大黄治疗急性百草枯中毒的作用研究

Effect of Rhubarb in the Treatment of Acute Paraquat Poisoning

目的:通过观察PQ中毒患者SOD、TNF-α、IL-6、PaO2、PaCO2、BUN和Cr水平,及血浆PQ浓度的变化,旨在探讨大黄在治疗PQ中毒中的作用。方法:36例急性百草枯中毒患者随机分为对照组(n=15)和治疗组(n=21),所有患者均给予常规治疗,对照组应用甘露醇导泻,治疗组应用生大黄混悬液导泻,采用酶联免疫吸附法(enzyme linked immunosorbent assay,ELISA)检测所有患者血清SOD、TNF-α、IL-6水平,高效液相色谱法(High Performance Liquid Chromatography,HPLC)测定患者血浆PQ浓度,并测定PaO2、PaCO2、BUN和Cr。结果:治疗组患者第1、3、7天PaO2、SOD水平显著高于对照组,PaCO2、BUN、Cr、TNF-α、IL-6水平和PQ浓度亦较对照组均显著降低(P<0.05)。结论:大黄可降低PQ中毒患者血中PQ浓度,抑制TNF-α、IL-6的表达,明显升高SOD的水平,改善PQ中毒患者肺、肾功能。

Objective： To study the effects and protecting mechanism of Rhubarb by observing the changes of Serum SOD, TNF-α,IL-6, PaO2, PaCO2, BUN and Cr levels and plasma paraquat concentration in patients with paraquat poisoning. Methods： 36 patients with paraquat poisoning were randomly divided into control group（n=21） and treatment group（n=15）. Both groups were treated with conventional therapy. The control group were treated with mannitol for catharsis, and the treatment group with rhubarb suspension. Serum SOD,TNF- α, IL-6 were measured by ELISA, and the plasma concentration of paraquat were measured by HPLC, and determined PaO2, PaCO2,BUN and Cr. Results： PaO2, SOD on 1, 3, 7 days of patients in the treatment group were significantly higher than that of the control group, and PaCO2, BUN, Cr, TNF-α, IL-6 level, the concentration of paraquat was significantly lower than the control group（P〈0.05）.Conclusion： Rhubarb can reduce the concentration of paraquat, inhibit exrpression of serum TNF-α, IL-6, and SOD levels rised in patients with paraquat poisoning. Furthermore, Rhubarb can improve the lung function and kidney function in patients with paraquat poisoning.