喜炎平治疗老年重症肺炎患者预后与中医证候的相关性研究

摘要

目的 观察喜炎平治疗不同中医证候分型的老年重症肺炎患者的临床疗效并探讨其机制.方法 选择本院ICU收治的96例老年重症肺炎患者,进行中医证候分型分组,治疗上均采用喜炎平注射液抗炎联合常规西医治疗的方法.治疗前后进行临床观察,记录生命体征及辅助检查,进行统计分析及比较.结果 92例老年重症肺炎患者,应用喜炎平联合常规西医治疗3d后,患者心率、呼吸较前下降,血压较前升高;血气分析氧分压较前升高,二氧化碳分压较前下降;C反应蛋白、PCT均较前下降;BNP水平较前下降(P＜0.05).治疗后总有效率为56.52％,按照中医证候分型分组:痰热闭肺证组26例,阴阳两虚蕴毒证组20例,瘀热蕴毒证组25例,热毒内蕴证组21例.瘀热蕴毒证组治疗后总有效72.00％;痰热闭肺证组总有效率69.23％;阴阳两虚蕴毒证组总有效率40.00％;热毒内蕴证总有效率38.10％.瘀热蕴毒证及痰热闭肺证组总有效率高于阴阳两虚蕴毒证组及热毒内蕴证组(P＜0.05).结论 临床上应用喜炎平联合常规西医治疗老年重症肺炎患者疗效肯定,中医症候分型方面,瘀热蕴毒证及痰热闭肺证组治疗有效率最高.%Objective:To observe the clinical curative effect of Xiyanping on elderly patients with severe pneumonia of different TCM Syndromes.Methods:96 elderly patients with severe pneumonia were divided into,oups of TCM syndromes and treated with the anti-inflammatory of Xiyanping Injectior.and conventional Western medicine.Clinical observation,vital signs and auxiliary examinations were performed before and after treatment,and statistical analysis and comparison were made.Results:Aften three days of treatment with Xiyanping combined with conventional Western medicine,heart rate and respiration rate decreased,blood pressure higher than before.The blood gas analysis showed that the partial pressure of oxygen i..reased and the partial pressure of carbon dioxide decreased,compared with before.CRP and PCT were lower than before,and the level of BNP decreased,compared with before (P＜ 0.05).The total effective rate was 56.52％ after treatment.According to syndrome differentiation type of traditional Chinese medicine,the group of phlegm-heat closed lung was 26 cases,Yin and Yang virtual poison group 20 cases,stasis hot accumulate poison group 25 cases and the heat intrinsic group 21 cases.The total effective rate of the stasis hot accumulate poison group was 72％,the group of phlegm-heat closed lung 69.23％,the group of Yin and Yang virtual poison 40％,the group of the heat intrinsic 38.1％.The total effective rate of stasis hot accumulate poison group and phlegm-heat closed lung was higher than that of Yin and Yang virtual poison group and heat intrinsic group (P＜ 0.05).Conclusion:In clinical application,the curative effect of Xiyanping combined with conventional Western medicine is definite in elderly patients with severe pneumonia.In the aspect of TCM syndrome type,the treatment efficiency of t e groups of the stasis hot accumulate poison and phlegm-heat closed lung is the highest.