抗菌药物联合八珍汤加减治疗气血两虚型产后发热疗效及对血清学影响
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摘要
目的产后发热是临床常见产科病症之一,出自《医学纲目》,表现为产妇分娩后持续发热,或突然高热,并伴有其他症状,如不及时治疗,易发生产褥感染,影响产妇健康,甚至危及生命。本研究分析气血两虚型产后发热治疗中抗菌药物联合八珍汤加减对临床疗效及血清学指标的影响。方法选取2015-03-30-2016-05-30锦州市妇婴医院就诊的86例气血两虚型产后发热患者作为研究对象。根据不同治疗方法将患者分为对照组39例和研究组47例。对照组采用抗菌药物治疗,研究组采用抗菌药物联合八珍汤加减治疗,对比两组患者的临床指标、血清学指标、临床疗效及不良反应发生情况。结果研究组平均退热时间为(1.46±0.34)d,低于对照组的(2.07±0.44)d,t=7.176,P<0.001;住院时间为(4.16±0.96)d,低于对照组的(6.05±1.26)d,t=7.778,P<0.001。治疗后,研究组血浆纤维蛋白原(fibrinogen,Fib)水平为(2.23±0.33)g/L,低于对照组的(3.27±0.46)g/L,t=12.181,P<0.001;血浆黏度水平为(1.27±0.35)mPa·s,低于对照组的(1.85±0.43)mPa·s,t=6.897,P<0.001;C反应蛋白(C-reactive protein,CRP)水平为(8.35±0.77)mg/L,低于对照组的(10.54±0.92)mg/L,t=11.768,P<0.001;白细胞计数水平为(9.50±0.85)×109 L-1,低于对照组的(11.65±0.97)×109 L-1,t=10.923,P<0.001。研究组总有效率为93.62%,高于对照组的69.26%,χ~2=8.800,P<0.001。研究组不良反应发生率为6.38%,低于对照组的23.08%,差异有统计学差异,χ~2=4.950,P=0.003。结论气血两虚型产后发热时采用抗菌药物联合八珍汤加减治疗能加快退热,明显改善患者血浆粘度和炎症状态,疗效显著,且安全性较高。
OBJECTIVE Postpartum fever is one of the common diseases in clinical obstetrics.It is published in the"Medical Outline".It is manifested as persistent fever after childbirth,or sudden high fever,accompanied by other symptoms.Without treatment in time,it is easy to send sputum infection,affecting the mother's healthy and even endangering the life.This study aims to analyze the effect of antibacterial drugs combined with Bazhen Decoction on clinical efficacy and serological indexes in postpartum fever treatment of qi and blood deficiency type.METHODS A total of 86 patients with postpartum fever with qi and blood deficiency in our hospital were retrospectively analyzed.Patients were divided into control group(n=39 cases)and study group(n=47 cases)according to different treatment methods.The patients in the control group were treated with antimicrobial agents.The patients in the study group were treated with antibacterial drugs and Bazhen Decoction.The clinical indexes,serological indexes,clinical efficacy and adverse reactions were compared between the two groups.RESULTS The mean antipyretic time and hospitalization time in the control group were(2.07±0.44)d and(6.05±1.26)d,respectively,which were significantly higher than those of the study group(1.46±0.34)d and(4.16±0.96)d(t1=7.176,t2=7.778,both P<0.001).The Fib,plasma viscosity,CRP and white blood cell count levels in the study group were(2.23±0.33)g/L,(1.27±0.35)mPa·s,(8.35±0.77)mg/L,(9.50±0.85)×109 L-1,respectively,significantly lower than those in the control group(3.27±0.46)g/L,(1.85±0.43)mPa·s,(10.54±0.92)mg/L,(11.65±0.97)×109 L-1.The difference was statistically significant(t=12.181,6.897,11.768,10.923,all P<0.001).The total effective rate of the control group(69.26%)was significantly lower than that of the study group(93.62%).The difference was statistically significant(χ~2=8.800,P <0.001).The incidence of adverse reactionsin the control group was 23.08%,significantly higher than 6.38% of the study group(χ~2=4.950,P=0.003).CONCLUSIONS The combination of antibacterial drugs and Bazhen Decoction can accelerate the patients' fever and improve the plasma viscosity and inflammation.The curative effect is remarkable and the safety is high.
OBJECTIVE Postpartum fever is one of the common diseases in clinical obstetrics.It is published in the"Medical Outline".It is manifested as persistent fever after childbirth,or sudden high fever,accompanied by other symptoms.Without treatment in time,it is easy to send sputum infection,affecting the mother's healthy and even endangering the life.This study aims to analyze the effect of antibacterial drugs combined with Bazhen Decoction on clinical efficacy and serological indexes in postpartum fever treatment of qi and blood deficiency type.METHODS A total of 86 patients with postpartum fever with qi and blood deficiency in our hospital were retrospectively analyzed.Patients were divided into control group(n=39 cases)and study group(n=47 cases)according to different treatment methods.The patients in the control group were treated with antimicrobial agents.The patients in the study group were treated with antibacterial drugs and Bazhen Decoction.The clinical indexes,serological indexes,clinical efficacy and adverse reactions were compared between the two groups.RESULTS The mean antipyretic time and hospitalization time in the control group were(2.07±0.44)d and(6.05±1.26)d,respectively,which were significantly higher than those of the study group(1.46±0.34)d and(4.16±0.96)d(t1=7.176,t2=7.778,both P<0.001).The Fib,plasma viscosity,CRP and white blood cell count levels in the study group were(2.23±0.33)g/L,(1.27±0.35)mPa·s,(8.35±0.77)mg/L,(9.50±0.85)×109 L-1,respectively,significantly lower than those in the control group(3.27±0.46)g/L,(1.85±0.43)mPa·s,(10.54±0.92)mg/L,(11.65±0.97)×109 L-1.The difference was statistically significant(t=12.181,6.897,11.768,10.923,all P<0.001).The total effective rate of the control group(69.26%)was significantly lower than that of the study group(93.62%).The difference was statistically significant(χ~2=8.800,P <0.001).The incidence of adverse reactionsin the control group was 23.08%,significantly higher than 6.38% of the study group(χ~2=4.950,P=0.003).CONCLUSIONS The combination of antibacterial drugs and Bazhen Decoction can accelerate the patients' fever and improve the plasma viscosity and inflammation.The curative effect is remarkable and the safety is high.
