【作者】 江俊；

【导师】 蒋丹；

【作者基本信息】 湖北中医药大学 ， 中医内科学， 2010， 硕士

【摘要】 目的：选择湖北省中医院呼吸内科部分住院病人,观察比较治疗组与对照组病人,探讨莫西沙星联合银翘散加减方治疗医院获得性肺炎(HAP)的临床价值。方法：湖北省中医院患医院获得性肺炎患者35例,中医诊断咳嗽、喘证。从中筛选符合下列条件的患者：无合并其它基础疾病,非孕妇或哺乳期妇女,均无对喹诺酮类及大环内酯类药物过敏史。可评价病例共31例。随机分成治疗组和对照组,治疗组15例,对照组16例。对照组常规治疗。治疗组和对照组在性别、年龄、体质量、既往病史、病情、心电图、检查结果和痰培养等方面,无统计学差异,具有可比性。治疗组对症常规治疗并给予莫西沙星片(拜复乐,德国Bayer公司拜尔药厂生产,规格400mg/片。口服,400mg/次,1次/天。),银翘散加减方(连翘、银花、苦桔梗、薄荷、竹叶、生甘草、荆芥穗、淡豆豉、牛蒡子。临证加减：热夹混浊,胸膈满闷,加藿香、郁金；津伤渴甚,加花粉；热毒较甚、项肿咽痛,加元参；肺气不利,咳甚,加杏仁；热渐入里,加细生地、麦冬；再不解,加知母、黄芩)。对照组常规治疗(对症治疗、随后根据痰培养选用抗生素)。疗效评定：根据卫生部颁发《抗菌药物临床研究指导标准》,根据临床症状、体征、实验室检查和细菌学检查进行综合评价以确定临床疗效,按痊愈、显效、进步和无效4级评定。结果：治疗组与对照组在年龄、性别、治疗前症状评分、感染的细菌种类上均无统计学差异,具有可比性。治疗后,治疗组与对照组在治疗后症状评分、所感染的细菌清除率上均有统计学差异,且治疗组细菌清除率为90.6%>对照组71.0%,,故可说明治疗组的临床治疗效果较对照组好。治疗后,治疗组与对照组在疗效等级、总有效率上无统计学差异,但治疗组有效率[总有效/总数]68.8%>对照组有效率48.4%。治疗后,治疗组与对照组,均出现了2例较轻症状的不良反应,且无统计学差异。结论：可认为：莫西沙星联合银翘散加减方在临床治疗医院获得性肺炎(HAP)上有较为可靠的价值。更多还原

【Abstract】 Purpose:To select some of Respiratory Medicine, Hubei Province, Chinese medicine hospital in-patients, observed and compared the treatment group and control group patients, of moxifloxacin combined Yinqiaosan Treatment of Modified Hospital acquired pneumonia (HAP) of clinical value.Method:Hubei Province Chinese Medicine Hospital suffering from hospital-acquired pneumonia in 35 patients, diagnosis of cough medicine, Asthma. Selected from patients meeting the following requirements: None combined with other underlying diseases, non-pregnant or lactating women, no to quinolones and macrolides history of drug allergy.31 patients evaluable patients. Randomly divided into treatment group and control group, treatment group 15 cases,16 cases of the control group. Routine treatment control group. Treatment and control groups in gender, age, body weight, past medical history, disease, electrocardiogram, examination results, and sputum culture and so on, no significant difference between comparable.Symptomatic treatment group given routine treatment and moxifloxacin tablets (thanks to complex music, the German Bayer Corporation Bayer Pharmaceuticals production, specifications 400mg/tablet. Oral,400mg/ times,1 time/day.), Plus or minus side Yinqiaosan (Forsythia, Silver Flower, bitter Campanulaceae, mint, bamboo leaves, raw licorice, Schizonepeta spike, SSP, Arctium. Clinical Modified:hot clip is poor, mediastinoscopy full nausea, plus Agastache rugosa, turmeric; Tianjin injury very thirsty, plus pollen; heat rather than toxicity, entry swollen sore throat, Canadian participation; lung negative, cough and even, Almond; heat gradually into the years, plus fine habitat, Ophiopogon japonicus; further understand, plus Zhimu, skullcap). Routine treatment control group (symptomatic treatment, then use antibiotics according to sputum culture).Efficacy Evaluation:According to the Ministry of Health issued "Guidance on Clinical Investigation of antibiotics standards", based on clinical symptoms, signs, laboratory tests, and bacteriology comprehensive assessment to determine the clinical efficacy, according to recover markedly, progress and assessment invalid 4. Results:Treatment and control groups in age, gender, symptom score before treatment, the infection had no significant difference between the types of bacteria, comparable.After treatment, the treatment group and control group in symptom score after treatment, the infection rate of bacterial clearance were statistically significant, and the treatment of the bacterial eradication rate was 90.6%> 71.0% in control group, and therefore may explain the clinical treatment group better treatment than the control group.After treatment, the treatment group and control group in efficacy levels, the total effective rate was not statistically significant, but the efficiency of the treatment group [total effective/total] 68.8%> control group was 48.4%.After treatment, the treatment group and control group, there were two cases of minor symptoms of adverse reactions, and no significant difference.Conclusion:Can be considered:joint Yinqiaosan moxifloxacin plus or minus side in the clinical treatment of hospital-acquired pneumonia (HAP) have a more reliable value.更多还原