Clinical Research On Supplementing Qi And Nourishing Yin,and Huotan Jiedu For Chronic Obstructive Pulmonary Disease Of Deficiency Of Both Qi And Yin,Phlegm-blood Stasis And Toxin Accumulation Type With Multidrug Resistant Organism Infection

Objective:Clinical effect is observeed by using supplementing qi and nourishing yin,huotan jiedu to cure chronic obstructive pulmonary disease of deficiency of both qi and yin,phlegm-blood stasis and toxin accumulation type with MDRO infection.It is studied to explore antibiotic effect of deficiency of both qi and yin,phlegm-blood stasis and toxin accumulation prescriptions,so as to provide more basis for its clinical application,to improve the connotation of traditional Chinese medicine syndrome types related to MDRO infection,to enrich traditional Chinese medicine theory in the treatment of MDRO and contribute to the treatment of MDRO.Methods:Ninety-four COPD patients with MDRO infection of deficiency of both qi and yin and phlegm-blood stasis and toxin accumulation were randomly divided into western medicine group(n=47)and integrated traditional Chinese and western medicine group(n=47).Both groups were treated with western medicine standard basic treatment,including the selection of sensitive antibiotics according to sputum culture(PDR according to clinical experience),oxygen therapy,application of bronchodilator and glucocorticoid etc.In addition,the integrated traditional Chinese and western medicine group was treated with self-made supplementing qi and nourishing yin,and huotan jiedu prescriptions on the basis of the western medicine’s standard basic treatment.The average course of treatment in both groups was 14 days.The changes of clinical symptoms,bacterial clearance rate of sputum culture,WBC,hs-CRP,PCT were observed before and after treatment.Results:Each group had 47 cases and caused 2 shedding cases.No obvious adverse reactions occured during the whole research.There was no significant difference in age,sex,course of disease and average course of disease between the two groups(P>0.05).After treatment,the scores of clinical symptoms and signs in the two groups decrease.The scores of clinical symptoms and signs in the integrated traditional Chinese and western medicine group(6.07±1.45)were significantly lower than the western medicine group(8.76±1.58)(P<0.05).As far the clinical efficacy of medicine after treatment,4 cases were clinically controlled,9 cases were markedly effective and 13 cases of effective in the integrated traditional Chinese and western medicine group.,and the total effective in the integrated traditional Chinese and western medicine group was 57.8%.In the western medicine group,1 case was clinically controlled,2 cases were markedly effective,12 cases were effective,and the total effective was 33.3%.There was a significant difference between the two groups in the total effective rate of clinical efficacy(P<0.05).The changes of sputum culture in the two groups before and after treatment.The number of bacteria in the two groups decreased after treatment.Compared with the western medicine group,the integrated traditional Chinese and western medicine group had significantly high clearance rate of MDRO(46.7%versus 24.4%)(P<0.05).In the integrated traditional Chinese and western medicine group,the average WBC count before treatment was12.36±1.63×10~9/L,the average value of hs-CRP was 101.34±11.52mg/L,and the positive rate of PCT was 73.3%.In the western medicine group,the average WBC count before treatment was 12.50±1.38×10~9/L,the average value of hs-CRP was99.09±17.24mg/L,and the positive rate of PCT was 71.1%.So there was no significant difference between the two groups before treatment(P>0.05).Compared with western medicine group after treatment,the integrated traditional Chinese and western medicine group had significantly less average WBC count(9.11±1.47×10~9/L versus 10.38±0.98×10~9/L),significantly less average value of hs-CRP(20.19±1.27mg/L versus 41.66±3.20 mg/L),significantly less positive rate of PCT(20%versus 35.6%)(P<0.05).Conclusion:(1)Supplementing qi and nourishing yin,huotan jiedu prescriptions combined with western medicine can significantly improve the symptoms of cough,expectoration and asthma in patients with COPD of deficiency of both qi and yin,phlegm-blood stasis and toxin accumulation type with MDRO infection.(2)Supplementing qi and nourishing yin,huotan jiedu prescriptions combined with western medicine has some inhibitory and killing effect on MDRO.(3)There were no obvious side effects after using supplementing qi and nourishing yin,huotan jiedu prescriptions combined with western medicine for COPD of deficiency of both qi and yin,phlegm-blood stasis and toxin accumulation type with MDRO infection,which proved that supplementing qi and nourishing yin,huotan jiedu prescriptions was safe and worthy of clinical promotion.