The Effect Of Tanreqing Combined With Early Enteral Nutrition On The Treatment Of MDRAB Type Severe Pneumonia

Objective:To investigate the effect of Tanreqing injection combined with early enteral nutrition on the severe pneumonia(SP)with Multi-drug Resistant Acinetobacter Baumannii(MDRAB).Methods:Seventy-seven patients with severe pneumonia who were treated in Zhangjiajie People’s Hospital from February 1,2019 to July 31,2020 were selected.Those clinical manifestations,signs,inspection results,imaging results and other results conform to the diagnostic criteria of severe pneumonia.The sputum culture results indicate MDRAB.According to the relevant national ethical regulations,the principle of independent choice and informed consent,the patients were signed in the informed consent.The patients were divided into three groups using random number extraction table method,and there were 29,25 and 23 people in blank group,the control group and the experimental group.All patients must conform to the diagnostic criteria of SP and the observation time was 7 days.Then the data before and after treatment were analyzed and discussed.Specific observation indicators are as follows: the basic conditions on admission,such as gender,age,the NRS total score and APACHE Ⅱ score;the infection indicators(WBC,CRP,PCT),immune functions(Ig A,Ig G,Ig M),albumin,oxygenation index(Pa O2/Fi O2),the pathogen clearance condition and clinical symptoms improving conditions(symptoms、signs and CT scans of the lungs)before and after intervention among the three groups;mechanical ventilation duration and the total ICU hospitalization duration.Results:1.In this research 77 cases with severe pneumonia were collected in which there were 29,25 and 23 cases in the blank group,control group and experimental group.Statistical analysis showed that there were no statistical differences in the basic conditions of patients among the three groups,and the data were comparable.2.There were no statistical differences in infection indicators(WBC,CRP,PCT),immune proteins(Ig A,Ig G,Ig M)and oxygenation index before intervention among the three groups,and the data were comparable.The WBC,PCT and CRP were decreased after intervention compared with that before treatment while the Ig A,Ig G,Ig M,Pa O2/Fi O2 were increased after intervention compared with that before treatment,and the changes were more obviously in the control group and the experimental group after treatment.And there was statistically significant.3.Comparing the data of the control group and the experimental group over the same period,we found that the infection indicators of the experimental group decreased more obviously than that of the control group.Immunoglobulin and oxygenation index improved significantly in the experimental group.And there was statistically significant.4.There were no statistical differences among the three groups in albumins before intervention,and the data were comparable.Albumin were higher after intervention than that before treatment among three groups and the album increase higher in the experimental group after treat-ment,followed by the control group.And there was statistically significant.5.Comparing the clinical effects and the Acinetobacter Baumannii(AB)removing condition after treetment 1 week among three groups,the total effective rate of was44.8%、60.0% and 87.0 in the blank group,control group and experimental group,Which showed an increasing trend.The data was lower in the blank group compare with that in the control group and the data in the experimental group was higher than that in the control group.All were statistically significant.There were significant differences in bacterial clearance rate among the three groups.The clearance rates of the three groups were 55.2%,72.0%,87.0,showed an increasing trend.The bacterial clearance rate in the blank group was worse than that in the control group treatment,and the bacterial clearance rate of control group was lower than that in the experimental group.All were statistically significant.6.Comparing the days required for mechanical ventilation and the days required for hospitaling in ICU after 1 week treatment,it was found that the experimental group had some advantages over the other two groups treatment and the control group had an advantage over the blank group.There was statistical difference.Conclusion:1.Tanreqing combined with early enteral nutrition treatment can reduce the infection indicators effectively,enhance nutrition absorption,improve nutritional status,increase the ability of immune regulation,alleviate the clinical symptoms and improve bacterial clearance rate effectively for MDRAB type severe pneumonia patients.2.Tanreqing combined with early enteral nutrition treatmen can improve alveolar ventilation,reduce the days of mechanical ventilation and shorten the days required for hospitaling in ICU for MDRAB type severe pneumonia patients.