Integrated Traditional Chinese and Western Medicine Nursing for a Case of Severe Pneumonia Complicated with Chronic Obstructive Pulmonary Disease

SHEN Hedian

doi:10.12209/CAIM202506290018

您当前的位置：

首页 >

文章列表页 >

Integrated Traditional Chinese and Western Medicine Nursing for a Case of Severe Pneumonia Complicated with Chronic Obstructive Pulmonary Disease

更新时间：2025-12-19

- Integrated Traditional Chinese and Western Medicine Nursing for a Case of Severe Pneumonia Complicated with Chronic Obstructive Pulmonary Disease
- Clinical Archives of Integrative Medicine (2025)
- 作者机构：
  
  北京市健宫医院重症医学科，北京， 100054
- 作者简介：
- 基金信息：
- DOI：10.12209/CAIM202506290018
  CLC：
- Received：29 June 2025，
  
  Revised：2025-09-25，
  
  Accepted：25 September 2025，
  
  Published Online：19 December 2025，
- 稿件说明：
移动端阅览
SHEN Hedian. Integrated Traditional Chinese and Western Medicine Nursing for a Case of Severe Pneumonia Complicated with Chronic Obstructive Pulmonary Disease[DB/OL].Clinical Archives of Integrative Medicine, 2025.
DOI：

SHEN Hedian. Integrated Traditional Chinese and Western Medicine Nursing for a Case of Severe Pneumonia Complicated with Chronic Obstructive Pulmonary Disease[DB/OL].Clinical Archives of Integrative Medicine, 2025. DOI： 10.12209/CAIM202506290018.

摘要

本文报道1例82岁女性重症肺炎合并慢性阻塞性肺疾病（COPD）患者的诊疗与护理过程。患者因“间断喘憋1 d，加重伴发热1 h”入院，中医诊断为喘病（痰浊阻肺证），西医诊断为重症肺炎、COPD急性加重期。入院后采取中西医结合综合治疗，即西医予无创呼吸机辅助通气、广谱抗感染、化痰、肠内营养支持及循环监测；中医治以燥湿化痰、宣肺平喘，配合耳穴压丸。护理方面，通过全面评估发现患者存在重度呼吸困难、痰液潴留及感染性休克风险，遂制定个性化护理方案，重点实施呼吸道管理、感染控制、并发症预防及中医特色护理。经14 d干预，患者呼吸功能显著改善，未发生深静脉血栓等并发症。出院后建立阶梯式随访计划，即1周内电话随访，1个月门诊复查，3个月评估生活质量，长期每3～6个月随访。通过系统化干预，患者呼吸功能及生活质量显著改善，为老年重症肺炎合并COPD的多学科管理提供实践参考。

Abstract

This article reports the diagnosis， treatment， and nursing process of a 82-year-old female patient with severe pneumonia and chronic obstructive pulmonary disease （COPD）. The patient was admitted due to "intermittent shortness of breath for 1 day， aggravated with fever for 1 hour". The traditional Chinese medicine diagnosis was asthma （phlegm obstruction of the lung）， and the Western medicine diagnosis was severe pneumonia and acute exacerbation of COPD. After admission， a combined treatment of Western and Traditional Chinese Medicine was adopted， including non-invasive ventilator-assisted ventilation， broad-spectrum anti-infection， expectoration， enteral nutrition support， and circulatory monitoring； the treatment in traditional Chinese medicine was to dry dampness， transform phlegm， and open the lung and calm asthma， combined with ear acupressure pills. In terms of nursing， through comprehensive assessment， it was found that the patient had severe respiratory distress， sputum retention， and the risk of septic shock， so an individualized nursing plan was formulated， focusing on respiratory tract management， infection control， complication prevention， and traditional Chinese medicine characteristic nursing. After 14 days of intervention， the patient's respiratory function significantly improved， and no complications such as deep vein thrombosis occurred. After discharge， a stepped follow-up plan was established， including 1-week phone follow-up， 1-month outpatient review， 3-month assessment of quality of life， and long-term follow-up every 3-6 months. Through systematic intervention， the patient's respiratory function and quality of life significantly improved， providing practical reference for multidisciplinary management of elderly patients with severe pneumonia combined with COPD.

关键词

Keywords

references

白云静，申洪波，孟庆刚 . 多元统计分析与中医证候规范化研究［J］. 世界中医药， 2010 ， 5 （ 4 ）： 272 - 274 .

BAI Y J ， SHEN H B ， MENG Q G . Multivariate Statistical Analysis and Standardization Research on TCM Syndromes ［J］. World Chin Med ， 2010 ， 5 （ 4 ）： 272 - 274 . （in Chinese）

张悦 . 慢性阻塞性肺疾病合并肺炎的证候学分布及其病原相关性研究［D］. 北京：北京中医药大学， 2019 .

陈兰芳，周志森，张锦棠 . 大剂量氨溴索联合左氧氟沙星治疗老年慢性阻塞性肺疾病伴重症肺炎的疗效分析［J］. 中国社区医师， 2022 ， 38 （ 20 ）： 45 - 47 .

CHEN L F ， ZHOU Z S ， ZHANG J T . Efficacy analysis of high-dose ambroxol combined with levofloxacin in treatment of elderly chronic obstructive pulmonary disease with severe pneumonia ［J］. Chin Community Dr ， 2022 ， 38 （ 20 ）： 45 - 47 . （in Chinese）

吴静，刘伟，杨强，等 . 盐酸氨溴索联合头孢哌酮舒巴坦钠治疗老年社区获得性肺炎疗效及对血清PCT、hs-CRP及ESR的影响［J］. 解放军医药杂志， 2020 ， 32 （ 7 ）： 47 - 50 .

