【摘要】 目的 观察纤支镜肺泡灌洗（BAL）联合痰热清注射液、口服细菌溶解产物治疗铜绿假单胞菌（PA）感染的支气管扩张患者的临床疗效。方法 选取2022年6月至2024年6月在湛江中心人民医院就诊的PA感染支气管扩张患者100例，按随机数字表法分为观察组（53例）和对照组（47例）。对照组患者使用痰热清注射液和口服细菌溶解物治疗，观察组在对照组用药基础上加以BAL治疗，观察并比较治疗前后两组患者中医证候积分、肺部状态、血气分析指标、炎症因子水平及临床疗效。结果 治疗后，两组临床指标均较治疗前均有所改善（P <0.05）；观察组治疗后中医证候积分、临床肺部感染评分（CPIS）、PaCO₂、pH、C反应蛋白（CRP）、白细胞介素1β（IL-1β）、肿瘤坏死因子α（TNF-α）水平均低于对照组（P <0.05）；观察组治疗后第1秒用力呼吸量（FEV₁）、肺活量（FVC）、呼气峰流速（PEF）、SaO₂、PaO₂指标水平均高于对照组（P <0.05）。结论 BAL联合痰热清注射液、口服细菌溶解产物治疗能减轻PA支气管扩张患者的临床症状，改善肺部状态及血气分析指标，降低体内炎症反应。更多还原

【Abstract】 Objective To observe the clinical efficacy of fiberoptic bronchoscopic bronchoalveolar lavage （BAL） combined with Tanreqing injection and oral bacterial lysate in the treatment of patients with bronchiectasis vaused by Pseudomonas aeruginosa （PA） infection.Methods A total of 100cases were selected of PA infection-related bronchiectasis patients who visited the Zhanjiang Central People’s Hospital from June 2022 to June 2024,and randomly divided them into an observation group （53 cases） and a control group （47 cases） using the coin toss method.Patients in the control group were treated with Tan Re Qing injection and oral bacterial lysates,while the observation group received BAL treatment in addition to the medication used in the control group.The changes in traditional Chinese medicine syndrome scores,pulmonary status,blood gas analysis indicators,inflammatory factor levels,and clinical efficacy before and after treatment were observed and compared between the two groups.Results After treatment,both groups showed significant improvements in clinical indicators compared to before treatment （P<0.05）.The observation group had lower levels of Traditional Chinese Medicine （TCM） syndrome scores,Clinical Pulmonary Infection Score （CPIS）,PaCO₂,pH,C-reactive protein（CRP）,interleukin-1β （IL-1β）,and tumor necrosis factor-α （TNF-α） after treatment compared to the control group （P<0.05）.Additionally,the observation group had significantly higher levels of forced expiratory volume in the first second （FEV₁）,forced vital capacity （FVC）,peak expiratory flow （PEF）,SaO₂,and PaO₂ after treatment compared to the control group （P<0.05）.Conclusions BAL combined with Tanreqing injection and oral bacterial lysate treatment can significantly alleviate clinical symptoms of patients with bronchiectasis caused by PA,improve their lung status and blood gas indicators,and reduce inflammatory reactions.更多还原