摘要
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.
出处
《中国急救医学》
CAS
CSCD
北大核心
2010年第7期596-598,共3页
Chinese Journal of Critical Care Medicine
关键词
急性呼吸窘迫综合征
痰热清注射液
黄芪注射液
细胞间黏附分子-1
肺功能
Acute respiratory distress syndrome
Tanreqing injection
Huangqi injection
Intercellular adhesion molecule - 1 ( ICAM - 1 )
Lung function