雾化吸入痰热清注射液对卒中相关性肺炎发生及细菌清除效果的影响
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摘要
目的:观察痰热清注射液雾化吸入对卒中相关性肺炎发生率及细菌清除效果的影响。方法:选取50例急性脑卒中患者,随机分为治疗组和对照组各25例。对照组给予急性脑卒中常规治疗,治疗组加用痰热清注射液雾化吸入。对比2组卒中相关性肺炎的发生率,观察2组治疗前后白细胞计数(WBC)、C-反应蛋白(CRP)的变化情况,分析卒中相关性肺炎的病原菌构成并对比治疗后的细菌清除率。结果:治疗组卒中相关性肺炎发生率8.00%,低于对照组的24.00%,但差异无统计学意义(P>0.05)。治疗后,2组WBC、CRP水平均较治疗前降低,差异均有统计学意义(P <0.05);治疗组WBC、CRP水平均低于对照组,差异均有统计学意义(P <0.05)。2组共检出致病菌7株,其中,治疗组2株,对照组5株。治疗组细菌清除率为100%,对照组细菌清除率为60.00%,2组比较,差异无统计学意义(P> 0.05)。结论:在常规治疗基础上加用痰热清注射液雾化吸入治疗急性脑卒中,可减少卒中相关性肺炎的发生,减轻炎症反应,细菌清除效果较好。
Objective: To observe the clinical effect of aerosol inhalation of Tanreqing injection on the incidence of stroke-related pneumonia and bacterial clearance. Methods:Divided 50 cases of patients with acute stroke randomly into the treatment group and the control group,25 cases in each group. The control group was received routine treatment for acute stroke,and the treatment group was additionally given aerosol inhalation of Tanreqing injection. Compared the incidence of stroke-related pneumonia between the two groups,observed the changes of white blood cell count(WBC) and C-reactive protein(CRP) in the two groups before and after treatment,and analyzed the pathogens of stroke-associated pneumonia and compared the bacterial clearance rate after treatment. Results:The incidence of stroke-associated pneumonia was 8.00% inthe treatment group,being lower than that of 24.00% in the control group,and there was no significant difference being found(P > 0.05). After treatment, the WBC and CRP levels in the two groups were lower than those before treatment,differences being significant(P < 0.05). The WBC and CRP levels in the treatment group were lower than those in the control group, differences being significant(P < 0.05). Seven strains of pathogenic bacteria were detected in the two groups,including 2 strains in the treatment group and 5 strains in the control group. The bacterial clearance rate was 100% in the treatment group and 60.00% in the control group, and there was no significant difference being found between the two groups(P > 0.05). Conclusion:The additional application of aerosol inhalation of Tanreqing injection on the basis of routine treatment for acute stroke can decrease the incidence of stroke-related pneumonia, reduce inflammation and improve bacterial clearance.
Objective: To observe the clinical effect of aerosol inhalation of Tanreqing injection on the incidence of stroke-related pneumonia and bacterial clearance. Methods:Divided 50 cases of patients with acute stroke randomly into the treatment group and the control group,25 cases in each group. The control group was received routine treatment for acute stroke,and the treatment group was additionally given aerosol inhalation of Tanreqing injection. Compared the incidence of stroke-related pneumonia between the two groups,observed the changes of white blood cell count(WBC) and C-reactive protein(CRP) in the two groups before and after treatment,and analyzed the pathogens of stroke-associated pneumonia and compared the bacterial clearance rate after treatment. Results:The incidence of stroke-associated pneumonia was 8.00% inthe treatment group,being lower than that of 24.00% in the control group,and there was no significant difference being found(P > 0.05). After treatment, the WBC and CRP levels in the two groups were lower than those before treatment,differences being significant(P < 0.05). The WBC and CRP levels in the treatment group were lower than those in the control group, differences being significant(P < 0.05). Seven strains of pathogenic bacteria were detected in the two groups,including 2 strains in the treatment group and 5 strains in the control group. The bacterial clearance rate was 100% in the treatment group and 60.00% in the control group, and there was no significant difference being found between the two groups(P > 0.05). Conclusion:The additional application of aerosol inhalation of Tanreqing injection on the basis of routine treatment for acute stroke can decrease the incidence of stroke-related pneumonia, reduce inflammation and improve bacterial clearance.
引文
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[11]黄燕玲,罗光伟,毛先明.痰热清对慢性阻塞性肺疾病大鼠支气管上皮多药耐药相关蛋白1表达的影响[J].中国老年学杂志,2017,37(2):318-320.
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[13]朱立成,李伟,尚云飞.痰热清注射液对AECOPD患者免疫功能的影响[J].临床肺科杂志,2014,19(1):58-59,91.
[14]王琼.痰热清治疗慢性支气管炎急性发作的疗效及对免疫球蛋白IgA、IgG和IgM的影响[J].浙江中医药大学学报,2013,37(6):706-708.
[2]Yan L,Qing Y,Xingyi J,et al.Etiologic diagnosis and clinical treatment of multiple drug-Resistant bacteria infection in elderly patients with stroke-Associated pneumonia after neurosurgery[J].Cell Biochem Biophys,2015,71(2):731-734.
[3]黎娜娜,刘世青,杜以明.痰热清注射液在呼吸系统感染性疾病中的应用[J].中国中医急症,2015,24(9):1595-1597.
[4]卒中相关性肺炎诊治中国专家共识组.卒中相关性肺炎诊治中国专家共识[J].中华内科杂志,2010,49(12):1075-1078.
[5]曾亚华,孙光华,封蔚彬.脑卒中患者并发肺部感染的危险因素分析及康复护理对策[J].中国实用护理杂志,2017,33(36):2811-2814.
[6]Yuan MZ,Li F,Tian X,et al.Risk factors for lung infection in stroke patients:a meta-analysis of observational studies[J].Expert RevAnti Infect Ther,2015,13(10):1289-1298.
[7]金爱芳,朱桂萍,杨萍妹,等.老年患者卒中相关性肺炎多药耐药菌感染的病原学与危险因素分析[J].中华医院感染学杂志,2016,26(12):2703-2705.
[8]梅蕊,王东升,葛平,等.痰热清注射液联合常规抗感染治疗对脑梗死患者肺部感染的治疗效果观察[J].中华医院感染学杂志,2017,27(22):5102-5104.
[9]韩芳,张新,张伟东.PCT、CRP及CPIS与脑卒中相关性肺炎的关联性研究[J].现代中西医结合杂志,2014,23(35):3886-3887,3990.
[10]宋远瑛.痰热清对产超广谱β-内酰胺酶肺炎克雷伯菌的体外抑制作用研究[J].中国实验诊断学,2016,20(1):84-86.
[11]黄燕玲,罗光伟,毛先明.痰热清对慢性阻塞性肺疾病大鼠支气管上皮多药耐药相关蛋白1表达的影响[J].中国老年学杂志,2017,37(2):318-320.
[12]蔡凌峰,王慧贤,林观康,等.痰热清注射液对慢性阻塞性肺疾病模型大鼠气道黏液高分泌的影响[J].成都医学院学报,2016,11(6):657-661.
[13]朱立成,李伟,尚云飞.痰热清注射液对AECOPD患者免疫功能的影响[J].临床肺科杂志,2014,19(1):58-59,91.
[14]王琼.痰热清治疗慢性支气管炎急性发作的疗效及对免疫球蛋白IgA、IgG和IgM的影响[J].浙江中医药大学学报,2013,37(6):706-708.