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Community-acquired pneumonia (CAP) is a common infection in the community, is a major disease threat to human health is one of the common pathogens are Streptococcus pneumoniae, Haemophilus influenzae, Staphylococcus aureus, and atypical pathogens are also increasing. By experience, both for outpatient or inpatient, the new fluoroquinolones (levofloxacin, gatifloxacin and moxifloxacin) drug of choice for the treatment of CAP.May 2002 ~ December 2005 in patients with community-acquired pneumonia, 67 cases are in line with the Chinese Medical Association of Respiratory Branch l999 to develop a "community-acquired pneumonia diagnosis and treatment guidelines (draft)" diagnostic criteria. Aged 18 to 65 years, mean 32.1 years; male 47 cases, 20 female; most patients with fever, cough, sputum is the main symptom of which 61 cases of fever chills, body tempera 38.5 24 cases; with Essential Hypertension 5 cases, 4 cases of coronary heart disease, 2 patients with cerebral vascular disease.
Chest X-ray examination showed sheets, patchy interstitial infiltrative shadow or change. Under the more common double-lung lesions, including 19 cases of pneumonia in the lower right, lower left 3O cases of pneumonia; 4 cases of pneumonia in the right, left, pneumonia in 3 cases; upper right pneumonia in 4 cases, 7 cases of pneumonia, upper left; and pleural effusion in 2 cases.
Laboratory tests were for blood tests in patients, the number of white blood c 10
Abstract: Objective: Int


egrative Medicine community-acquired pneumonia (CAP) The clinical efficacy. Methods: 160 patients with CAP were randomly divided into 2 groups, 80 patients in control group given routine western medicine, the treatment group 80 cases of conventional therapy in Western medicine based on the use side Qingfei self detoxification treatment. 2 clinical efficacy observed before and after treatment, the white blood cell count (WBC) changes. Results: The total effective rate was 97.5% in the control group, the total effective rate was 81.25%. The difference between 2 groups is statistically significant (P0.05) were comparable.
0.75. TCM diagnosis and syndrome differentiation, refer to "the guiding principles of Chinese medicine clinical research new drugs" air temperature Hyperactivity phlegm blocking the lung disease standards.
1.3 Inclusion criteria meet the above Chinese and Western medicine diagnostic criteria, aged 18 to 70 years, to complete a course of treatment with the treatment, to follow-up data were complete.
1.4 Exclusion criteria does not meet the diagnostic criteria in the Western who does not cooperate with treatment, combined effect of other serious physical illness would affect evaluators failed to complete the whole course of treatment, with serious heart, liver, kidney, brain primary disease.
The clinical diagnosis of CAP based . Newly emerging cough, sputum, or the original respiratory symptoms increased, and the emergence of purulent sputum; with or without chest pain. 2. F = 38 degrees.
