老年耐药铜绿假单胞菌肺炎的中医证型演变规律及与炎症指标相关性的研究

发布时间：2019-01-02 16:22

【摘要】：目的:探讨老年耐药铜绿假单胞菌肺炎中医证型的演变规律及与炎症指标的相关性,给临床治疗开拓新思路。方法:收集2014年9月—2016年3月山东中医药大学附属医院重症医学科老年耐药铜绿假单胞菌肺炎60例。通过对患者不同时间点炎症指标及中医证型进行分析,探讨老年耐药铜绿假单胞菌肺炎的中医证型演变规律及与炎症指标的相关性。结果:根据60例患者不同时间点炎症指标的变化及中医证型的分布,可知患者在第7天感染达到高峰,WBC、CRP、PCT、体温及痰量值达到高峰,血小板出现反应性降低,第14天到达后期时,WBC、CRP、PCT、体温和痰量逐渐降低,血小板逐渐升高,各项指标均趋于正常;入组第1天中医证型以痰热壅肺证居多,其次为风热犯肺证,入组第7天中医证型以肺胃热盛证居多,其次为痰热壅肺证,热闭心包证增加明显,入组第14天中医证型以气阴两虚证居多,邪陷正脱证亦显著增加。结论:老年耐药铜绿假单胞菌肺炎第1天主要为痰热壅肺证,第7天演变为肺胃热盛证,第14天则以气阴两虚证为主;并中医证型演变与炎症指标具有相关性;炎症指标可作为类症状和类指标用于协助判断老年耐药铜绿假单胞菌肺炎的中医证型。
[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.
【学位授予单位】：山东中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R259

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