通腑泻热合剂灌肠联合常规疗法治疗重症肺炎发热临床研究
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R563.1

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Clinical Study on Enema of Tongfu Xiere Mixture Combined with Routine Therapy for Fever in Patients with Severe Pneumonia
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    摘要:

    目的:观察通腑泻热合剂灌肠联合常规疗法治疗重症肺炎发热的临床疗效。方法:将90例痰热壅肺型重症肺炎发热患者随机分为观察组和对照组各45例。2组均行机械通气和心电监护,并给予抗感染,维持水、电解质、酸碱平衡,扩张支气管、物理降温、化痰祛痰、抗炎等常规疗法与常规护理措施。观察组同期采用通腑泻热合剂灌肠,2组疗程均为5 d。比较2组的退热时间、病情程度[急性生理学和慢性健康状况评分系统Ⅱ (APACHEⅡ) 评分、临床肺部感染评分(CPIS)]、降钙素原(PCT)、C-反应蛋白(CRP)、动脉血气分析指标[动脉血氧分压(PaO2)、二氧化碳分压(PaCO2)、血氧饱和度(SaO2)]。结果:治疗后,2组APACHEⅡ评分及CPIS均较治疗前降低(P<0.01),观察组APACHEⅡ评分及CPIS均低于对照组(P<0.01)。2组PCT、CRP水平均较治疗前下降(P<0.01),观察组PCT、CRP水平均低于对照组(P<0.01)。2组PaO2、SaO2均较治疗前上升(P<0.01),PaCO2均较治疗前下降(P<0.01)。观察组PaO2、SaO2均高于对照组(P<0.05),PaCO2低于对照组(P<0.05)。结论:在常规疗法基础上加用通腑泻热合剂灌肠可使重症肺炎患者尽早解除发热症状,减轻炎症和疾病的严重程度,改善肺的通气功能,从而有利于病情的控制。

    Abstract:

    Abstract:Objective:To observe the clinical effect of enema of Tongfu Xiere mixture combined with routine therapy for fever in patients with severe pneumonia. Methods: A total of 90 cases of patients with fever and severe pneumonia of phlegm-heat obstructing the lung type were randomly divided into the observation group and the control group,45 cases in each group. Both groups were given mechanical ventilation,electrocardiographic monitoring as well as routine therapy and nursing, namely anti- infection, maintaining the balance of water, electrolyte and acid base, expansion of bronchus, physical cooling, dispelling and resolving phlegm and anti- inflammation. At the same period, the observation group was given enema of Tongfu Xiere mixture. Both groups were treated for five days. The fever subsidence time, the degree of disease evaluated by the scores of Acute Physiology and Chronic Health Evaluation Ⅱ(APACHE Ⅱ) and Clinical Pulmonary Infection Score(CPIS),procalcitonin(PCT),C-reactive protein(CRP) as well as analysis indexes of arterial blood gas,namely partial pressure of oxygen(PaO2), partial pressure of carbon dioxide(PaCO2) and oxygen saturation(SaO2) were compared between the two groups. Results:After treatment,the scores of APACHE Ⅱ and CPIS in the two groups were decreased when compared with those before treatment(P<0.01),and the two scores in the observation group were lower than those in the control group(P<0.01). The levels of PCT and CRP in the two groups were decreased when compared with those before treatment(P<0.01), and the two levels in the observation group were lower than those in the control group(P<0.01). The levels of PaO2 and SaO2 in the two groups were increased when compared with those before treatment(P<0.01),and the levels of PaCO2 were decreased(P<0.01). The levels of PaO2 and SaO2 in the observation group were higher than those in the control group(P<0.05), and the level of PaCO2 was lower than that in the control group(P<0.05). Conclusion: Based on routine treatment,the enema of Tongfu Xiere mixture for patients with severe pneumonia can relieve fever symptom as early as possible,reduce inflammation and disease severity,and improve ventilation function of the lung,which is conducive to the control of severe pneumonia.

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李维维,吴素平,田葛兰,蔡春燕.通腑泻热合剂灌肠联合常规疗法治疗重症肺炎发热临床研究[J].新中医,2020,52(17):153-156

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  • 在线发布日期: 2020-09-06
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