两组中药方剂对糖尿病足产 ESBLs大肠埃希菌和MRSA 体外药物敏感性试验结果分析

摘要

Objective To understand the inhibitory and treatment effects of Coptis chinensis and Coptis chinensis with Musk prescriptions for diabetic foot producing extended-spectrum beta lactamase ( ESBLs ) Escherichia coli and methicillin-resistant Staphylococcus aureus ( MRSA) .Methods The patients diagnosed as diabetic foot were enrolled . After culturing , 138 isolates of bacteria were isolated , and 67 isolates of ESBLs Escherichia coli and MRSA were screened.The minimum inhibitory concentrations (MIC) of Coptis chinensis (prescription 1) and Coptis chinensis with Musk ( prescription 2) were determined by agar dilution method .The treatment effect of the 2 groups of prescriptions for diabetic foot was observed .Results The MIC of prescription 1 for 35 isolates of ESBLs Escherichia coli was ≥128 mg/mL, and the MIC of prescription 2 was 32 mg/mL.The MIC scope of prescription 2 was 32-128 mg/mL.The MIC for 32 isolates of MRSA droped from 32 mg/mL ( prescription 1 ) to 8 mg/mL ( prescription 2 ) .Compared with prescription 1, the MIC of prescription 2 decreased significantly , the treatment effect was distinct , and the differences were statistically significant (P<0.05).Conclusions Traditional Chinese medicine prescription Coptis chinensis with Musk has inhibitory and treatment effects for diabetic foot producing ESBLs Escherichia coli and MRSA, which is a novel method for clinical treatment .%目的：了解黄连液和黄连液联合麝香2组方剂对糖尿病足常见多重耐药菌———产超广谱β-内酰胺酶（ESBLs）大肠埃希菌和耐甲氧西林金黄色葡萄球菌（MRSA）的抑菌和治疗效果。方法收集确诊为糖尿病足的患者，经细菌培养分离出病原菌138株，筛选出其中的产ESBLs大肠埃希菌和MRSA共67株，运用琼脂稀释法检测中药组方一（黄连液）及组方二（黄连液联合麝香）对2种病原菌的最小抑菌浓度（ MIC）。同时观察2组方剂对糖尿病足的治疗效果。结果组方一对35株产ESBLs大肠埃希菌的MIC≥128 mg／mL，而组方二其MIC值下降至32 mg／mL，组方二的MIC值范围为32～128 mg／mL。32株MRSA的MIC值也从组方一的32 mg／mL降至组方二的8 mg／mL。经比较发现，加入麝香的组方二对2种细菌的MIC值较组方一下降明显，并且疗效显著，差异有统计学意义（P＜0．05）。结论用中药组方黄连液联合麝香对糖尿病足常见的病原菌———产ESBLs大肠埃希菌和MRSA具有显著的抑菌作用，这为今后的临床治疗提供了一种新的方法。