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温阳益气法治疗重型颅脑损伤亚低温后肺炎30 例临床观察
张启杨,王 冠,王雪岩
0
(天津中医药大学,天津,300193;天津中医药大学第二附属医院,天津,300250)
摘要:
目的:观察温阳益气法治疗重型颅脑损伤亚低温后肺炎的临床疗效。方法:将60例重型颅脑损伤患者随机分为治疗组和对照组,每组各30例。2组患者均接受亚低温治疗,对照组另予西医综合基础治疗,治疗组在对照组基础上再予温阳益气法之代表方参附汤治疗。观察2组患者临床疗效、肺炎指标、肺部感染指数评分(CPIS)、肺炎严重指数分级(PSI)及不良反应发生情况。结果:总有效率治疗组为83.33%(25/30),对照组为60.00%(18/30),2组比较,差异有统计学意义(P<0.05);治疗后第14天治疗组的体温、血清CRP、CPIS评分及PSI评分明显低于对照组,且2组患者治疗后第14天的各项指标均明显低于第1天;2组治疗前后均未发现明显不良反应。结论:温阳益气法治疗重型颅脑损伤亚低温后肺炎的临床疗效确切,对提高重型颅脑损伤患者生存概率和促进功能恢复具有重要意义。
关键词:  重型颅脑损伤  亚低温肺炎  中西医结合疗法  温阳益气法  参附汤
DOI:
Clinical effect of Yang-warming and Qi-tonifying therapy in treatment of pneumonia after mild hypothermia for severe traumatic brain injury:An analysis of 30 cases
ZHANG Qiyang,WANG Guan,WANG Xueyan
(Tianjin University of Traditional Chinese Medicine,Tianjin 300193,China;The Second Affiliated Hospital of Tianjin University of Traditional Chinese Medicine,Tianjin 300250,China)
Abstract:
Objective:To investigate the clinical effect of Yang-warming and Qi-tonifying therapy in the treatment of pneumonia after mild hypothermia for severe traumatic brain injury.Methods:A total of 60 patients with severe traumatic brain injury were randomly divided into treatment group and control group,with 30 patients in each group.The patients in the control group were given mild hypothermia therapy combined with multimodality Western medicine therapy,and those in the treatment group were given Shenfu decoction,a classic prescription of Yang-warming and Qi-tonifying therapy,in addition to the treatment in the control group.The two groups were observed in terms of clinical outcome,pneumonia indices,clinical pulmonary infection score (CPIS),pneumonia severity index (PSI),and adverse reactions.Results:There was a significant difference in overall response rate between the treatment group and the control group [83.33% (25/30) vs 60.00% (18/30),P<0.05].On day 14 after treatment,the treatment group had significantly lower body temperature,serum C-reactive protein,CPIS,and PSI score than the control group,and both groups had significant reductions in these indices from day 1 to day 14 after treatment.No obvious adverse reactions were observed before and after treatment.Conclusion:Yang-warming and Qi-tonifying therapy has a marked clinical effect in the treatment of pneumonia after mild hypothermia for severe traumatic brain injury,with great significance in improving the survival probability of patients with severe traumatic brain injury and promoting functional recovery.
Key words:  severe traumatic brain injury  pneumonia after mild hypothermia  integrated traditional Chinese and Western medicine therapy  Yang-warming and Qi-tonifying therapy  Shenfu decoction

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