大剂量沐舒坦及血必净联合应用在ARDS患者中的肺保护作用

Study of large dose ambroxol combined with Xuebijing injection on the lung protection in patients with ARDS

目的探讨大剂量沐舒坦及血必净联合应用在ARDS患者中的肺保护作用。方法将60例ARDS患者随机分为两组(n=30):对照组静脉应用沐舒坦150 mg,3次/日;观察组静脉输注沐舒坦150 mg,3次/日;联合应用血必净注射液,50 ml静脉输注,2次/日;两组均持续用药5 d。观察两组患者分别在用药前及用药后5 d的氧合指数及呼吸力学指标的变化,并应用ELISA分别测定患者用药前及用药后5 d血清中肿瘤坏死因子(TNF-α)的变化。结果与对照组相比,应用大剂量沐舒坦联合血必净治疗能更有效的改善ARDS患者肺顺应性、降低气道阻力、改善低氧血症,降低患者血清中TNF-α水平,减轻炎症反应,有效的缩短呼吸机使用时间及ICU停留时间,但两组患者28d存活率无明显差异。结论研究结果表明应用大剂量沐舒坦联合血必净治疗能更有效的改善ARDS患者的低氧血症、降低气道阻力、改善肺顺应性。

Objective：To investigate the large dose ambroxol combined with Xuebijing injection on the lung protection in patients with ARDS . Method：60 patients with ARDS were randomly divided into two groups（n = 30）：control group：am-broxol intravention（150mg,intravenous drip,3 times / day）;observation group ：ambroxol combined Xuebijing injection intravention,（ambroxol 150 mg,intravenous drip 3 times / day;Xuebijing injection 50ml,intravenous drip,2 times /day）;Both groups were received 5 days treatment,changes of oxygenation index and respiratory mechanics were observed before and after the treatment,tumor necrosis factor（TNF - α）of serum was measured by ELISA. Results：Compared with control group,high dose ambroxol incombination with Xuebijing injection group showed advantages in improving lung com-pliance and hypoxemia,in reducing airway resistance,the level of TNF - αand the inflammation response of ARDS,Venti-lation time and ICU residence time were more shorter. But 28 - day survival rate of patients had no significant different be-tween groups. Conclusion：The results showed that large doses of mucosolvan joint Xuebijing can more effectively improve the treatment of patients with ARDS hypoxemia,reduce airway resistance and improve lung compliance.