice a day for nebulization. In the treatment group, 40 cases of Qingfei Huatan Decoction (Fritillaria cirrhosa, Campanulaceae, Melon, Pinellia ternata, Morus alba each 15g, Anemarrhena asphodeloides, Scutellaria baicalensis, Almond 10g, licorice 5g) Decoction 100m L, inhalation therapy atomization speed of 5m L / min, 2 times / d; Western medicine treatment with the control group. Continuous treatment of 10d for a course of treatment. Clinical symptoms, body temperature, APACHE score, white blood cell count, PCT, adverse reactions were observed. Treatment of a course of treatment to determine the efficacy. [Result] In the treatment group, 11 cases were cured, 13 cases were markedly effective, 12 cases were effective, 4 cases were ineffective and the total effective rate was 90.00%. In the control group, 7 cases were cured, 11 cases were markedly effective, 11 cases were effective and 11 cases were ineffective. The total effective rate was 72.50%. The treatment group was better than the control group (P <0.05). Related indicators improved in both groups (P <0.01), and the treatment group improved better than the control group (P <0.01). [Conclusion] Qingfei Huatan Decoction combined with western medicine is effective in treating ventilator-associated pneumonia without serious adverse reactions and is worth promoting.
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