目的 探討痰熱清注射液聯(lián)合莫西沙星治療老年社區(qū)獲得性肺炎的臨床療效和安全性。方法 選取2014年6月-2015年10月在天津市第四中心醫(yī)院住院的老年社區(qū)獲得性肺炎患者86例,隨機(jī)分為對(duì)照組和治療組,每組各43例。對(duì)照組靜脈滴注鹽酸莫西沙星氯化鈉注射液0.4 g/次,1次/d;治療期間若病情好轉(zhuǎn)則改為口服鹽酸莫西沙星片0.4 g/次,1次/d。治療組在對(duì)照組治療的基礎(chǔ)上靜脈滴注痰熱清注射液20 mL,加入到250 mL生理鹽水中,1次/d。兩組均連續(xù)治療10 d。治療后,評(píng)價(jià)兩組的臨床療效,同時(shí)比較臨床癥狀、體征緩解以及實(shí)驗(yàn)室療效指標(biāo)的變化。結(jié)果 治療后,對(duì)照組、治療組總有效率分別為88.37%、97.67%,兩組總有效率比較差異具有統(tǒng)計(jì)學(xué)意義(P<0.05)。治療組在退熱、咳嗽咳痰緩解、肺部啰音消失方面均優(yōu)于對(duì)照組,差異具有統(tǒng)計(jì)學(xué)意義(P<0.05)。兩組患者治療3、10 d后白細(xì)胞計(jì)數(shù)、中性粒細(xì)胞比例、C-反應(yīng)蛋白(CRP)水平均較治療前下降,同組治療前后差異比較具有統(tǒng)計(jì)學(xué)意義(P<0.05);且治療組這些指標(biāo)的下降程度均優(yōu)于對(duì)照組,兩組比較差異具有統(tǒng)計(jì)學(xué)意義(P<0.05)。結(jié)論 痰熱清注射液聯(lián)合莫西沙星治療老年社區(qū)獲得性肺炎具有較好的臨床療效,可以迅速地改善臨床癥狀和實(shí)驗(yàn)室檢查指標(biāo),且不良反應(yīng)發(fā)生率低,具有一定的臨床推廣應(yīng)用價(jià)值。

Objective To explore the clinical efficacy and safety of Tanreqing Injection combined with moxifloxacin in treatment of senile community acquired pneumonia. Methods Patients (86 cases) with senile community acquired pneumonia in Tianjin Fourth Center Hospital from June 2014 to October 2015 were randomly divided into control and treatment groups, and each group had 43 cases. The patients in the control group were iv administered with Moxifloxacin Hydrochloride and Sodium Chloride Injection 0.4 g/time, once daily. If the patients got better during the treatment, antibiotics could be changed to Moxifloxacin Hydrochloride Tablets 0.4 g/time, once daily. The patients in the treatment group were iv administered with Tanreqing Injection on the basis of the control group, 20 mL/time adding into 250 mL physiological saline, once daily. Two groups were treated for 10 d. After treatment, the clinical efficacies were evaluated, and the changes of clinical symptoms, relief of signs, and laboratory examination indexes were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 88.37% and 97.67%, respectively, and there were differences between two groups (P < 0.05). Antipyretic action, ease of cough, and pulmonary rales disappeared time in treatment group were better than those in the control group, with the significant difference between two groups (P < 0.05). After treatment for 3 and 10 d, the count of white blood cells, neutrophils ratio, and CRP levels in two groups were significantly decreased, and the difference was statistically significant in the same group (P < 0.05). After treatment, the observational indexes in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P < 0.05). Conclusion Tanreqing Injection combined moxifloxacin has good clinical effect in treatment of senile community acquired pneumonia , and can improve symptoms and laboratory examination indexes with less adverse reactions, which has a certain clinical application value.