补肺益肾贴对呼吸机依赖患者痰液SP-A的影响

Effect of Bufei Yishen Decoction on sputum SP-A in ventilator dependent patients

目的观察补肺益肾贴对呼吸机依赖患者痰液肺表面活性物质相关蛋白-A(SP-A)含量的影响,探索SP-A在导致呼吸机依赖中可能的机制。方法将重庆市中医院符合呼吸机依赖患者52例,随机分为实验组与对照组。实验组在西医常规治疗基础上加用补肺益肾贴外用治疗7 d,对照组单纯采用西医常规治疗,留取各组入组当天、第3天、第7天的痰液标本,检测两组患者痰液中SP-A水平,记录氧合指数、脱机时间、28 d死亡率及每日按需吸痰频率。结果 1)实验组痰液中SP-A水平随治疗时间延长呈递增趋势,差异有统计学意义(P <0.05);对照组痰液中SP-A水平前后无明显变化(P> 0.05);两组入组第3、7天SP-A含量进行组间比较,实验组较对照组改善明显(P <0.05)。2)两组治疗后,患者氧合情况均有不同程度改善,但两组组间比较,实验组较对照组改善明显(P <0.05)。3)两组患者脱机时间及28 d死亡率差异无统计学意义(P> 0.05)。结论外用补肺益肾贴敷能增加呼吸机依赖患者肺内SP-A的分泌,对患者氧合情况有一定改善作用,能减少肺内痰液的分泌,但其对脱机时间及28 d死亡率无影响。

Objective:To observe the influence of the content changes of herbal Plaster as adjuvant therapy pulmonary on ventilator-dependent patients and to explore the possible mechanism of SP-A in ventilator dependence. Methods:52 patients admitted to Chongqing Traditional Chinese Medicine Hospital,were divided into experimental group and control group.experimental group was treated with Bufei Yishen Decoction for 7 days on the basis of routine western medicine,and control group was treated with routine western medicine alone. Sputum samples from each group on the same day,the 3 rd day and the 7 th day were collected. The levels of SP-A in sputum of the two groups were measured. The oxygenation index,offline time,28-day mortality and daily sputum suction frequency were recorded. Results:1)The experimental group after the application of Bufei Yishen Decoction,the level of SP-A in sputum increased with the prolongation of treatment time(P < 0.05). There was no significant difference in the level of SP-A in sputum between the two groups(P > 0.05). There was no significant difference in the level of SP-A in sputum between before and after treatment in the control group(P < 0.05). On the 3 rd and 7 th day,the content of SP-A in group A was significantly better than group B,and the difference was statistically significant(P < 0.05). 2)After treatment,the oxygenation of patients in experimental group and control group were improved in varying degrees,but the improvement in group A was significantly better than that incontrol group(P <0.05). 3)There was no significant difference in offline time and 28-day mortality between the two groups(P >0.05). 4)After entering the group,the sputum suction frequency of the two groups showed a downward trend,the difference was statistically significant(P < 0.05),and on the 7 th day,the sputum suction frequency of the experimental group was significantly better than that of the control group,and the difference was statistically significant(P > 0.05). Conclusion:External application of Bufei Yishen Decoction can increase the secretion of SP-A in the lungs of ventilator-dependent patients,improve the oxygenation of patients,and reduce the secretion of sputum in the lungs,but it has no effect on the offline time and 28 days mortality.