Clinical Observation Of Ventilator-associated Pneumonia With The Type Of Phlegm-heat Obstructing Lung By Therapy Of Ventilating Lung And Relieving Viscera

Objective To observe the curative effect of the therapy which ventilating lung and relieving viscera on ventilator-associated pneumonia with the type of phlegm-heat obstructing lung, to investigate the mechanism of the therapy which ventilating lung and relieving viscera in the treatment of VAP, to evaluate its effectiveness and safety, to provide objective basis for the treatment of ventilator-associated pneumonia by therapy of ventilating lung and relieving viscera.Methods 60 patients were selected from the Department of Intensive Care Unit (ICU) in Chinese Medicine Hospital of Ningbo with ventilator-associated pneumonia diagnosis standard in 2015 September to 2016 September in the outpatient. Patients were randomly divided into two groups,30 cases in each group. Control group was treated with antibiotics, expectorants, adjusting water electrolyte and acid-base balance, nutritional support and other comprehensive care, and treatment group was given the modified Xuanbai-Chengqi decoction of the theapy which ventilating lung and relieving viscera besides the same treatment as control group.Results 1.Clinical curative effect:The total effective rate was 93.33% in the treatment group, which was superior to 80.00% in the control group, and there were significant difference between the two groups(p<0.05).2.TCM syndrome scores:TCM syndrome scores in two groups after the treatment of three days and seven days were obviously decreased than before receiving the treatment (P< 0.05); compared with the control group, TCM syndrome scores in the treatment group were significantly decreased after seven days (P=0.001, P<0.01).3. Inflammatory indexes:Inflammatory indexes (WBC, CRP, PCT) in two groups after the treatment of three days and seven days were decreased than before receiving the treatment(P < 0.05);compared with the control group, WBC, CRP and PCT in the treatment group were decreased after seven days (P<0.05).4. Clinical pulmonary infection score (CPIS):CPIS in two groups after the treatment of three days and seven days were obviously decreased than before receiving the treatment (P< 0.05); compared with the control group, CPIS in the treatment group were significantly decreased after seven days(P=000, P<0.01).5.Oxygenation index:Oxygenation index in two groups after the treatment of three days and seven days were increased than before receiving the treatment (P<0.05); compared with the control group, oxygenation index in the treatment group were dramatically inproving after seven days(P=0.004,P<0.01).6. Safety:blood, urine and stool routine, liver and kidney function, electrocardiogram and other detection had no obvious abnormal changes in the treatment group, and no adverse reactions wasoccurred in the course of treatment.Conclusion The therapy of ventilating lung and relieving viscera in the treatment of ventilator-associated pneumonia with the type of phlegm-heat obstructing lung can significantly improve improve the clinical symptoms and signs, improve oxygenation index, alleviate the inflammation reaction, control pneumonia,so that it can offline and extubation as soon as possible,reduce the mechanical ventilation time and the days of illness.Obviously serious adverse adverse have not been found in the process of treatment. The treatment is effective and safe, so it deseved promotion and application.