摘要
目的:观察麻杏石甘汤联合替加环素治疗老年多重耐药菌(MDRO)重症肺炎患者的效果。方法:选取2021年1月至2023年1月该院收治的80例老年MDRO重症肺炎患者进行前瞻性研究,按照随机数字表法将其分为对照组和观察组各40例。对照组给予替加环素治疗,观察组在对照组基础上联合麻杏石甘汤治疗,比较两组临床疗效,治疗前后中医证候积分,炎性因子[C反应蛋白(CRP)、降钙素原(PCT)、白细胞介素-1β(IL-1β)]水平,NOD样受体热蛋白结构域相关蛋白3(NLRP3)、半胱氨酸蛋白酶-1(CASPASE-1)、凋亡相关斑点样蛋白(ASC)水平及不良反应发生率。结果:观察组治疗总有效率为90.00%,高于对照组的72.50%,差异有统计学意义(P<0.05);治疗后,两组胸闷胸痛、咳嗽气粗、身热烦渴及痰黄带血等中医证候积分均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05);两组CRP、PCT、IL-1β水平均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05);两组NLRP3、CASPASE-1、ASC水平均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05);两组治疗期间均未发生明显不良反应。结论:麻杏石甘汤联合替加环素治疗老年MDRO重症肺炎患者,可提高临床疗效,降低中医证候积分,减轻机体炎症反应,降低NLRP3、CASPASE-1、ASC水平,效果优于单纯替加环素治疗。
Objective:To observe effects of Maxing Shigan decoction combined with Tigecycline in treatment of elderly patients with severe pneumonia caused by multidrug-resistant bacteria(MDRO).Methods:A prospective study was conducted on 80 elderly patients with severe pneumonia caused by MDRO admitted to this hospital from January 2021 to January 2023.They were divided into control group and observation group according to the random number table method,40 cases in each group.The control group was treated with Tigecycline,while the observation group was treated with Maxing Shigan decoction on the basis of that of the control group.The clinical efficacy,the TCM syndrome scores before and after the treatment,the levels of inflammatory factors[C-reactive protein(CRP),procalcitonin(PCT),interleukin-1β(IL-1β)],the levels of NODlike receptor thermal protein domain-related protein 3(NLRP3),cysteine protease-1(CASPASE-1)and apoptosis-related spot-like protein(ASC),and incidence of adverse reactions were compared between the two groups.Results:The total effective rate of the observation group was 90.00%,which was higher than 72.50%of the control group,and the difference was statistically significant(P<0.05).After the treatment,the scores of TCM syndromes such as chest tightness and chest pain,cough and coarseness,general fever and thirst,yellow phlegm with blood in the two groups were lower than those before the treatment,those in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).The levels of CRP,PCT and IL-1βin the two groups were lower than those before the treatment,those in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).The levels of NLRP3,CASPASE-1 and ASC in the two groups were lower than those before the treatment,those in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).However,no obvious adverse re
作者
张艳芳
方伟
ZHANG Yanfang;FANG Wei(Department of Respiratory Medicine of Affiliated Hospital of Traditional Chinese Medicine,of Nanyang Medical College,Nanyang 473000 Henan,China)
出处
《中国民康医学》
2023年第24期96-98,111,共4页
Medical Journal of Chinese People’s Health
关键词
麻杏石甘汤
替加环素
多重耐药菌
重症肺炎
炎性因子
中医证候积分
Maxing Shigan decoction
Tigecycline
Multidrug-resistant bacteria
Severe pneumonia
Inflammatory factor
TCM syndrome score
