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目的了解中西医联合用药治疗脑梗死患者肺部感染的疗效,为中医院脑病科病区预防控制医院感染提供参考。方法选取2008年1月-2013年6月脑病科收治的脑梗死合并肺部感染患者231例,将其随机分为治疗组126例和对照组105例;两组均给予相同的常规治疗手段,治疗组加用中药汤剂治疗,观察两组的临床症状改善时间、药物不良反应,检测T淋巴细胞亚群指标,治疗3个疗程后评价治疗效果。结果治疗组的咳嗽、咳痰液、发热、湿啰音的改善时间均显著低于对照组(t=0.485、0.619、0.449、0.540,P<0.05),对照组治疗3个疗程后的CD4+和CD4+/CD8+比值显著高于治疗前(t=0.656、0.570,P<0.05);治疗组治疗3个疗程后的CD4+和CD4+/CD8+比值显著高于治疗前,CD8+显著低于治疗前(t=0.479、0.619、0.653,P<0.05);治疗组治疗3个疗程后的CD4+和CD4+/CD8+比值显著高于对照组(t=0.607、0.524,P<0.05);治疗3个疗程后,治疗组的总有效率96.8%,显著高于对照组(χ2=4.056,P<0.05);对照组的药物不良反应发生率7.6%,治疗组的药物不良反应发生率7.1%,差异无统计学意义。结论中西医联合用药治疗脑梗死患者肺部感染具有较高的疗效,不增加不良反应的发生,具有较高的临床推广价值。
Objective To understand the curative effect of combined traditional Chinese and western medicine in the treatment of pulmonary infection in patients with cerebral infarction and provide references for the prevention and control of nosocomial infections in the encephalopathy department of Chinese medicine hospital. Methods A total of 231 patients with cerebral infarction and pulmonary infection admitted from January 2008 to June 2013 were randomly divided into treatment group (126 cases) and control group (105 cases). Both groups were given the same routine treatment, The treatment group was treated with Chinese medicine decoction, and the clinical symptom improvement time, adverse drug reaction and T lymphocyte subsets index were observed in both groups. The therapeutic effects were evaluated after 3 courses of treatment. Results The improvement time of cough, sputum, fever and wet rales in the treatment group were significantly lower than those in the control group (t = 0.485,0.619,0.449,0.540, P <0.05) (T = 0.656, 0.570, P <0.05). The ratio of CD4 + and CD4 + / CD8 + in the treatment group after three courses of treatment was significantly higher than that before treatment, and the level of CD8 + in the treatment group was significantly lower than that before treatment (t = 0.479,0.619,0.653, P <0.05). The ratio of CD4 + and CD4 + / CD8 + in the treatment group after 3 courses of treatment was significantly higher than that in the control group (t = 0.607,0.524, P <0.05) The total effective rate was 96.8%, which was significantly higher than that of the control group (χ2 = 4.056, P <0.05). The incidence of adverse drug reactions in the control group was 7.6%, and the incidence of adverse drug reactions in the treatment group was 7.1% with no significant difference. Conclusion The combination of TCM and WM treatment of lung infection in patients with cerebral infarction has a higher efficacy, does not increase the incidence of adverse reactions, has a high clinical value.