Clinical Study On The Intervention Of Xuedu Qing Prescription On Carbapenem-resistant Klebsiella Pneumoniae Severe Pneumonia (Excess Syndrome Of Lung-heat And Viscera)

1 ObjectiveIn this study,Xueduqing prescription（comprehensive ICU protocol of Anhui Provincial Hospital of Traditional Chinese Medicine）was applied to carbapenem-resistant Klebsiella pneumoniae severe pneumonia（lung heat and fu organs demonstration）patients,and inflammation-related indicators,blood gas results,pathogenic bacteria clearance,infection,prognostic related scores and TCM symptom scores before and after treatment were observed and recorded.The clinical effect of Xuedu Qing on patients with carbapenem-resistant Klebsiella pneumoniae pneumonia was analyzed comprehensively.2 Methods60 patients with carbapenem-resistant Klebsiella pneumoniae severe pneumonia（demonstration of lung heat and fu organs）meeting the inclusion criteria were selected from January 2021 to December 2022 in the comprehensive ICU of Anhui Hospital of Traditional Chinese Medicine.They were divided into Xueduqing prescription group（Xueduqing prescription+Western medicine）and simple Western medicine group（simple Western medicine）by random drawing method.The simple western medicine group adopted standardized Western medicine treatment;Routine treatment was continued in the Xueduqing prescription group,and the Xueduqing decoction prepared by the Tianyao Office of Anhui Hospital of Traditional Chinese Medicine was added.Administration method:oral or nasal feeding,one bag at a time,each bag dose was 100ml,and the administration time was divided into morning and evening,each treatment cycle was 14 days.Infection-related examination items（HBP,PCT,NLR,WBC,NE%,IL-6,SAA）,blood gas examination items（Pa O₂,OI,LAC）,prognosis and severity scores（TCM symptom score,CPIS score,SOFA score,APACHEⅡscore）and details of the Xuefuqing prescription group and the western medicine group before and after treatment were compared Bacterial clearance rate and overall clinical response rate.3 results（1）compared to blood poisonous clear and pure western medicine group,the basis of patient information（age,gender,basic diseases）there was no statistically significant difference（P＞0.05）.Infection-related items（HBP,SAA,PCT,WBC,NLR,NE%,IL-6）,blood gas examination items（Pa O₂,OI,LAC）,prognosis and severity scores（TCM symptom score,CPIS score,SOFA score,APACHEⅡscore）of the two groups before treatment had no statistical significance,and were comparable（P＞0.05）（2）The indexes of infection reaction（PCT,SAA,WBC,HBP,NE%and IL-6）in Xueduqing prescription group were all decreased after treatment compared with before treatment（P<0.05）,and the decrease was more significant in Xueduqing prescription group（P<0.05）.Clinical study on the intervention of Xueduqing Prescription on carbapenem-resistant Klebsiella pneumoniae severe pneumonia（lung heat and Fu organs）（3）Compared Xueduqing prescription group and simple western medicine group,the blood gas indicators（Pa O₂,OI,LAC）were improved after 14 days of treatment,and Xueduqing prescription group improved more significantly（P<0.05）（4）The scores（SOFA score,CPIS score,APACHEⅡscore,TCM symptom score）of Xueduqingfang group and simple western medicine group were compared,which were decreased compared with before treatment（P<0.05）,and the decrease was significant in Xueduqingfang group（P<0.05）.（5）The clearance rate of drug-resistant bacteria in the two groups was compared.After 1 cycle of treatment,the clearance rate of drug-resistant bacteria in the Xueduqing prescription group was significantly higher than that in the simple western medicine group,and the difference was statistically significant（P<0.05）.（6）After 1 treatment cycle,the effective rate of Xueduqing formula group was higher than that of the other group,the difference was statistically significant（P<0.05）.4 ConclusionsCompared with Western medicine alone,Xueduqing recipe combined with conventional Western medicine treatment can better inhibit the inflammatory response of carbapenem-resistant Klebsiella pneumoniae patients with severe pneumonia（demonstration of lung heat and fu organs）,improve tissue hypoxia and hypoperfusion,exorcism and healing to enhance the clearance rate of pathogenic bacteria,improve clinical symptoms and control disease progression.To provide evidence-based basis for TCM treatment of severe pneumonia caused by multi-drug resistant bacteria.