Evaluation Of The Efficacy Of Xue BiJing Combined With Piperacillin/tazobactam In The Treatment Of Severe Pneumonia

Background:Severe pneumonia is one of the most common respiratory diseases or comorbidities of critically ill patients in the ICU.The patients’ condition progresses quickly and cannot be dealt with in time.It can develop into septic shock and eventually lead to multiple organ dysfunction syndrome(MODS).It is the ICU patients the main cause of death.The pathological process of severe pneumonia is complicated,often accompanied by severe inflammation,oxidative stress,immune dysfunction,coagulation dysfunction,and multiple organ failure.The application of long-term antibacterial drugs will inevitably increase the probability of drug-resistant bacteria.Therefore,the correct selection of antibacterial drugs and shortening the medication cycle are the key to the treatment of severe pneumonia in clinical departments.Objective:This trial aims to study the efficacy of XueBiJing combined with piperacillin/tazobactam in the treatment of patients with severe pneumonia caused by Klebsiella pneumoniae.By comparing patients’ clinical symptoms,inflammatory factor expression,and APACHE II,PSI,CPIS and other scores,expound the therapeutic effect of XueBiJing combined with piperacillin/tazobactam,and provide better anti-infective diagnosis and treatment for severe pneumonia with multiple clinical treatment options.Method:From a total of 54 patients who were hospitalized in the Department of Critical Care Medicine,China-Japan Union Hospital of Jilin university from October 2018 to December 2020,who met the diagnosis of severe pneumonia caused by Klebsiella pneumoniae,were divided into two groups according to their treatment plan.Group A piperacillin/tazobactam combined with XueBiJing group,group B piperacillin/tazobactam group,28 patients in group A,26 patients in group B,each in the first after admission record clinical symptoms and related inspection indicators on day 1 and day 7,with improvement of PSI risk level(significantly effective + effective)as the primary end point,secondary results comparing procalcitonin,white blood cell count,inflammatory factors,oxygenation index,platelet count,general status,etc.Results:1.Comparing the basic information of the two groups of patients,there was no statistically significant difference in gender,age,BMI,combined underlying diseases,SOFA score,PSI score,CPIS score,and APACHE II score of the two groups.The cases are comparable.2.Before treatment,the two groups of patients compared white blood cell count,procalcitonin,platelet count,Pa O2/Fi O2,IL-6,IL-10,and general status indicators.There was no statistical difference.After 7days of treatment,the white blood cell count and decreased procalcitonin,PSI score,SOFA score,APACHEII score,respiratory rate,body temperature,and pulse were all lower than before,oxygenation index were higher than before.Among them,XueBiJing combined with piperacillin/tazobactam group decreased more significantly than the piperacillin/tazobactam group alone;especially in the expression of pro-inflammatory factor IL-6,the inflammatory factors in the Xuebijing combined piperacillin/tazobactam group were significantly reduced compared with the piperacillin/tazobactam group alone,which was statistically significant.3.By comparing the PSI improvement scores of the two groups before and after treatment,the effective rate of the two groups of patients after receiving the treatment =(singnificantly effective + effective)/total number,the two groups of treatment plans have statistical differences,and after pairwise comparison,it is found that XueBiJing combined piperacillin/tazobactam treatment group was better than the piperacillin/tazobactam group.Conclusion:1.The treatment improvement rate of Xuebijing combined with piperacillin/tazobactam group on severe pneumonia caused by Klebsiella pneumoniae is better than that of piperacillin/tazobactam group alone;2.Patients with severe pneumonia caused by Klebsiella pneumoniae in the Xuebijing combined piperacillin/tazobactam group can significantly improve the general state of the patient,increase the oxygenation index,and reduce the body’s inflammatory response after treatment.