目的 探讨痰热清注射液联合莫西沙星治疗老年社区获得性肺炎的临床疗效和安全性。方法 选取2014年6月-2015年10月在天津市第四中心医院住院的老年社区获得性肺炎患者86例,随机分为对照组和治疗组,每组各43例。对照组静脉滴注盐酸莫西沙星氯化钠注射液0.4 g/次,1次/d;治疗期间若病情好转则改为口服盐酸莫西沙星片0.4 g/次,1次/d。治疗组在对照组治疗的基础上静脉滴注痰热清注射液20 mL,加入到250 mL生理盐水中,1次/d。两组均连续治疗10 d。治疗后,评价两组的临床疗效,同时比较临床症状、体征缓解以及实验室疗效指标的变化。结果 治疗后,对照组、治疗组总有效率分别为88.37%、97.67%,两组总有效率比较差异具有统计学意义(P<0.05)。治疗组在退热、咳嗽咳痰缓解、肺部啰音消失方面均优于对照组,差异具有统计学意义(P<0.05)。两组患者治疗3、10 d后白细胞计数、中性粒细胞比例、C-反应蛋白(CRP)水平均较治疗前下降,同组治疗前后差异比较具有统计学意义(P<0.05);且治疗组这些指标的下降程度均优于对照组,两组比较差异具有统计学意义(P<0.05)。结论 痰热清注射液联合莫西沙星治疗老年社区获得性肺炎具有较好的临床疗效,可以迅速地改善临床症状和实验室检查指标,且不良反应发生率低,具有一定的临床推广应用价值。

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.