摘要
目的:探讨刺络拔罐联合中药治疗鲍曼不动杆菌肺炎的疗效及对细菌清除、急性生理功能和慢性健康状况评分Ⅱ(acute physiology and chronic health evaluationⅡ,APACHE Ⅱ)的影响。方法:选取2017年5月至2019年1月汕头市中心医院收治的鲍曼不动杆菌肺炎患者90例,按照随机数字表法分为对照组和观察组,每组45例。对照组患者单纯给予常规抗菌药物治疗,观察组患者在对照组的基础上给予刺络拔罐联合中药治疗,7 d为1个疗程,连续治疗2个疗程。比较两组患者的临床疗效、细菌清除率,治疗前后APACHE Ⅱ评分、血清白细胞计数(WBC)、C反应蛋白(CRP)及降钙素原(PCT)水平的差异,记录患者重症加强护理病房(intensive care unit,ICU)住院时间和28 d病死情况。结果:观察组患者的总有效率为91. 11%(41/45),明显高于对照组的73. 33%(33/45),差异有统计学意义(P <0. 05);观察组患者的细菌清除率为75. 56%(34/45),明显高于对照组的44. 44%(20/45),差异有统计学意义(P<0. 05)。治疗1、2周后,观察组患者的APACHE Ⅱ评分明显低于对照组,差异均有统计学意义(P<0. 05);治疗后,观察组患者的WBC、CRP及PCT水平明显低于对照组,差异均有统计学意义(P<0. 05)。观察组患者的ICU住院时间为(15. 35±2. 10) d,明显短于对照组的(22. 78±3. 11) d,差异有统计学意义(P<0. 05);观察组患者28 d病死率为6. 67%(3/45),明显低于对照组的22. 22%(10/45),差异有统计学意义(P<0. 05)。结论:刺络拔罐联合中药治疗鲍曼不动杆菌肺炎的疗效确切,利于有效清除细菌,减轻或消除患者肺炎相关症状、体征,减轻炎症反应,缩短ICU住院时间,降低病死率。
OBJECTIVE: To probe into the efficacy of blood-letting puncture and cupping combined with traditional Chinese medicine in treatment of pneumonia induced by Acinetobacter baumannii and its effects on bacterial clearance and acute physiology and chronic health evaluation Ⅱ( APACHE Ⅱ) score. METHODS: 90 patients with pneumonia induced by A. baumannii admitted into Shantou Central Hospital from May 2017 to Jan. 2019 were selected and divided into control group and observation group via random number table,with 45 cases in each group. The control group was treated with conventional antibiotics,while the observation group was given blood-letting puncture and cupping combined with traditional Chinese medicine based on the control group,both groups were given two treatment courses( 7 days as a treatment course). Differences in clinical efficacy,bacteria clearance rates,APACHEⅡ scores,serum white blood cell count( WBC),C-reactive protein( CRP) and procalcitonin( PCT) levels were compared between two groups before and after treatment,the hospital stays in ICU and death rates in 28 days were recorded. RESULTS: The total effective rate of observation group was 91. 11%( 41/45),which was significantly higher than that of the control group( 73. 33%,33/45),with statistically significant difference( P < 0. 05);the bacteria clearance rate of observation group was 75. 56%( 34/45),which was significantly higher than that of the control group( 44. 44%,20/45),with statistically significant difference( P < 0. 05). At 1 week and 2 weeks after treatment,the APACHE Ⅱ scores of observation group were significantly lower than those of the control group,with statistically significant differences( P < 0. 05);after treatment,the WBC,CRP and PCT levels of observation group were significantly lower than those of the control group,with statistically significant differences( P < 0. 05). The hospital stay in ICU of the observation group was( 15. 35±2. 10) days,which was shorter than that of the control group[( 22. 78± 3. 11) days],with statistically significant differences( P < 0. 05);the death rate in 28 days of the observation group was 6. 67%( 3/45),which was significantly lower than that of the control group( 22. 22%,10/45),with statistically significant difference( P < 0. 05). CONCLUSIONS: The efficacy of blood-letting puncture and cupping combined with traditional Chinese medicine in treatment of pneumonia induced by A. baumannii is remarkable,which is conducive to effective bacterial clearance,reduce or eliminate pneumonia symptoms and signs,relieve inflammation reaction,shorten hospital stays in ICU and lower death rate.
作者
蔡耿秋
陈伟宏
CAI Gengqiu;CHEN Weihong(Dept.of Acupuncture,Shantou Central Hospital,Guangdong Shantou 515031,China)
出处
《中国医院用药评价与分析》
2020年第1期40-43,共4页
Evaluation and Analysis of Drug-use in Hospitals of China
基金
广东省中医药管理局科研项目(No.20182144)
关键词
刺络拔罐
中药
鲍曼不动杆菌性肺炎
细菌清除
APACHEⅡ评分
Blood-letting puncture and cupping
Traditional Chinese medicine
Pneumonia induced by Acinetobacter baumannii
Bacteria clearance rate
APACHE Ⅱ score
