大蒜素注射液联合伏立康唑治疗肺部真菌感染的疗效观察
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摘要
目的探讨大蒜素注射液联合伏立康唑治疗肺部真菌感染的临床效果。方法选取西安交通大学第二附属医院2016年5月—2017年10月收治的肺部真菌感染患者116例,随机分成对照组合和治疗组,每组各58例。对照组第1天静脉注射注射用伏立康唑,400 mg/次,第2天减至200 mg/次,2次/d,待患者体温恢复正常、肺部病灶明显吸收、症状消失或明显好转后,改为口服伏立康唑片,200mg/次,2次/d。治疗组在对照组基础上静脉滴注大蒜素注射液,60mg加入5%葡萄糖注射液250 mL,再加入50 mg利多卡因注射液,1次/d。两组均治疗14 d。观察两组患者临床疗效,同时比较治疗前后两组患者真菌感染清除率和生命体征变化。结果治疗后,对照组临床有效率为75.86%,显著低于治疗组的94.83%,两组比较差异具有统计学意义(P<0.05)。治疗后,对照组真菌感染清除率为72.41%,明显低于治疗组的91.38%,两组比较差异具有统计学意义(P<0.05)。治疗后,两组体温、呼吸频率、脉搏频率、收缩压、舒张压均明显降低(P<0.05),且治疗组患者生命体征明显低于对照组(P<0.05)。结论大蒜素注射液联合伏立康唑治疗肺部真菌感染能有效改善临床症状体征,提高临床疗效,且不良反应轻微。
Objective To investigate the clinical effect of Allitride Injection combined with voriconazole in treatment of pulmonary fungal infection. Methods Patients(116 cases) with pulmonary fungal infection in the Second Affiliated Hospital of Xi'an Jiaotong University from May 2016 to October 2017 were randomly divided into control and treatment groups, and each group had 58 cases. Patients in the control group were iv administered with Voriconazole for injection for the first day, 400 mg/time, and reduced to 200 mg/time from 2nd day, twice daily, they were po administered with Voriconazole Tablets after temperature returned to normal, absorption of pulmonary lesions, symptoms disappeared or improved markedly, 200 mg/time, twice daily. Patients in the treatment group were iv administered with Allitride Injection on the basis of the control group, 60 mg added into 5% glucose injection 250 mL, and 50 mg lidocaine was also added, once daily. Patients in two groups were treated for 14 d. After treatment, the clinical efficacy was evaluated, and the clearance rate of fungal infection, the change of vital signs in two groups before and after treatment was compared. Results After treatment, the clinical efficacy in the control group was 75.86%, which was significantly lower than 94.83% in the treatment group, and there were differences between two groups(P < 0.05). After treatment, the clearance rate of fungal infection in the control group was 72.41%, which was significantly lower than 91.38% in the treatment group, and there were differences between two groups(P < 0.05). After treatment, temperature, breathing frequency, pulse frequency, systolic and diastolic blood pressure in two groups was significantly decreased(P < 0.05), and the vital signs in the treatment group were significantly lower than that in the control group(P < 0.05). Conclusion Allitride Injection combined with voriconazole in treatment of pulmonary fungal infection can effectively promote clinical symptoms and signs, improve clinical efficacy, and has slight adverse reactions.
Objective To investigate the clinical effect of Allitride Injection combined with voriconazole in treatment of pulmonary fungal infection. Methods Patients(116 cases) with pulmonary fungal infection in the Second Affiliated Hospital of Xi'an Jiaotong University from May 2016 to October 2017 were randomly divided into control and treatment groups, and each group had 58 cases. Patients in the control group were iv administered with Voriconazole for injection for the first day, 400 mg/time, and reduced to 200 mg/time from 2nd day, twice daily, they were po administered with Voriconazole Tablets after temperature returned to normal, absorption of pulmonary lesions, symptoms disappeared or improved markedly, 200 mg/time, twice daily. Patients in the treatment group were iv administered with Allitride Injection on the basis of the control group, 60 mg added into 5% glucose injection 250 mL, and 50 mg lidocaine was also added, once daily. Patients in two groups were treated for 14 d. After treatment, the clinical efficacy was evaluated, and the clearance rate of fungal infection, the change of vital signs in two groups before and after treatment was compared. Results After treatment, the clinical efficacy in the control group was 75.86%, which was significantly lower than 94.83% in the treatment group, and there were differences between two groups(P < 0.05). After treatment, the clearance rate of fungal infection in the control group was 72.41%, which was significantly lower than 91.38% in the treatment group, and there were differences between two groups(P < 0.05). After treatment, temperature, breathing frequency, pulse frequency, systolic and diastolic blood pressure in two groups was significantly decreased(P < 0.05), and the vital signs in the treatment group were significantly lower than that in the control group(P < 0.05). Conclusion Allitride Injection combined with voriconazole in treatment of pulmonary fungal infection can effectively promote clinical symptoms and signs, improve clinical efficacy, and has slight adverse reactions.
