黄芪注射液雾化吸入联合无创正压通气治疗重症支气管哮喘疗效及对血浆8-异前列腺素、IL-25、ET-1水平的影响

Curative efficacy of Huangqi injection by atomization inhalation with noninvasive positive pressure ventilation on severe bronchial asthma and influence on levels of plasma eight different prostaglandins,IL-25 and ET-1

目的观察黄芪注射液雾化吸入联合无创正压通气(NPPV)治疗重症支气管哮喘患者疗效及对血浆8-异前列腺素(8-iso-PG)、白细胞介素-25(IL-25)、内皮素-1(ET-1)水平的影响。方法将80例重症支气管哮喘患者随机分为观察组40例和对照组40例,2组均给予常规治疗,对照组在常规治疗基础上给予NPPV治疗,观察组在对照组基础上给予黄芪注射液雾化吸入治疗,2组均连续治疗7 d。观察2组治疗前后血浆8-iso-PG、IL-25、ET-1水平及气道功能指标[达峰容积比(PFV)、潮气量(VT)、呼出75%潮气量时的呼气流速/潮气呼气峰流速(25/PF)和潮气呼气中期流速/潮气吸气中期流速(ME/MI)]和肺功能指标[用力肺活量(FVC)、第1秒用力呼气容积(FEV_1)、呼气峰值流速(PEF)、FEV_1占用力肺活量百分比(FEV_1/FVC)]变化情况,统计2组治疗期间的临床结局。结果 2组治疗后血浆8-iso-PG、IL-25、ET-1水平均显著降低(P均<0.05),气道功能指标和肺功能指标均明显升高(P均<0.05),且观察组上述指标改善情况均明显优于对照组(P均<0.05);观察组治疗期间并发症发生率、气管插管率、住院总费用均明显低于对照组(P均<0.05),住院时间明显短于对照组(P均<0.05)。结论黄芪注射液雾化吸入联合NPPV治疗重症支气管哮喘患者能够显著改善患者气道及肺功能,促进预后康复,其机制可能与抑制机体血浆8-iso-PG、IL-25、ET-1水平有关。

Objective It is to observe the curative effect of Huangqi injection by atomization inhalation with noninvasive positive pressure ventilation （NPPV） on severe bronchial asthma and influence on the levels of plasma eight different pros~ taglandins（8-iso-PG）, interleukin 25 （IL-25） , endothelin 1 （ ET-1 ）. Methods 80 cases of severe bronchial asthma pa- tients were randomly divided into observation group and control group, 40 cases in each group. Both groups were given con- ventional therapy, additionally, the control group was treated with NPPV, the observation group was treated with Huangqi injection by atomization inhalation plus NPPV. Both groups were continually treated for 7 days. The changes of plasma 8- iso-PG, IL-25, ET-1 and airway function indexes [ reach peak volume ratio （PFV）, tidal volume （VT）, breathe out 75% tidal volume when expiratory flow/moisture expiratory peak flow velocity （25/PF） and moisture mid expiratory flow rate/ mid moisture suction flow rate （ME/MI） ] and lung function indexes [ forced vital capacity （FVC）, forced expiratory vol- ume in 1 s （FEV~）, peak expiratory flow （PEF）, FEV~ percentage of forced vital capacity （FEVI/FVC） ] before and af- ter treatment and the clinical outcomes during treatment were observed in both groups. Results After treatment the levels of plasma 8-iso-PG, IL-25, ET-1 were significantly lower while the airway function indexes and pulmonary function indexes were significantly higher than those before treatment in both groups （ P 〈 0.05 ）, and the improvements of the above indicators in the observation group were significantly better than those in the control group （ P 〈 0.05 ） ; the occurrence rates of complica- tions during treatment, endotracheal intubation rate, total hospitalization expenses were significantly lower while the hospital-ization time was significantly shorter in the observation group than those in the control group （ P ~ 0.05 ）. Conclusion Huangqi injection by atomization inhalation combined with NPPV can significantly improve the patient＇ s airway and lung function, promote the rehabilitation outcome in the treatment of severe bronchial asthma, the mechanism may be related to its inhibition of the levels of plasma 8-iso-PG, IL-25, ET-1.