加味桃仁承气汤辅助机械通气对急性肺损伤/急性呼吸窘迫综合征患儿的疗效观察

Clinical efficacy of Jiawei Taoren Chengqi Tang with the assistance of mechanical ventilation on acut lung injury( ALI) / acute respiratory distress syndrome( ARDS) children

目的观察加味桃仁承气汤辅助机械通气治疗急性肺损伤(ALI)/急性呼吸窘迫综合征(ARDS)患儿的疗效及对急性生理学和慢性健康状况Ⅱ(APACHEⅡ)评分、炎症因子的影响。方法 87例纳入研究的ALI/ARDS患儿随机分为治疗组和对照组,对照组42例给予机械通气等常规治疗,治疗组45例在对照组治疗的基础上给予加味桃仁承气汤,治疗7 d后观察2组心电监护、血气指标、APACHEⅡ评分和炎症的变化情况。结果治疗组总有效率为91.12%,对照组为76.19%,2组比较差异有统计意义(P<0.05);治疗7 d后,2组患儿血气指标、APACHEⅡ评分以及IL-6,TNF-α,CRP水平均有所改善,与同组治疗前比较差异均有统计意义(P<0.05),且除Pa CO_2外,治疗组上述指标改善幅度更大,与对照组治疗后比较差异有统计意义(P<0.05)。结论加味桃仁承气汤辅助机械通气治疗小儿ALI/ARDS疗效确切,可能与该方抑制炎症反应有关。

Objective To investigate the clinical efficacy of Jiawei Taoren Chengqi Tang with the assistance of mechanical ventilation on acut lung injury（ ALI）/acute respiratory distress syndrome （ARDS） children and its influences on the APACHE II scores and inflammatory factors. Methods 87 cases of ALI/ARDS in children were randomly divided into a treatment group and a control group. The 42 patients in the control group were treated with the mechanical ventilation and other conventional treatment. The 45 patients in the treatment group, based on the above treatment, were given Jiawei Taoren Chengqi Tang. After the treatment for 7 days, the electrocardiograph monitoring and the blood indicators were observed, including the respiratory rate （ R）, heart rate （ HR）, mean arterial pressure （MAP）, arterial oxygen saturation （SPO2 ）, partial pressure of oxygen （PaO2 ）, carbon dioxide partial pressure （PaCO2）. The APACHE II scores and the inflammatory markers in two groups were observed, including the changes of tumor necrosis factor-α （TNF-α）, interleukin-6 （IL-6） and C-reactive protein （CRP）. Results The total effective rate in the treatment group was 91.12% and that in the control group was 76. 19%, the two groups had statistically significant differences （P〈0.05）. After the treatment for 7 days, the R, HR, MAP, SPO2, PaO2, PaCO2, APACHE II Rating and IL-6, TNF-α, CRP levels in 2 groups were improved, the differences were statistically significant compared with those in the same group before the treatment （P〈0.05）. The improvements of the above indicators in the treatment group, except PaCO2 , were even bigger, the differences were statistically significant （P〈0.05）. Conclusion Jiawei Taoren Chengqi Tang with the assistance of the mechanical ventilation was definitely effective on ALl / ARDS children, due to the possibility of its restriction to the inflammatory responses.