中国中西医结合急救杂志2025，Vol.32Issue(6)：683-689,7.DOI:10.3969/j.issn.1008-9691.2025.06.008
中医序贯疗法预防神经外科术后颅内感染和肺炎的临床研究
Clinical study on sequential traditional Chinese medicine therapy combined with Angong Niuhuang pill for prevention of post-neurosurgical intracranial infection and pneumonia
摘要
Abstract
Objective To evaluate the clinical efficacy of sequential traditional Chinese medicine(TCM)therapy combined with Angong Niuhuang pill in preventing postoperative infections and reducing antimicrobial use in neurosurgical patients.Methods Patients undergoing neurosurgery at Beijing Tiantan Hospital,Capital Medical University,from August 2024 to February 2025 were non-randomly assigned to 2 intensive care unit(ICU)with comparable medical resources based on the hospital information system(HIS)routine.One ICU served as the integrated TCM and Western medicine group(TCM-WM group),and the other as the conventional Western medicine control group(WM group).The TCM-WM group received early-phase prevention of intracranial infection followed by late-phase therapy to replenish qi,nourish yin,moisten the lungs,clear heat,and resolve phlegm.The WM group received standard Western treatment.Both groups were observed concurrently after enrollment.Primary endpoints included incidence of pneumonia and intracranial infection,neurological recovery,clinical pulmonary infection score(CPIS),and antimicrobial use intensity defined daily dose(DDD).Secondary endpoints included length of hospital and ICU stay,28-day all-cause mortality,and medical costs.Results A total of 101 patients completed the study,TCM-WM group 55 cases,WM group 46 cases.There was no statistically significant difference in baseline data between the two groups of patients,including general information and preoperative disease severity,indicating that the baseline characteristics were balanced and comparable.The incidence of postoperative pulmonary infection was significantly lower in the TCM-WM group than that in the WM group[5.5%vs.26.1%,relative risk(RR)=0.210,95%confidence interval(95%CI)was 0.060-0.710,P=0.005].Intracranial infection incidence was low and did not differ significantly between TCM-WM group and WM group(1.82%vs.2.17%,P=1.000).Compared with the WM group,the TCM-WM group demonstrated lower CPIS scores(β=-1.900,95%CI was-2.800 to-1.000,P<0.001),higher Glasgow coma scale(GCS)scores at 14 days postoperation(β=3.800,95%CI was 2.900-4.700,P<0.001),and reduced DDD values(28.6±4.2 vs.104.8±18.3,P<0.001),ICU stay(days:12.6±1.8 vs.21.3±2.4,P<0.001)and total hospital stay(days:18.2±1.9 vs.32.6±3.1,P<0.001)were significantly shorter in the TCM-WM group,with a mean reduction in total hospitalization cost(yuan:115 632±9 842 vs.178 295±15 637,P<0.001).There was no statistically significant difference in in 28-day all-cause mortality was observed between the TCM-WM group and the WM group(RR=0.420,95%CI was 0.080-2.100,P=0.414].Conclusions Sequential TCM therapy combined with Angong Niuhuang pill can reduce postoperative pneumonia incidence,decrease antimicrobial use,lower antibiotic dependence,optimize infection prevention,and reduce medical expenditures in neurosurgical patients.This integrated TCM-WM approach offers a cost-effective treatment strategy in the era of bacterial resistance.关键词
中西医结合/神经外科/肺炎/颅内感染/预防Key words
Integrated traditional Chinese and Western medicine/Neurosurgery/Pneumonia/Intracranial infection/Prevention引用本文复制引用
王强,傅鹂婕,王玉妹,周纡,周颖,周益民..中医序贯疗法预防神经外科术后颅内感染和肺炎的临床研究[J].中国中西医结合急救杂志,2025,32(6):683-689,7.基金项目
北京市中医药科技发展资金项目(BJZYYB-2023-99) Beijing Traditional Chinese Medicine Science and Technology Development Fund Project(BJZYYB-2023-99) （BJZYYB-2023-99）
