痰热清注射液治疗严重肺挫伤的临床疗效

Therapeutic effect of high dose dexamethasone combined with Tanreqing in treatment of severe pulmonary contusion

目的探讨痰热清注射液治疗严重肺挫伤的临床疗效。方法选择78例严重肺挫伤患者,随机分为对照组(n=38)和痰热清组(n=40),对照组接受常规治疗,痰热清组同时加入痰热清注射液治疗,每天1次,连用7天;对照组患者治疗第1、第7天行血气分析,并检测治疗第1、第4、第7天血清肿瘤坏死因子-a(TNF-a)、白细胞介素-6(IL-6)和白细胞介素-8(IL-8)的含量,比较治疗期间;两组患者急性呼吸窘迫综合征(ARDS)和多器官功能障碍综合征(MODS)的发生率,治愈率和死亡率。结果治疗前两组血气分析指标及血清TNF-a、IL-6、IL-8水平无显著差异(P>0.05);治疗后痰热清组血气分析指标较同期对照组显著改善(P<0.05),血清TNF-a、IL-6和IL-8水平较对照组显著下更明显(P<0.05),ARDS,MODS发生率和死亡率痰热清组显著低于对照组(P<0.05)。结论应用痰热清注射液能显著抑制炎症介质的释放,促进肺部修复,提高肺组织氧合能力,提高肺挫伤患者预后和生存率。

Objective To evaluate the clinical efficacy of high dose dexamethasone combined with Tanreqing injection in the treatment of severe pulmonary contusion. Methods 78 severe pulmonary contusion patients were randomly divided into the control group （n = 38 ） and the Tanreqing group （n = 40）. The control group received conventional therapy, and the Tanreqing group was given Tanreqing injection treatment, once per day for 7 days. The control group was given blood gas analysis at the 1st and 7th days and the detection of serum tumor necrosis faetor-A （TNF-a）, leukocyte interleukin 6 （IL-6） and white cell interleukin 8 （IL-8） at the 1 st, 4th and 7th days. The incidence of acute respiratory distress syndrome （ARDS） and multiple organ dysfunction syndrome （MODS）, and their cure rate and mortality were compared between the two groups. Results The results of blood gas analysis and serum TNF-a, IL-6 levels showed no significant difference between the two groups before treatment （P 〈 0.05）. The results of blood gas analysis in the Tanreqing group were better than those of the control group after treatment （ P 〈 0.05 ）. The levels of TNF-a and IL-6 in the Tanreqing group decreased more significantly than those in the Control group at the 4th and 7th days after treatment （P 〈 0.05 ）. The incidence and mortality of acute respiratory distress syndrome （ARDS） and multiple organ dysfunction syndrome （MODS） in the Tanreqing group was lower than in the control group （P 〈 0. 05）. Conclusion High dose dexamethasone combined with Tanreqing can inhibit the production of inflammatory cytokines significantly, protect lung function effectively, increase lung tissue oxygenation, and improve the prognosis and survival in patients with severe pulmonary contusion.