WU J ， LIU W ， YANG Q ， et al . The efficacy of ambrisentan hydrochloride combined with cefoperazone sulbactam sodium in the treatment of elderly community-acquired pneumonia and its effects on serum PCT， hs-CRP and ESR ［J］. Med Pharm J Chin People’s Liberation Army ， 2020 ， 32 （ 7 ）： 47 - 50 . （in Chinese）

和瑞莲 . 盐酸氨溴索与头孢哌酮舒巴坦钠治疗老年社区获得性肺炎患者的临床效果及对血清PCT、hs-CRP、ESR的影响［J］. 江西医药， 2023 ， 58 （ 7 ）： 860 - 861， 883 .

HE R L . The clinical efficacy of ambrisentan hydrochloride combined with cefoperazone sulbactam sodium in the treatment of elderly patients with community-acquired pneumonia and its effects on serum PCT， hs-CRP and ESR ［J］. Jiangxi Med J ， 2023 ， 58 （ 7 ）： 860 - 861， 883 . （in Chinese）

李晓琴，向悦华 . 恩施地区居民慢性阻塞性肺疾病急性加重住院情况与气候变化相关性分析［J］. 公共卫生与预防医学， 2023 ， 34 （ 2 ）： 83 - 86 .

LI X Q ， XIANG Y H . Correlation analysis of acute exacerbation of chronic obstructive pulmonary disease and climate change in Enshi， Hubei Province ［J］. J Public Health Prev Med ， 2023 ， 34 （ 2 ）： 83 - 86 . （in Chinese）

刘冬梅，杨建章 . 慢性阻塞性肺疾病急性加重住院患者血清N末端脑钠肽前体、D-二聚体水平变化的研究［J］. 贵州医药， 2023 ， 47 （ 2 ）： 224 - 226 .

LIU D M ， YANG J Z . Study on the Changes of Serum N-Terminal Brain Natriuretic Peptide Propeptide and D-Dimer Levels in Hospitalized Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease ［J］. Guizhou Med J ， 2023 ， 47 （ 2 ）： 224 - 226 . （in Chinese）

刘婷，李洋，石志红，等 . 雾化吸入性糖皮质激素对慢性阻塞性肺疾病急性加重住院患者血清TNF-α HDAC2及PTX3水平的影响［J］. 河北医学， 2023 ， 29 （ 5 ）： 814 - 819 .

LIU T ， LI Y ， SHI Z H ， et al . Effect of inhaled coricosteroids on serum TNF-α HDAC2 and PTX3 levels in hospitalized patients with acute exacerbation of chronic obstructive pulmonary disease ［J］. Hebei Med ， 2023 ， 29 （ 5 ）： 814 - 819 . （in Chinese）

ZHANG J ， YAO W Z ， YOU X D ， et al . Comparative analysis of medical expenditure with nebulized budesonide versus systemic corticosteroids in hospitalized patients with acute exacerbations of chronic obstructive pulmonary disease in China ［J］. Int J Chron Obstruct Pulmon Dis ， 2019 ， 14 ： 1195 - 1207 .

包秋丽 . 中药穴位贴敷联合痰热清雾化治疗慢性阻塞性肺疾病伴重症肺炎临床研究［J］. 新中医， 2024 ， 56 （ 20 ）： 141 - 145 .

BAO Q L . Clinical study on Chinese medicine point application combined with phlegm-heat clearing atomization for chronic obstructive pulmonary disease complicated with severe pneumonia ［J］. New Chin Med ， 2024 ， 56 （ 20 ）： 141 - 145 . （in Chinese）

张晶慧，廖新菊，朱茜，等 . 穴位贴敷联合耳穴压豆在慢性阻塞性肺疾病患者中的应用效果［J］. 中国当代医药， 2022 ， 29 （ 25 ）： 137 - 139， 147 .

ZHANG J H ， LIAO X J ， ZHU Q ， et al . The application effect of acupoint application combined with ear acupressure bean in patients with chronic obstructive pulmonary disease ［J］. China Mod Med ， 2022 ， 29 （ 25 ）： 137 - 139， 147 . （in Chinese）

Views

下载量

CSCD

Alert me when the article has been cited

提交

Tools

Publicity Resources

Nursing Experience of Auricular Acupuncture Points Combined with Acupoint Application in Improving Severe Pneumonia： A Case Report

Nursing Ward Round Case of an Elderly Patient with Severe Pneumonia Complicated by Multisystem Diseases

Nursing Experience of Integrated Traditional Chinese and Western Medicine in Treating a Patient with Lumbar Impediment

Case Report on SBAR Standardized Communication Combined with Standardized Transport in a COPD Patient

Ear Apex Bloodletting Therapy for Phlegm-Heat Obstructing the Lung Type Cough in Chronic Obstructive Pulmonary Disease： A Nursing Experience

Related Author

LI Qing

WANG Wei

WANG Mengfan

LIU Huan

ZHANG Tingting

HAN Jianping

LI Ying

WU Nan

Related Institution

Department of Emergency， Beijing Jiangong Hospital

Department of Orthopedics， Dongzhimen Hospital Beijing University of Chinese Medicine

Department of Emergency， Dongfang Hospital Beijing University of Chinese Medicine

th Acupuncture Ward， Huguosi TCM Hospital Affiliated to Beijing University of Chinese Medicine

Department of Respiratory Medicine， Beijing Hospital of Traditional Chinese Medicine， Capital Medical University

⁰