痰热清联合黄芪注射液对急性呼吸窘迫综合征患者肺功能的影响

Effect of Tanreqing combined with Huangqi injection on acute respiratory distress syndrome

目的 观察痰热清注射液联合黄芪注射液对急性呼吸窘迫综合征（ARDS）患者肺功能的影响,并分析它们的作用机制.方法 选择ARDS患者62例,按随机原则分为常规机械通气对照组31例,机械通气＋痰热清联合黄芪注射液治疗组31例,分别测定两组患者机械通气0、24、48、72 h血浆细胞间黏附分子-1（ICAM-1）水平、血气分析;监测相应时间的潮气量（Vt）、氧浓度（FiO2）、呼气末正压（PEEP）、吸气末压力（EIP）等呼吸参数,并计算氧合指数（PaO2/FiO2）、呼吸指数（RI）、肺动态顺应性（Cdyn）.结果两组机械通气0 h血浆ICAM-1水平、PaO2/FiO2、RI、Cdyn比较差异均无统计学意义（P＞0.05）;与对照组比较,治疗组机械通气48、72 h血浆ICAM-1水平明显下降（P＜0.05）,PaO2/FiO2、RI、Cdyn均有明显改善（P＜0.05）;与机械通气0、24、48 h 比较,对照组72 h PaO2/FiO2开始上升（P＜0.05）,但RI、Cdyn无明显变化（P＞0.05）.结论 痰热清注射液联合黄芪注射液可抑制ARDS患者血浆ICAM-1水平,同时对肺功能有很好的改善作用,有助于提高保护性通气策略的有效性.

Objective To observe the effect of traditional Chinese medicine Tanreqing combined with Huangqi injections on acute respiratory distress syndrome （ ARDS ） and to analyze the mechanism of its function. Methods 62 cases with acute lung injury were randomized into control group （n=31） and treatment group （n = 31 ）. In the control group, the patients received only routine mechanical ventilation ; In the treatment group, the patients received ventilation and Tanreqing combined with Haangqi injection. The level of intercellular adhesion molecule - 1 （ ICAM - 1 ） ） and the blood gas were determined at 0, 24, 48,72 h after ventilation together with the values of tidal volume（ Vt）, FiO2, PEEP, EIP, PaO2/FiO2, RI and Cdyn （pulmonary dynamic compliance） in both groups. Results There was no statistical difference in the concentration of ICAM - 1, the values of PaO2/FiO2 , RI and Cdyn at 0 h between the two groups （P 〉 0.05 ）. The levels of ICAM - 1 in the treatment group were significantly lower than those in the control group at 48 and 72 h（ P 〈 0. 05 ）. In the treatment group, the PaO2/FiO2 at 72 h was higher than those at 0, 24 and 48 h（ P 〈 0.05 ） with no difference in RI and Cdyn （P 〉0.05 ）. PaO2/FiO2 ,RI and Cdyn in the treatment group were better than those in the control group at 48 and 72 h （P 〈 0. 05 ）. Conclusion Traditional Chinese medicine Tanreqing combined with Huangqi injections can suppress the level of ICAM - 1 and improve lung function, which is helpful to improving the effect of protective ventilation.