人偏肺病毒感染致肺炎中西医结合诊疗1例
A Case of Diagnosis and Treatment of Integrated Chinese and Western Medicine of Pneumonia Caused by Human Metapneumovirus Infection
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1.南京中医药大学附属南京中医院感染性疾病科, 江苏, 南京,210001
2.南京中医药大学温病学教研室,江苏, 南京,210001
3.杨进国家名老中医药专家传承工作室, 江苏, 南京, 210001
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张弘,张彦亮,杨进,等.人偏肺病毒感染致肺炎中西医结合诊疗1例[DB/OL].(2023-12-18)[2023-12-18].https://cccl-tcm.cacm.org.cn/thesisDetails?columnId=46082100&Fpath=home&index=0&lang=zh
ZHANG Hong,ZHANG YanLiang,YANG Jin,et al.A Case of Diagnosis and Treatment of Integrated Chinese and Western Medicine of Pneumonia Caused by Human Metapneumovirus Infection[J].,
张弘,张彦亮,杨进,等.人偏肺病毒感染致肺炎中西医结合诊疗1例[DB/OL].(2023-12-18)[2023-12-18].https://cccl-tcm.cacm.org.cn/thesisDetails?columnId=46082100&Fpath=home&index=0&lang=zh DOI:
ZHANG Hong,ZHANG YanLiang,YANG Jin,et al.A Case of Diagnosis and Treatment of Integrated Chinese and Western Medicine of Pneumonia Caused by Human Metapneumovirus Infection[J]., DOI:.
病史摘要,2,患者陈某2023年7月8日出现发热,咳嗽,咳少量黄痰,自行服用“阿莫西林、氨酚黄那敏”后热退,咳嗽未见明显还转。7月16日咳嗽加重,痰中带有血块,至我院急诊查胸部CT提示两下肺散在炎症,遂因“发热伴咳嗽9天,加重1天”入院,入院症见:暂无发热,咳嗽,咯黄痰,偶有痰中带血块,无喘憋胸痛,无呼吸困难,纳眠差,二便如常,舌质红,苔黄腻,脉滑数。既往高血压、2型糖尿病、腔隙性脑梗死、冠状动脉粥样硬化性心脏病、左乳 恶性肿瘤切除术后。中医诊断 风温病(痰热壅肺)。西医诊断 社区获得性肺炎,非重症;高血压3级 很高危;2型糖尿病;腔隙性脑梗死;冠状动脉粥样硬化性心脏病;左乳恶性肿瘤切除术后。干预措施 患者入院后完善相关检查,先予哌拉西林钠舒巴坦钠抗感染,溴己新止咳化痰,同时予降压、降糖、稳定斑块等控制基础疾病对症治疗。呼吸道多种病原体靶向测序:人偏肺病毒47695 copies/ml,根据结果提示患者肺部感染为人偏肺病毒感染所致,遂停用抗菌药物,以中药口服清热解毒,止咳化痰(具体方药见正文)。疗效转归 患者住院期间经治疗后,咳嗽咳痰症状明显改善,无发热,无胸闷心慌等不适,出院后门诊继续口服中药治疗,服用中药半月余后无发热,无咳嗽咳痰,无胸闷心慌,余未见明显不适。
Summary of case histry, On July 8, 2023, The patient chen appeared fever, cough, cough a small amount of yellow sputum, taking "Amoxicillin, paracetamol Huang Namin", fever disappeared, cough did not return to obvious. On July 16th, the cough became more serious, and the sputum contained blood clots. The chest CT examination in our hospital showed that there were scattered inflammation of the lung. She was admitted with"Fever and cough for 9 days, aggravated by 1 day". Admission to see:No Fever, cough, yellow sputum, occasionally sputum with blood clots, no wheezing chest pain, no breathing difficulties, poor sleep, red tongue, slightly greasy fur yellow, pulse floating number. Pre-existing Hypertension, type 2 diabetes, lacunar infarction, coronary arteriosclerosis, left breast malignancy resection.,TCM diagnosis, wind-warm disease ( yndrome of phlegm-heat obstructing lung) .,Western medicine diagnosis, community acquired pneumonia, non-severe, hypertension, type 2 diabetes, lacunar infarction, coronary arteriosclerosis, left breast, after malignant tumor resection. ,Interventions,: After admission,patients were given piperacillin-sulbactam for anti-infection, Bromhexine for cough and sputum reduction, and antihypertensive, hypoglycemic and plaque stabilization therapy.Targeted sequencing of multiple respiratory pathogens: human metapneumovirus 47695 copies/ml. The results suggested that the pulmonary infection was caused by human metapneumovirus, so the antibiotics were stopped, and the traditional Chinese medicine was taken orally for clearing away heat and toxin, relieving cough and resolving phlegm (see text for specific prescriptions) .,Clinical outcomes, After treatment, the symptoms of cough and expectoration were obviously improved, no fever, no chest tightness, no palpitation, and so on. After discharge, the outpatient continued to take oral Chinese medicine treatment, more than half a month after taking Chinese medicine no fever, no cough expectoration, no chest tightness flustered.
肺炎人偏肺病毒感染hMPV中药
pneumoniahuman metapneumovirus infectionhMPVtraditional Chinese medicine
VAN D H B G,DE J J C,GROEN J,et al.A newly discovered human pneumovirus isolated from young children with respiratory tract disease.[J].Nat Med,2001,7(6):719-24.
VAN D H B G., HERFST S S L,CANE P A,alet,. Antigenic and genetic variability of human metapneumo viruses. Emerg. Infect. Dis. 2004;10:658–666.
MACKAY I M,BIALASIEWICZ S,JACOB K C,et al.Genetic diversity of human metapneumovirus over 4 consecutive years in australia.[J].J Infect Dis,2006,193(12):1630-3.
van den Hoogen B.G., van Doornum G.J., Fockens J.C., Cornelissen J.J., Beyer W.E., de Groot R., Osterhaus A.D., Fouchier R.A. Prevalence and clinical symptoms of human metapneumovirus infection in hospitalized patients. J. Infect. Dis. 2003;188:1571–1577.
WILLIAMS J V,HARRIS P A,TOLLEFSON S J,et al.Human metapneumovirus and lower respiratory tract disease in otherwise healthy infants and children.[J].N Engl J Med,2004,350(5):443-50.
人偏肺病毒感染诊疗方案(2023年版)[J].中国感染控制杂志,2023,22(07):869-870.
WALSH EE,PETERSON DR,FALSEY AR.Human metapneumovirus infections in adults: another piece of the puzzle.[J].Arch Intern Med,2008,168(22):2489-2496.
Marie ève Hamelin,BoivinGuy.Development and validation of an enzyme-linked immunosorbent assay for human metapneumovirus serology based on a recombinant viral protein[J].Clin. Diagn. Lab. Immunol.,2005,12(2):249-253.
李荣培,余春梅,陈昕,等.玉屏风散预防人偏肺病毒感染的实验研究[J].中华中医药杂志,2011,26(10):2288-2291.
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