邓氏清霾汤对痰热郁肺型急性肺损伤的治疗作用

Study on Therapeutic Effect of Deng-Shi-Qing-Mai-Tang on Patients with Phlegm-heat-obstructing-the-lung Acute Lung Injury

目的观察邓氏清霾汤对痰热郁肺型急性肺损伤(ALI)的治疗作用。方法将47例ALI患者随机分为常规治疗组(A组)14例、常规治疗加邓氏清霾汤组(B组)17例、常规治疗加甲泼尼龙组(C组)16例。A组给予呼吸机介入、祛痰、抗感染等常规治疗,B组在A组治疗的基础上每日口服邓氏清霾汤2次,C组在A组治疗的基础上每日口服甲泼尼龙片2次,每次8 mg。疗程均为7 d。治疗前后分别测定呼吸频率、心率、氧合指数、炎症因子(IL-1β、IL-6、IL-10、TNF-α)水平、呼吸机使用时间、Murray肺损伤评分等。结果 3组患者治疗后的呼吸频率、心率、氧合指数较治疗前均有明显改善(P<0.01)。与A组比较,治疗后B组、C组的心率、氧合指数、胸片浸润象限个数、Murray肺损伤评分均显著下降(P<0.05),呼吸机通气时间显著缩短(P<0.01),各炎症因子明显下降(P<0.01,P<0.05)。A组治愈2例,有效9例,无效3例,总有效率78.57%;B组治愈5例,有效10例,无效2例,总有效率88.24%;C组治愈6例,有效8例,无效2例,总有效率87.5%。结论邓氏清霾汤能显著改善患者临床症状、增加氧合指数、降低Murray肺损伤评分及减少呼吸机使用时间。其机制可能通过抑制炎症反应来治疗痰热郁肺型ALI。

Objective To observe the therapeutic effect of Deng-Shi-Qing-Mai-Tang on patients with phlegm-heat-obstructing-the-lung type acute lung injury（ALI）. Methods Forty-seven ALI patients were randomly divided intoroutine treatment group（A group,14 cases）,routine treatment plus Deng-Shi-Qing-Mai-Tang（B group,17 cases）,conventional treatment plus methylprednisolone group（C group,16 cases）. Routine treatment for A groupgroup included ventilator intervention,expectorant,anti-infective and other conventional treatment;treatment for Bgroup included Routine treatment for group A plus taking 100 m L Deng-Shi-Qing-Mai-Tang twice daily;treatmentfor C group included the Routine treatment for group A plus taking 8 mg methylprednisolone twice daily. The courseof treatment was 7 d. Respiratory rate,heart rate,oxygenation index,levels of inflammatory cytokines（IL-1β,IL-6, IL-10 and TNF-α）, ventilator duration and Murray lung injury score were recorded before and aftertreatments. Results Respiratory rate, heart rate, oxygenation index, ventilation time of ventilator and score ofMurray lung injury after treatment were significantly improved in groups A,B and C than those before treatment（P〈0.05）. The values of B and C in both groups were significantly lower than those in group A（P〈0.05）,whilethere was no significant difference between B and C groups（P〈0.05）. In group A,2 cases were cured,9 cases were effective and 3 cases were ineffective. The total cure rate was 78.57%. In group B,5 cases were cured,10 cases were effective and 2 cases were ineffective. The total cure rate was 88.24%. In group C,6 cases were cured,8 cases were effective and 2 cases were ineffective,the total cure rate was 87.5%. However,there was no statisticaldifference between the three groups（P〉0.05）. Conclusion Deng-Shi-Qing-Mai-Tang can significantly improveclinical symptoms,increase oxygenation index,reduce Murray lung injury score and reduce ventilator use time. Themechanism may be through the inhibition of inflammatory reaction to treat phlegm and heat lung ALI.