| 摘要: |
| ［摘要］ 目的 探讨以米诺环素为基础联合用药并配合中药麻黄升麻汤加减治疗多重耐药鲍曼不动杆菌肺炎的有效性和安全性。方法 选择该院重症监护室（ICU）及ICU观察室于2013-01～2018-03收治的多重耐药鲍曼不动杆菌致肺炎患者34例，随机分为治疗组和对照组，每组17例。对照组予米诺环素(0.2 g/d，首剂加倍)联合头孢哌酮舒巴坦钠大剂量(12 g/d)，或联合哌拉西林他唑巴坦(11.25 g/d)等治疗方案。治疗组在此基础上配合中药麻黄升麻汤加减治疗。均以14 d为1个疗程，1个疗程结束后，观察比较两组患者临床总有效率、细菌清除率、血清炎性标志物改善情况。结果 治疗组临床总有效率、细菌清除率高于对照组（P<0.05）。治疗组血清炎性标志物改善治疗前后比较差异有统计学意义（P<0.05）。结论 应用米诺环素(0.2 g/d，首剂加倍)联合头孢哌酮舒巴坦钠大剂量(12 g/d)，或联合哌拉西林他唑巴坦(11.25 g/d)，配合中药麻黄升麻汤加减的治疗方案可明显降低血清炎性因子水平，提高对多重耐药鲍曼不动杆菌肺炎的临床疗效及鲍曼不动杆菌的细菌清除率，值得临床推广应用。 |
| 关键词: 米诺环素 麻黄升麻汤加减 多重耐药鲍曼不动杆菌肺炎 |
| DOI：10.3969/j.issn.1674-3806.2019.10.09 |
| 分类号:R 563.1 |
| 基金项目:广东省2015年建设中医药强省立项资助科研课题（编号：2015115） |
|
| Observation on the curative effect of minocycline and other combination drugs plus modified ephedra cimicifugae decoction on multidrug-resistant Acinetobacter baumannii pneumonia |
|
XU Cheng-yong, XIE Wei-xin, WU Chun-hong, et al.
|
|
Department of Intensive Care Unit, Jieyang Hospital of Traditional Chinese Medicine, Guangdong 522000, China
|
| Abstract: |
| ［Abstract］ Objective To explore the efficiency and safety of minocycline and other combination drugs plus modified ephedra cimicifugae decoction on multidrug-resistant Acinetobacter baumannii(MDRAB) pneumonia. Methods Thirty-four patients with pneumonia caused by multi-drug resistant acinetobacter baumannii were collected from the ICU and ICU observation rooms of the hospital during January 2013 and March 2018 and were divided into the treatment group and the control group, with 17 cases in each group. Secretions of the lower respiratory tract were collected from the thirty-four patients and MDRAB were isolated from the secretions. In the control group, minocycline(0.2 g/d, first dose doubled) combined with cefoperazone-sulbactam large dose(12 g/d), or combined with piperacillin-tazobactam(11.25 g/d) was given to the patients. The treatment group was treated with the same treatment as the control group plus Traditional Chinese Medicine(TCM) modified ephedra cimicifugae decoction. Both groups were treated for 14 days as a course of treatment. After one course of treatment, the clinical total effective rate, bacterial clearance rate and the improvement of serum inflammatory markers were observed and compared between the two groups. Results The therapeutic effect and the bacterial clearance rate of the treatment group were significantly higher than those of the control group(P<0.05). There were significant difference in serum inflammatory markers before and after treatment in the treatment group(P<0.05). Conclusion Minocycline(0.2 g/d, first dose doubled) in combination with large dose of cefoperazone-sulbactam(12 g/d), or combined with piperacillin-tazobactam(11.25 g/d) in association with TCM ephedra cimicifugae decoction can significantly reduce the levels of serum inflammatory cytokines, improve the clinical effect of MDRAB pneumonia and eliminate the bacteria of Acinetobacter baumannii, and is worthy of clinical application. |
| Key words: Minocycline Modified ephedra cimicifugae decoction Multidrug-resistant acinetobacter baumannii(MDRAB) pneumonia |
