中华中医药学刊

目的 评估清热化痰通腑法对高血压脑出血早期胃管鼻饲后继发性肺部感染的作用效果。方法 选择高血压脑出血早期胃管鼻饲后继发性肺部感染患者100例。按照等比例随机分为对照组与观察组，每组50例。对照组予以基础治疗；观察组在对照组基础上，予以清热化痰通腑法。2周为1个疗程。比较两组疗效。治疗前后测定炎症指标[白细胞介素-6(Interleukin-6,IL-6)、肿瘤坏死因子-α(Tumor necrosis factor-α,TNF-α)、超敏C反应蛋白(Hypersensitivity C-reactive protein, Hs-CRP)]和动脉血气指标[动脉血氧分压(Partial pressure of oxygen, PaO₂)、动脉二氧化碳分压(Partial pressure of carbon dioxide, PaCO₂)],评价临床肺部感染评分(Clinical pulmonary infection score, CPIS)。结果 观察组的临床疗效优于对照组，差异有统计学意义(P<0.05)。治疗2周观察组血清IL-6、TNF-α和Hs-CRP低于对照组，差异有统计学意义(P<0.05)。治疗2周观察组PaO₂高于对照组，PaCO₂低于对照组，差异有统计学意义(P<0.05)。治疗1周、治疗2周观察组CPIS评分低于对照组，差异有统计学意义(P<0.05)。结论 清热化痰通腑法对高血压脑出血早期胃管鼻饲后继发性肺部感染的控制效果确切，有助于抑制炎症和改善动脉血氧，减轻感染程度。

Objective To evaluate the effect of the clearing heat, resolving phlegm and dredging Fu-organs method on secondary pulmonary infection after early gastric tube nasogastric feeding in patients with hypertensive intracerebral hemorrhage. Methods A hundred patients with secondary pulmonary infection after early gastric tube nasogastric feeding in hypertensive intracerebral hemorrhage were selected and randomly divide into two groups, with 50 cases in each group. The control group received basic treatment. On the basis of the control group, the observation group was treated with the method of clearing heat, resolving phlegm and dredging Fu-organs. One course of the treatment was two weeks. The therapeutic effects of two groups were compared. The inflammatory markers[interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),hypersensitivity C-reactive protein(hs-CRP)] and arterial blood gas indicators[partial pressure of oxygen(PaO₂),partial pressure of carbon dioxide(PaCO₂)] before and after treatment were used to evaluate clinical pulmonary infection score(CPIS). Results The clinical efficacy of the observation group was better than that of the control group, and the difference was statistically significant(P<0.05). The serum levels of IL-6,TNF-α and hs-CRP in the observation group after 2 weeks of treatment were lower than those of the control group and the difference was statistically significant(P<0.05). After 2 weeks of treatment, the value of PaO₂ in the observation group was higher than that in the control group, and the value of PaCO₂ was lower than that in the control group, with a statistically significant difference(P<0.05). The CPIS score of the observation group was lower than that of the control group after 1 and 2 weeks of treatment, and the difference was statistically significant(P<0.05). Conclusion The clearing heat, resolving phlegm and dredging Fu-organs method has a definite control effect on secondary pulmonary infection after early gastric tube nasogastric feeding in hypertensive intracerebral hemorrhage, which helps to inhibit inflammation, improve arterial blood oxygen and reduce the degree of infection.