防己黄芪汤对单肺通气患者的保护作用

Protective Effects of Fangji Huangqi Tang on Patients Undergoing One-lung Ventilation

目的:观察防己黄芪汤对开胸单肺通气患者术中肺再灌注损伤的保护作用。方法:46例食道癌择期开胸手术患者,分级属美国麻醉医师协会Ⅰ～Ⅱ级,随机分为2组,每组23例:A组为中药干预+常规治疗组,术前连续7 d口服防己黄芪汤;B组为常规治疗对照组。术中及术后分别在麻醉诱导后双肺通气时(T1)、单肺通气后1 h(T2)、单肺通气后2 h(T3)及术后2 h(T4)时段,采外周动脉血3 mL进行分析,测定患者动脉氧分压(PaO2)、动脉氧饱和度(SpO2)、血浆超氧化物歧酶(SOD)、丙二醛(MDA)及中性粒细胞(PMN)计数的数值。结果:A组PaO2和SpO2在T2,T3,T4时段较B组高,有显著差异(P<0.01)。麻醉后,两组血浆SOD均下降,MDA及PMN升高。在T1,T2,T3,T4时段,A组SOD下降的程度明显小于B组(P<0.01);在T2,T3,T4时段,A组MDA升高的程度较小,与B组比较有显著差异(P<0.01);在T1,T2,T3,T4时段,A组PMN升高的程度较小,与B组比较有显著差异(P<0.01)。结论:中药防己黄芪汤对单肺通气、肺缺血再灌注(LIRI)所致的肺损伤,有较好保护作用。

Objective：To observe the effects of Fangji Huangqi tang on arterial blood-gas analysis and cytokines of patients undergoing one-lung ventilation.Method： Forty-six patients with esophageal cancer undergoing open thoracic operation,American standards association（ASA） level Ⅰ-Ⅱ,were randomLy divided into two groups（n=23）.Group B,the control group,were given routine treatment,while group A were given the traditional Chinese medicine（TCM） intervention in addition,by taking Fangji Huangqi tang in 7 days preoperational orally.3 mL peripheral blood samples were taken from the radial artery while bilateral-lungs ventilation after anesthesia induction（T1）,60 mins after one lung ventialation（OLV）（T2）,120 mins after OLV（T3） and 120 mins after the operation（T4） for PaO2,SpO2 and assay of plasma superoxide dismutase（SOD）,malondialdehyde（MDA） and pdymorphonuclears（PMN） value.Result： PaO2 and SpO2 of group A were significantly higher than group B when T2,T3 and T4（P0.01）.After anesthesia,the SOD values decreased while the MDA and PMN values increased in both two groups.In T1,T2,T3 and T4 periods,the decline of SOD value in group A was significantly less than that of group B（P0.01）;while in T2,T3,T4 periods,the increase of MDA value in group A was significantly less than that of the control group（P0.01）;while in T1,T2,T3 and T4 periods,the increase of PMN value in group A was significantly less than that of the control group（P0.01）.Conclusion： The TCM intervention of Fangji Huangqi tang can effectively protect the lung function from the damages caused by OLV and ischemia reperfusion injury lung（LIRI）.