清肺汤对急性呼吸窘迫综合征患者呼出气冷凝液和血清中内皮素-1、前列腺素E_2的影响

Effects of Qingfeitang on ET-1 and PGE_2 in exhaled breath condensate and serum of patients with ARDS

目的:观察清肺汤对急性呼吸窘迫综合征(ARDS)患者呼出气冷凝液(EBC)及血清中内皮素-1(ET-1)和前列腺素E2(PGE2)的影响及其临床意义。方法:选取南通大学第二附属医院ICU行机械通气的52例ARDS患者,分为常规治疗组和清肺汤组,每组26例。52例患者均在治疗的第1、5天采用Ecoscreen呼出气冷凝液收集器收集EBC标本,同步留取血清,以ELISA法测定EBC和血清中ET-1和PGE2浓度。结果:治疗后,清肺汤组EBC和血清ET-1水平均低于常规治疗组(均P<0.05)。治疗后,清肺汤组血清PGE2水平低于常规治疗组(P<0.05)。治疗前后氧合指数改善差值,清肺汤组高于常规治疗组(P<0.05)。清肺汤组机械通气时间短于常规治疗组(P<0.05)。结论:ARDS患者联用中药清肺汤有助于控制炎症反应,减轻肺损伤,提高疗效。

Objective To observe the changes of endothelin-1 （ET-1） and prostaglandin E2 （PGE2） in exhaled breath condensate （EBC） and serum of patients with acute respiratory distress syndrome （ARDS） after treated by Qingfeitang and investigate its clinical value. Methods 52 ARDS patients receiving mechanical ventilation at intensive care unit （ICU） were divided into the Qingfeitang treatment group and the control group, with 26 cases in each group. The EBC were collected by Ecoscreen condenser within 24 h after diagnosis of ARDS and on the 5th day of medication, and the venous blood were collected at the same time. The levels of ET-1 and PGE2 in the EBC and serum of different period were measured by EIA. Results （1） After treatment, The levels of ET-1 in EBC and serum of the Qingfeitang treatment group were significantly lower than those of the control group. （2） After treatment, the levels of PGE2 in serum of the Qingfeitang treatment group were significantly lower than that of the control group. （3） The oxygenation index difference before and after treatment of Qingfeitang in the treatment group was higher than in the control group. （4） The duration of mechanical ventilation of the Qingfeitang treatment group was significantly less than that of the control group. Conclusions Qingfeitang could be an effective method for alleviating acute respiratory distress syndrome.