血必净注射液辅助治疗肾移植术后肺炎痰热挟瘀阻肺证的临床疗效分析

发布时间：2018-02-04 08:14

  本文关键词： 肾移植术 肺炎 血必净注射液　出处：《福建中医药大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:采用血必净注射液联合常规治疗治疗肾移植术后肺炎属痰热挟瘀阻肺证者,与常规治疗组对比,观察2组治疗前后相关炎症指标、细胞免疫、凝血功能、肾功能、生活质量的变化情况,探讨血必净注射液对肾移植术后肺炎患者的辅助治疗作用。方法:收集2015年7月-2017年1月在南京军区福州总医院呼吸与危重症医学科、干细胞治疗科、泌尿外科三科住院部符合肾移植术后肺炎纳入标准的患者42例,依据随机数字表将其分为对照组22例,试验组20例。两组均予以包括抗感染、控制性氧疗、解痉、化痰、平喘等在内的常规治疗,试验组在常规治疗的基础上加用血必净注射液(天津红日药业股份有限公司)50ml+NS 100ml静滴2/日,疗程为7天。两组病人均于治疗前(D0)、治疗第3日(D3)、治疗第7日(D7)检测外周血白细胞计数(WBC)、中性粒细胞比率(NE%)、淋巴细胞计数(LY)、降钙素原(PCT)、C反应蛋白(CRP)、D-二聚体、血小板计数(PLT)、纤维蛋白原(Fib)、活化部分凝血酶原时间(APTT)、凝血酶原时间(PT)、血肌酐(SCR)、尿素氮(BUN)及行APACHEⅡ评分,于D0及D7检测外周血CD3、CD4、CD8、CD4/CD8。所有数据均应用统计学软件SPSS20.0进行统计分析。结果:1.两组病人治疗前一般资料、WBC、NE%、LY、PCT、CRP、D-二聚体、PLT、Fib、APTT、PT、SCR、BUN、CD3、CD4、CD8、CD4/CD8、APACHEⅡ评分差异无统计学意义(P0.05)。2.D3 试验组 WBC、NE%、PCT、CRP、SCR、BUN、D-二聚体、APACHEⅡ评分较前有所下降,差异具有统计学意义(P0.05);对照组WBC、NE%、PCT、CRP、BUN、D-二聚体、APACHEⅡ评分较前有所下降,差异具有统计学意义(P0.05);试验组与对照组相对比,PCT、CRP下降更明显,差异具有统计学意义(P0.05)。D7两组 WBC、NE%、PCT、CRP、SCR、BUN、D-二聚体、APACHEⅡ评分较前有所下降,差异具有统计学意义(P0.05);试验组与对照组相对比,PCT、CRP、SCR、BUN、D-二聚体、APACHEⅡ评分下降更明显,差异具有统计学意义(P0.05)。两组治疗前后 LY、PLT、Fib、APTT、PT、CD3、CD4、CD8、CD4/CD8 差异无统计学意义(P0.05)。3.无论D3日或D7日,试验组总体疗效优于对照组(P0.05)。结论:1.血必净注射液能有效改善肾移植术后肺炎属痰热挟瘀阻肺证患者的临床症状,减轻炎症反应。2.血必净注射液对肾移植术后肺炎属痰热挟瘀阻肺证患者可改善凝血功能异常。3.血必净注射液对肾移植术后肺炎属痰热挟瘀阻肺证患者可改善肾功能异常。4.血必净注射液对于增强肾移植术后肺炎属痰热挟瘀阻肺证患者的细胞免疫功能方面疗效尚未明确,有待进一步研究。
[Abstract]:Objective: to use Xuebijing injection combined with routine therapy to treat pneumonia after renal transplantation which belongs to phlegm-heat combined with stagnation of lung syndrome. Compared with the routine treatment group, the inflammatory indexes, cellular immunity and coagulation function were observed before and after treatment in two groups. Changes of renal function and quality of life. Objective: to investigate the effect of Xuebijing injection on the treatment of pneumonia patients after renal transplantation. Methods: from July 2015 to January 2017, collected from the Department of Respiratory and critical Medicine of Fuzhou General Hospital of Nanjing military region. Forty-two patients who met the admission criteria of pneumonia after renal transplantation were divided into control group (n = 22) according to random digital table. There were 20 cases in the experimental group. Both groups were given routine treatment including anti-infection, controlled oxygen therapy, spasmolysis, phlegm reduction, asthma relief and so on. The experimental group was treated with Xuebijing injection on the basis of routine therapy (Tianjin Hongri Pharmaceutical Co., Ltd.) 50ml NS 100ml intravenous drip 2 days. The course of treatment was 7 days. The patients in both groups were treated with D0 and D3 on 3rd and D7 on 7th respectively. The white blood cell count and neutrophil ratio were detected by WBC and neutrophil ratio (neutrophil ratio, neutrophil ratio, neutrophil ratio, neutrophil ratio, neutrophil ratio). Lymphocyte count, procalcitonin (PCT) C-reactive protein (CRP), platelet count (PLT), fibrinogen (Fib). Activated partial prothrombin time (APTTT), prothrombin time (PTT), serum creatinine (SCR), bun (bun) and APACHE 鈪，

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