白细胞非升高性上呼吸道感染858例诊治观察

杨红丽+梁雯+金燕会

【摘要】目的探讨白细胞非升高性上呼吸道感染的抗生素治疗及中药治疗效果, 以提高合理用药。方法对858例白细胞非升高性上呼吸道感染患者进行分组治疗观察, 随机分为抗生素治疗组429例和中药治疗组429例。两组均采用一般支持和对症治疗, 抗生素组加用罗红霉素胶囊0.15 b.i.d.口服(此组均无大环内脂类抗生素过敏史), 中药治疗组加用中药清热解毒口服液或双黄连口服液10~20 ml t.i.d.口服。结果两组治疗时间均为3~7 d。罗红霉素治疗组治愈312例, 显效99例, 无效18例, 总有效率95.80%；中药治疗组治愈324例, 显效84例, 无效21例, 总有效率95.10%；两组疗效比较差异无统计学意义(P>0.05)。结论白细胞非升高性上呼吸道感染的治疗, 无需应用抗生素, 在对症、支持的基础上辅以中药治疗即可。

【关键词】上呼吸道感染；病毒；抗生素；耐药性

Clinical observation on 858 cases of non-elevated white blood cell of upper respiratory tract infectionYANG Hong-li, LIANG Wen, JIN Yan-hui. Beijing Puren Hospital, Beijing 100062, China

【Abstract】Objective To investigate the effect of antibiotic therapy and traditional Chinese medicine in the treatment to non-elevated white blood cell of upper respiratory tract infection, in order to improve the rational use of drugs. Methods There were 858 cases of non-elevated white blood cell of upper respiratory tract infection treated with observation group who were randomly divided into the antibiotics treatment group in 429 cases and the antibiotic treatment group of Chinese medicine in 429 cases. Two groups were given general support and symptomatic treatment,antibiotic group was added with roxithromycin capsules 0.15 BID oral ( this group were not macrolide antibiotic allergy historiclly), group of traditional Chinese medicine was treated with traditional Chinese medicine for Qingre Jiedu oral liquid or 10-20 ml TID oral Shuanghuanglian oral liquid. Results Treatment of two groups lasted 3~7day. Roxithromycin treatment group: 312 cases were cured, 99 cases effective, 18 cases ineffective, the total effective rate was 95.80%; Chinese medicine treatment group: 324 cases were cured, 84 cases effective, 21 cases ineffective, the total effective rate was 95.10%; the effect difference of two groups have no statistical significance(P>0.05). Conclusion There is no need application of antibiotics treating upper respiratory tract infection, for using traditional Chinese medicine against the symptomatic is enough.

【Key words】Upper respiratory tract infection; Virus; Antibiotics; Resistance急性上呼吸道感染是指鼻腔、咽或喉部急性炎症的概称。常见病因为病毒, 少数由细菌引起［1］。临床诊治上呼吸道感染, 除了结合临床症状及体征外, 一般常参考血常规白细胞是否升高来大概划分病毒性或是细菌性感染。白细胞升高一般多为细菌性感染所致, 白细胞正常或降低多为病毒性或支原体等感染所致。血白细胞升高者临床一般多用抗生素治疗, 但血白细胞正常或降低者的治疗该如何合理用药呢？作者就此进行了观察, 现报告如下。

1资料与方法

1. 1一般资料选择门诊诊断为急性上呼吸道感染患者858例, 年龄15~89岁, 其中男性415例, 女性443例。主要……