引文
[1]Aoki T,Kimura Y,Oya A,et al.Hematological and biochemical features of postpartum fever in the heavy draft mare[J].J Equine Vet Sci,2016,27(1):13-16.
[2]李敏,刘敏修.中西医结合治疗产后发热40例疗效观察[J].中医药导报,2013,19(8):101,103.
[3]马永剑,侯莉娟.丁象宸教授应用小柴胡汤合生化汤加减治疗产后发热体会[J].陕西中医,2015,36(9):1228-1229.
[4]杨娜.中西医结合治疗产后发热60例[J].中国中医药现代远程教育,2016,14(6):111-112.
[5]邓彩云,张龙月,陈莹,等.中西医结合治疗产后发热临床研究[J].中医学报,2016,31(6):892-895.
[6]朱月,朱颖.朱颖教授运用银翘散合生化汤加减治疗外感夹瘀型产后发热经验[J].现代中医药,2014,34(1):9-10.
[7]刘德佩,廖云霞,贾昀扬.中药治疗产后血虚发热的临床及机理研究[J].徐州医科大学学报,2018,38(4):274-277.
[8]周莉,彭瑛.当归补血汤联合西药治疗血虚阳浮型产后发热49例[J].河南中医,2015,35(7):1624-1625.
[9]马万增,杨静,王山.八珍汤加减联合抗菌药物治疗气血两虚型产后发热的临床观察[J].中国药房,2017,28(17):2410-2413.
[10]McLean ARD,Boel M,McGready R,et al.Antibody Responses to Plasmodium falciparum and Plasmodium vivax and Prospective Risk of Plasmodium spp.Infection Postpartum[J].Am J Trop Med Hyg,2017,96(5):1197-1204.
[11]印贤琴,侯俐,沈娅.生化汤加减联合抗菌药物治疗血瘀型产后发热的临床观察[J].中国药房,2016,27(14):1966-1968.
[12]李明亮,梁登辉.荆防四物汤联合抗生素治疗产后外感发热疗效观察[J].现代中西医结合杂志,2015,24(26):2907-2909.
[13]董兵轮.补中益气汤对产后发热患者炎症反应的影响[J].现代中西医结合杂志,2017,26(17):1873-1875.
[14]丁想珍.解毒活血汤治疗感染邪毒型产后发热患者的临床观察[J].西南国防医药,2017,27(2):175-177.
[15]Aoki T,Kimura Y,Oya A,et al.Hematological and biochemical features of postpartum fever in the heavy draft mare[J].J Equine Sci,2016,27(1):13-16.
[2]李敏,刘敏修.中西医结合治疗产后发热40例疗效观察[J].中医药导报,2013,19(8):101,103.
[3]马永剑,侯莉娟.丁象宸教授应用小柴胡汤合生化汤加减治疗产后发热体会[J].陕西中医,2015,36(9):1228-1229.
[4]杨娜.中西医结合治疗产后发热60例[J].中国中医药现代远程教育,2016,14(6):111-112.
[5]邓彩云,张龙月,陈莹,等.中西医结合治疗产后发热临床研究[J].中医学报,2016,31(6):892-895.
[6]朱月,朱颖.朱颖教授运用银翘散合生化汤加减治疗外感夹瘀型产后发热经验[J].现代中医药,2014,34(1):9-10.
[7]刘德佩,廖云霞,贾昀扬.中药治疗产后血虚发热的临床及机理研究[J].徐州医科大学学报,2018,38(4):274-277.
[8]周莉,彭瑛.当归补血汤联合西药治疗血虚阳浮型产后发热49例[J].河南中医,2015,35(7):1624-1625.
[9]马万增,杨静,王山.八珍汤加减联合抗菌药物治疗气血两虚型产后发热的临床观察[J].中国药房,2017,28(17):2410-2413.
[10]McLean ARD,Boel M,McGready R,et al.Antibody Responses to Plasmodium falciparum and Plasmodium vivax and Prospective Risk of Plasmodium spp.Infection Postpartum[J].Am J Trop Med Hyg,2017,96(5):1197-1204.
[11]印贤琴,侯俐,沈娅.生化汤加减联合抗菌药物治疗血瘀型产后发热的临床观察[J].中国药房,2016,27(14):1966-1968.
[12]李明亮,梁登辉.荆防四物汤联合抗生素治疗产后外感发热疗效观察[J].现代中西医结合杂志,2015,24(26):2907-2909.
[13]董兵轮.补中益气汤对产后发热患者炎症反应的影响[J].现代中西医结合杂志,2017,26(17):1873-1875.
[14]丁想珍.解毒活血汤治疗感染邪毒型产后发热患者的临床观察[J].西南国防医药,2017,27(2):175-177.
[15]Aoki T,Kimura Y,Oya A,et al.Hematological and biochemical features of postpartum fever in the heavy draft mare[J].J Equine Sci,2016,27(1):13-16.