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目的:观察益肺化痰活血方雾化吸入联合西药治疗呼吸机相关性肺炎(VAP)的临床疗效。方法:将72例VAP患者随机分为对照组及观察组,每组36例。对照组进行常规西医治疗,观察组在对照组治疗基础上雾化吸入自拟益肺化痰活血方,治疗7天后,比较2组治疗前后肺部感染评分(CPIS)、氧合指数(Pa O2/Fi O2)、血清C-反应蛋白(CRP)及降钙素原(PCT)水平,并比较2组的机械通气时间及ICU住院时间。结果:治疗后,2组Pa O2/Fi O2均较治疗前有所上升(P<0.01),CPIS均较治疗前减少(P<0.01);观察组Pa O2/Fi O2高于对照组(P<0.01),CPIS低于对照组(P<0.01)。2组CRP及PCT水平均较治疗前下降(P<0.01);观察组CRP及PCT水平低于对照组(P<0.01)。观察组机械通气时间较对照组减少(P<0.05),ICU住院时间较对照组有下调趋势,但相比,差异无统计学意义(P>0.05)。结论:在常规治疗基础上加用益肺化痰活血方雾化吸入,对VAP患者有较好的临床疗效,优于单纯西药治疗。
Objective: To observe the clinical curative effect of Yifei Huatan Huoxue Fang atomizing inhalation combined with Western medicine in treating ventilator-associated pneumonia (VAP). Methods: 72 patients with VAP were randomly divided into control group and observation group, 36 cases in each group. The control group was treated with routine western medicine. The observation group was treated with atomization inhalation and phlegm and activating blood circulation on the basis of the control group. After 7 days of treatment, the pulmonary infection score (CPIS) and oxygenation index (Pa O2 / Fi O2), serum C-reactive protein (CRP) and procalcitonin (PCT) were measured. The duration of mechanical ventilation and ICU stay in both groups were compared. Results: After treatment, PaO2 / FiO2 increased in both groups (P <0.01), and CPIS decreased compared with those before treatment (P <0.01). PaO2 / FiO2 in the observation group was higher than that in the control group <0.01), CPIS lower than the control group (P <0.01). The levels of CRP and PCT decreased in both groups before treatment (P <0.01). The levels of CRP and PCT in the observation group were lower than those in the control group (P <0.01). The duration of mechanical ventilation in the observation group was lower than that in the control group (P <0.05), and the length of stay in the ICU was lower than that of the control group. However, the difference was not statistically significant (P> 0.05). Conclusion: Based on routine treatment, the combination of Yifan Huatan Huoxue Fang inhalation has good clinical efficacy in patients with VAP, which is better than that of western medicine alone.