摘要
目的观察酪酸梭菌活菌联合阿莫西林克拉维酸钾治疗肺炎链球菌肺炎的的临床疗效。方法选取我院2017年8月~2018年3月确诊为肺炎链球菌肺炎的患者68例,使用阿莫西林克拉维酸钾治疗为对照组,使用酪酸梭菌活菌联合阿莫西林克拉维酸钾的为观察组。按随机数字表法分组,每组34例。两组均治疗两周。比较两组的退热时间、咳嗽咳痰消失时间、肺部啰音消失时间、胸片恢复正常时间以及治疗总有效率。结果观察组的发热消退时间、咳嗽消退时间、肺啰音消退时间、住院时间均短于对照组,差异有统计学意义(P <0.05)。观察组治疗总有效率为97.05%,对照组为67.64%,观察组明显高于对照组,差异有统计学意义(P <0.05)。结论酪酸梭菌活菌联合阿莫西林克拉维酸钾在治疗具有耐药性的肺炎链球菌肺炎上,疗效显著且安全,值得于临床推广。
Objective To observe clinical curative effects of clostridium butyricum live bacteria combined with amoxicillin and clavulanate potassium in treatment of pneumococcal pneumonia.Methods 68 patients who were diagnosed aspneumococcal pneumonia in our hospital from August 2017 to March 2018 were selected.Patients who were treated with amoxicillin and clavulanate potassium were set as the control group while patients who were treated with clostridium butyricum live bacteria combined with amoxicillin and clavulanate potassium were set as the observation group.According to the random number table method,they were divided into two groups,with 34 cases in each group.Both groups were treated for two weeks.The defervescence time,the disappearancetime of cough and expectoration,the disappearance time of lung rale,the time of return to normal of chest film and the total effective rate of treatment were compared between the two groups.Results The defervescence time,the disappearance time of cough,the disappearance time of lung rale and hospital stay in the observation group were shorter than those in the control group.The difference was statistically significant(P < 0.05).The total effective rate of the observation group was 97.05%,significantly higher than that of the control group 67.64%.The difference was statistically significant(P < 0.05).Conclusion Clostridium butyricum live bacteria combined with amoxicillin and clavulanate potassium in treatment of pneumococcal pneumonia has significant curative effectsand it is safe,which is worthy of clinical promotion.
引文
[1]李虹,赵丽华,王笑晴.阿奇霉素联合痰热清治疗肺炎链球菌肺炎的疗效观察[J].贵阳中医学院学报,2012,34(2):44-45.
[2]Yan T.Role of anti-inflammatory cytokines in pathogenesis of pediatric mycoplasma pneumoniae pneumonia[J].Journal of Biological Regulators&Homeostatic Agents,2016,30(2):541.
[3]刘青,施毅.肺炎链球菌肺炎诊治进展[J].东南国防医药,2013,15(5):499-502.
[4]龚庆华,李桦,杨涛毅.美洛西林联合阿奇霉素治疗小儿肺炎链球菌肺炎的临床疗效分析[J].实用医院临床杂志,2017,14(2):98-100.
[5]马绍磊,王宇杰,曹权,等.肺炎链球菌尿抗原检测对成人社区获得性肺炎链球菌肺炎诊断效能的Meta分析[J].中华危重病急救医学,2016,28(6):528-533.
[6]惠燕霞,卢先雷,马启明,等.肺炎链球菌鉴定方法分析[J].中华医院感染学杂志,2016,26(2):283-285.
[7]Schuijt TJ,Lankelma JM,Scicluna BP,et al.Original article:The gut microbiota plays a protective role in the host defence against pneumococcal pneumonia[J].Gut,2016,65(4):575-583.
[8]Sgambatti S,Minamisava R,Bierrenbach AL,et al.Early impact of 10-valent pneumococcal conjugate vaccine in childhood pneumonia hospitalizations using primary data from an active population-based surveillance[J].Vaccine,2016,34(5):663-670.
[9]王愿,蔡培泉,姜秀峰.肺炎链球菌毒力基因检测与临床研究[J].中华医院感染学杂志,2016,26(8):1684-1686.
[10]葛玲丽,韩志英,朱镭,等.肺炎链球菌671株的临床分布及耐药性分析[J].中国药物与临床,2016,16(7):974-976.
[11]陈永超.阿莫西林克拉维酸钾对小儿化脓性扁桃体炎的疗效[J].临床医学,2016,36(4):115-116.
[12]胡汉军,叶志华.阿莫西林克拉维酸钾治疗儿童肺炎的临床疗效及安全性分析[J].中国医刊,2015,50(2):104-106.
[13]陈益民,沙建平,刘社兰,等.肠道和呼吸道菌群与肺部疾病的研究新进展[J].中国微生态学杂志,2017,29(10):1234-1240.
[14]李伟然,汪志凌,万朝敏.肠道菌群与"肠-肺"轴之间的关系[J].中华实用儿科临床杂志,2017,32(7):548-551.
[15]刘璐,吴媛媛,李满祥.生命早期肠道菌群失调与支气管哮喘[J].中华肺部疾病杂志(电子版),2014,7(2):77-79.
[16]娄玉霞.酪酸梭菌二联活菌散防治婴幼儿肺炎继发腹泻疗效观察[J].儿科药学杂志,2013,19(5):25-27.
[17]蒋圣灿,孙颖,汪丹红,等.口服酪酸梭菌活菌片联合小儿速泻停颗粒治疗轮状病毒肠炎的效果观察[J].中国医药,2016,11(1):90-93.
[18]朱建央,阎云芸.匹多莫德联合酪酸梭菌活菌散治疗儿童抗生素相关性腹泻的临床疗效及对免疫功能与肠道菌群的影响[J].中国微生态学杂志,2016,28(4):436-439.