大承气汤治疗急性呼吸窘迫综合征疗效及对血清白细胞介素表达的影响

Evaluation of Dachengqi Decoction in Treating Acute Respiratory Distress Syndrome and Its Effect on Serum Interleukin Expression

目的：研究大承气汤治疗急性呼吸窘迫综合征（ARDS）的疗效评价及对血清白细胞介素表达的影响。方法：选取2015年2月—2016年1月在医院进行治疗的76例ARDS患者,按照抽签法分为观察组和对照组,38例每组。对照组采取基础治疗,观察组在此基础上加以大承气汤完成治疗。比较两组患者临床疗效,住院时间和机械通气时间,白细胞介素表达,凝血指标,并发症。结果：治疗后,观察组临床总有效率显著高于对照组[92.11%（35/38）比71.05%（27/38）]（P〈0.05）。观察组的住院时间和机械通气时间显著短于对照组（P〈0.05）。观察组的白细胞介素-6（IL-6）、白细胞介素-8（IL-8）、白细胞介素-1β（IL-1β）水平低于对照组[（95.43±7.35）ng/L、（87.65±8.23）ng/L、（8.32±0.82）ng/L比（167.98±12.32）ng/L、（142.16±11.31）ng/L、（15.87±1.65）ng/L]（P〈0.05）。观察组的纤维蛋白（FIB）、血小板计数（PLT）水平高于对照组[（2.98±0.32）g/L、（165.43±14.32）×10~9/L比（2.53±0.22）g/L、（134.32±12.01）×10~9/L]（P〈0.05）,活化部分凝血活酶时间（APTT）、凝血酶原时间（PT）水平低于对照组[（28.78±2.32）s、（10.67±0.98）s比（32.76±2.87）s、（13.45±1.22）s]（P〈0.05）。观察组的并发症发生率显著低于对照组[10.53%（4/38）比31.58%（12/38）]（χ~2=5.067,P〈0.05）。结论：大承气汤治疗ARDS,能有效降低血清IL-6、IL-8、IL-1β表达,改善患者凝血指标,临床疗效良好。

Objective： To study the effect of Dachengqi Decoction on acute respiratory distress syndrome （ARDS） and its effect on serum interleukin expression. Methods： Seventy - six patients with ARDS who were treated in our hospital from February 2015 to January 2016 were divided into observation group and control group according to the lottery meth- od. The control group used the basis treatment and the observation group were given Daehengqi Decoction on the basis of control group to complete the treatment. The clinical efficacy, hospital stay and mechanical ventilation time, interleukin expression and coagulation index and complication were compared between the two groups. Results： After treatment, the total effective rate of the observation group was significantly higher than the control group＇ s [92. 11% （35/38） vs 71.05 % （27/38） ] （P 〈 0.05 ）. The hospital stay and mechanical ventilation time in the observation group were signifi- cantly shorter than those in the control group （ P 〈 0. 05 ）. The levels of interleukin - 6 （ IL - 6）, interleukin - 8 （ IL - 8 ） and interleukin - 1β （ IL - 1β） in the observation group were lower than those in the control group [ （95.43 ± 7.35 ） ng/L, （87.28± 8.23 ） ng/L, （8.32 ± 0.82） ng/L VS （ 167.98 ± 12.32） ng/L, （ 142.16 ± 11.31 ） ng/L, （ 15.87± 1.65 ） ng/L]. The levels of fibrin （FIB） and platelet count （PLT） in the observation group were significantly higher than those in the control group [ （2.98±0.32） g/L, （ 165.43± 14.32） ×109/L vs （2.53±0.22） g/L, （ 134.32 ± 12.01 ） × 109/L] （P 〈 0. 05 ）. The levels of activated thromboplastin （APTT） and prothrombin time （PT） were lower than those intheeontrolgroup[（28.78± 2.32）8, （10.67 ± 0.98）8VS（32.76±2.87） s, （13.45 ±1.22）8] （P〈0.05）. The incidence of complications in the observation group was significantly lower than that in the control group [ 10.53% （4/ 38 ） vs 31.58 % （ 12/38 ） ] （ χ2 = 5. 067, P 〈 0. 05 ）. Conclusion ： Daehengqi Decoction can effectively reduce the expres- sions of IL - 6, IL - 8 and IL - 1β in serum and improve the coagulation index. The clinical curative effect is good.