發(fā)布時(shí)間：2019-01-02 16:22

【摘要】：目的:探討老年耐藥銅綠假單胞菌肺炎中醫(yī)證型的演變規(guī)律及與炎癥指標(biāo)的相關(guān)性,給臨床治療開拓新思路。方法:收集2014年9月—2016年3月山東中醫(yī)藥大學(xué)附屬醫(yī)院重癥醫(yī)學(xué)科老年耐藥銅綠假單胞菌肺炎60例。通過對(duì)患者不同時(shí)間點(diǎn)炎癥指標(biāo)及中醫(yī)證型進(jìn)行分析,探討老年耐藥銅綠假單胞菌肺炎的中醫(yī)證型演變規(guī)律及與炎癥指標(biāo)的相關(guān)性。結(jié)果:根據(jù)60例患者不同時(shí)間點(diǎn)炎癥指標(biāo)的變化及中醫(yī)證型的分布,可知患者在第7天感染達(dá)到高峰,WBC、CRP、PCT、體溫及痰量值達(dá)到高峰,血小板出現(xiàn)反應(yīng)性降低,第14天到達(dá)后期時(shí),WBC、CRP、PCT、體溫和痰量逐漸降低,血小板逐漸升高,各項(xiàng)指標(biāo)均趨于正常;入組第1天中醫(yī)證型以痰熱壅肺證居多,其次為風(fēng)熱犯肺證,入組第7天中醫(yī)證型以肺胃熱盛證居多,其次為痰熱壅肺證,熱閉心包證增加明顯,入組第14天中醫(yī)證型以氣陰兩虛證居多,邪陷正脫證亦顯著增加。結(jié)論:老年耐藥銅綠假單胞菌肺炎第1天主要為痰熱壅肺證,第7天演變?yōu)榉挝笩崾⒆C,第14天則以氣陰兩虛證為主;并中醫(yī)證型演變與炎癥指標(biāo)具有相關(guān)性;炎癥指標(biāo)可作為類癥狀和類指標(biāo)用于協(xié)助判斷老年耐藥銅綠假單胞菌肺炎的中醫(yī)證型。
[Abstract]:Objective: to explore the evolution of Chinese medicine syndrome type of drug resistant Pseudomonas aeruginosa pneumonia and its correlation with inflammatory indexes, and to develop a new way of clinical treatment. Methods: from September 2014 to March 2016, 60 cases of drug-resistant Pseudomonas aeruginosa pneumonia in the Department of intensive Medicine, affiliated Hospital of Shandong University of traditional Chinese Medicine were collected. Based on the analysis of inflammatory indexes and TCM syndrome types at different time points in patients, the evolution of TCM syndromes of drug-resistant Pseudomonas aeruginosa pneumonia and its correlation with inflammatory indexes were discussed. Results: according to the changes of inflammatory indexes at different time points and the distribution of TCM syndromes in 60 patients, the infection reached the peak on the 7th day, the body temperature and sputum volume of WBC,CRP,PCT, reached the peak, and the platelet reactivity decreased. At the end of the 14th day, the body temperature and sputum volume of WBC,CRP,PCT, decreased gradually, the platelet increased gradually, and all the indexes tended to be normal. On the 1st day, phlegm and heat obstruction of the lung, wind heat invading the lung, lung heat flourishing in the 7th day, phlegm and heat blocking the lung, heat blocking the pericardium were the main syndromes of TCM syndrome in the first day of entering the group, the second was phlegm heat blocking the lung syndrome, and the second was the syndrome of heat blocking the pericardium. On the 14th day, Qi-Yin deficiency syndrome was the main type of TCM syndromes, and the syndromes of qi and yin deficiency were also increased significantly. Conclusion: the main causes of drug-resistant Pseudomonas aeruginosa pneumonia are phlegm heat blocking lung syndrome on the first day, lung stomach heat flourishing syndrome on the 7th day, qi and yin deficiency syndrome on the 14th day, and the development of TCM syndrome type is correlated with inflammation index. The inflammatory index can be used as a kind of symptom and index to help judge the Chinese medicine syndrome type of drug resistant Pseudomonas aeruginosa pneumonia.
【學(xué)位授予單位】：山東中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R259

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 洪波;鐘之州;鐘一棠;;鐘一棠治療風(fēng)溫肺熱病經(jīng)驗(yàn)[J];浙江中醫(yī)雜志;2014年01期

2 楊暉;彭素娟;華光;;宣肺清痰飲治療老年重癥肺炎19例臨床觀察[J];中醫(yī)藥導(dǎo)報(bào);2013年12期

3 陳方圓;于秀妍;馬笑雪;;MRSA的耐藥機(jī)制及臨床藥物治療方案相關(guān)研究進(jìn)展[J];中外醫(yī)療;2011年17期

4 蒲曉東;;溫病學(xué)教材應(yīng)將活血化淤法編入溫病的主要治法[J];時(shí)珍國(guó)醫(yī)國(guó)藥;2009年07期

5 周育平;李春生;;肺炎雙球菌復(fù)制家兔溫病發(fā)熱模型的研究[J];北京中醫(yī);2007年08期

6 鄒于民;;增液湯和血腑逐瘀湯治療風(fēng)溫肺熱病52例臨床觀察[J];中國(guó)冶金工業(yè)醫(yī)學(xué)雜志;2007年03期

7 ;社區(qū)獲得性肺炎診斷和治療指南[J];中華結(jié)核和呼吸雜志;2006年10期

8 方怡,冉丕鑫;重癥社區(qū)獲得性肺炎炎性機(jī)制研究進(jìn)展[J];國(guó)外醫(yī)學(xué).呼吸系統(tǒng)分冊(cè);2005年01期

9 李家泰,李耘,齊慧敏;2002—2003年中國(guó)革蘭陰性細(xì)菌耐藥性監(jiān)測(cè)研究[J];中華檢驗(yàn)醫(yī)學(xué)雜志;2005年01期

10 文魁,謝曼君,吳水河;老年急性呼吸道感染C蛋白及IL-6檢測(cè)臨床評(píng)價(jià)[J];實(shí)用預(yù)防醫(yī)學(xué);2004年02期

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