引文
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[10]张平.伏立康唑治疗慢性肾功能不全合并肺部真菌感染的疗效[J].医学临床研究,2017,34(8):1487-1488, 1491.
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[12]吴晶,王亮,曹永兵,等.《中药大辞典》记载的抗真菌中药体外药效再评价[J].中国真菌学杂志,2016,11(6):348-353.
[13]高甜,柴惠,沃兴德.大蒜素的药理作用及其开发应用[J].医学研究杂志, 2011, 40(5):12-15.
[14]龚钰清,陈悦,任泽久,等.氟康唑胶囊联合大蒜素注射液治疗慢性乙型重型肝炎合并真菌感染的疗效分析[J].中国现代医学杂志, 2006, 16(2):276-278, 180.
[15]闫芳,陈倪,杨芳,等.大蒜素治疗细菌感染所致呼吸机相关性肺炎的临床研究[J].湖南中医药大学学报, 2017, 37(3):313-316.
[2]路振宇,党殿杰,刁淑梅.肺部真菌感染50例临床分析[J].山西医药杂志, 2014, 43(13):1540-1541.
[3]张娟,廖银根.伏立康唑的抗真菌机制与治疗药物监测进展[J].中国药房, 2012, 23(14):1322-1324.
[4]中华内科杂志编辑委员会.侵袭性肺部真菌感染的诊断标准与治疗原则[J].中华内科杂志,2006,45(8):697-700.
[5]中华医学会.抗菌药物临床应用指导原则[J].中华医学杂志, 2004, 26(22):2026-2056.
[6]黄婷婷,王佳贺.老年肺部真菌感染危险因素的研究进展[J].实用老年医学, 2016, 39(12):977-979.
[7]周有旺,陶文.伏立康唑序贯治疗慢性阻塞性肺疾病急性加重期合并肺曲霉病的临床研究[J].现代药物与临床, 2014, 29(10):1149-1152.
[8]王奢,梁蓓蓓.21世纪上市新抗菌药物临床应用现状(三)[J].临床药物治疗杂志, 2008, 6(2):7-10.
[9]张晓艳,李蕾芳,张国香,等.伏立康唑在原发性肾病综合征患者肺部真菌感染治疗中的应用效果分析[J].中华医院感染学杂志, 2016, 26(17):3939-3941.
[10]张平.伏立康唑治疗慢性肾功能不全合并肺部真菌感染的疗效[J].医学临床研究,2017,34(8):1487-1488, 1491.
[11]朱萍,蒋正立.伏立康唑的不良反应综述[J].中国药业, 2011, 20(23):95.
[12]吴晶,王亮,曹永兵,等.《中药大辞典》记载的抗真菌中药体外药效再评价[J].中国真菌学杂志,2016,11(6):348-353.
[13]高甜,柴惠,沃兴德.大蒜素的药理作用及其开发应用[J].医学研究杂志, 2011, 40(5):12-15.
[14]龚钰清,陈悦,任泽久,等.氟康唑胶囊联合大蒜素注射液治疗慢性乙型重型肝炎合并真菌感染的疗效分析[J].中国现代医学杂志, 2006, 16(2):276-278, 180.
[15]闫芳,陈倪,杨芳,等.大蒜素治疗细菌感染所致呼吸机相关性肺炎的临床研究[J].湖南中医药大学学报, 2017, 37(3):313-316.