Drug treatment of community acquired pneumonia 3. Signs of pulmonary consolidation and (or) moist rales. 4. 10 109 / L or 80ml/4h, or acute renal failure requiring dialysis. The initial empirical antimicrobial therapy CAP recommended a vast territory, local natural environment and social and economic development are very different, CAP pathogen distribution and antibiotic resistance rate epidemiology is not consistent and requires further research and accumulate data, the following recommendations for treatment is only a matter of principle, should be selected with specific situations. Young adults 1. Young adults, in patients without underlying diseases: common pathogens: Streptococcus pneumoniae, Mycoplasma pneumoniae, Chlamydia pneumoniae, Haemophilus influenzae. Choice of antimicrobial agents: macrolides, penicillin, sulfamethoxazole, doxycycline (Dox), the first-generation cephalosporins, new quinolones (as following ofloxacin, sparfloxacin, song cutting sand star etc.). Aged 2. The elderly or patients with underlying diseases: common pathogens: Streptococcus pneumoniae, Haemophilus influenzae, aerobic gram-negative bacilli, Staphylococcus aureus, the card he Mora monocytogenes. Choice of antibiotics: second generation cephalosporins, lactam / -lactamase inhibitor, or joint macrolides, new quinolones. 3 hospitalized patients. Need to hospitalized patients: common pathogens: Streptococcus pneumoniae, Haemophilus influenzae, complex bacteria (including anaerobic bacteria), aerobic gram-negative bacilli, Staphylococcus aureus, Chlamydia pneumoniae, respiratory viruses. Antimicrobial drug selection: the second-generation cephalosporins alone or in combination macrolide; cefotaxime or ceftriaxone alone, or take macrolides; new quinolones and new macrolides; penicillin or first-generation cephalosporins, quinolones or aminoglycosides combined. 4 critically ill patients. Critically ill patients: common pathogens: Streptococcus pneumoniae, gram-negative aerobic bacteria, Legionella pneumophila bacteria, Mycoplasma pneumoniae, respiratory viruses, Haemophilus influenzae, and so on. Antimicrobial drug selection: macrolide cefotaxime or ceftriaxone combined; broad-spectrum activity with anti-Pseudomonas penicillin lactamase inhibitors or cephalosporins, or one of the former two combined macrocyclic lactones; carbapenems; the use of new quinolone allergy to penicillin combined aminoglycoside. Note: penicillin intermediate level (MIC0.1 ~ 1.0 g/ml) resistant pneumococcal pneumonia can still choose to penicillin, but the need to improve the content, such as intravenous penicillin G240 million U q4 ~ 6h. Existence of high levels of resistance or resistance to high-risk factors should be selected cefotaxime, ceftriaxone, a new quinolone, or vancomycin, imipenem. bronchiectasis complicated by pneumonia, Pseudomonas aeruginosa is a common pathogen, empirical treatment choice should take into account of this. In addition to the recommended drugs, some people advocate quinolones United macrolides, it is easy to think that these drugs penetrate the bacterial biofilm or damage. suspected inhalation of factors should be combined with metronidazole or clindamycin, or give priority to ampicillin / sulbactam, amoxicillin / clavulanic acid. antibiotic treatment can usually be hot back and the main respiratory symptoms improved 3 days after the withdrawal, depending on the pathogen, severity of disease severity varies. In addition to effective antibiotic treatment of severe pneumonia, but supportive care is very important. After the initial treatment of CAP to assess and address 1. 48 ~ 72h after initial treatment and diagnosis of the disease should be evaluated. Response to the first effective treatment showed decreased body temperature, respiratory symptoms can also be improved. White blood cell recovery and X-foci usually appear later. Where the symptoms do not necessarily take into account the results of sputum examination etiology, remains the original treatment. If symptoms improve significantly, parenteral administration may use the same kind or similar antibacterial spectrum, or pathogens by susceptibility testing to identify and prove sensitive to oral administration of oral preparations, the implementation of sequential therapy; the original who can be discharged in good health medication. 2. 72h after the initial treatment of symptoms without improvement or deterioration is easy degrees to improve the complex and, as a treatment failure, its causes and treatment: (1) drugs not covered by the bacteria or bacterial resistance. Sputum culture results with laboratory and evaluate its significance, careful adjustment of antibiotics, and repeat the pathogenic examination. (2) specific pathogen infections such as tuberculosis, fungus, Pneumocystis carinii, viruses, or endemic infectious diseases. Should re-analysis of the information and make the appropriate checks, including further testing of the bacteria normally necessary, invasive inspection techniques used, a clear etiological diagnosis and adjust the treatment. (3) complications (such as empyema, migratory lesions) or the existence of host factors influencing efficacy (eg, immunocompromised). Should be further checked and confirmed, the appropriate treatment. (4) Non-infectious diseases misdiagnosed as pneumonia. Careful physical examination the patient should be carefully collected and relevant examination for diagnosis. (This guide by the Chinese Medical Council respiratory disease units in May 1998 will be held in Shanghai in the third national lung infection and interstitial lung disease academic session).


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