参附注射液联合持续血液灌流治疗百草枯中毒患者的肺损伤

Shenfu injection combined with continuous hemoperfusion in the treatment of Paraquat poisoning patients with lung injury

目的探讨参附注射液联合持续血液灌流治疗百草枯中毒患者肺损伤的效果。方法选择2016年4月-2019年4月我院收治的百草枯中毒患者46例,按照随机数字表法将其分为2组,各23例。对照组患者给予常规药物联合持续血液灌流治疗,观察组患者在此基础上联合参附注射液治疗,观察2组患者的疗效及治疗前后的Ⅲ型前胶原肽(PⅢNP)、一氧化氮(NO)、一氧化氮合酶(NOS)、诱导型一氧化氮合酶(i NOS)水平以及呼吸功能参数。结果观察组患者的治疗总有效率(95.65%)较对照组(69.57%)高,差异具有统计学意义(P<0.05);与治疗前比较,2组患者治疗3 d后的PⅢNP、NO、NOS及i NOS水平均升高(P<0.05);与治疗3 d后比较,2组患者治疗7 d后的NO、NOS及i NOS水平均降低(P<0.05),PⅢNP升高(P<0.05);观察组患者治疗3,7 d的上述指标均低于对照组(P<0.05)。观察组治疗后RR、PEEP较对照组低,且VT高于对照组,差异具有统计学意义(P<0.05)。结论参附注射液联合持续血液灌流治疗百草枯中毒患者的效果较佳,且能够有效降低肺功能损伤程度,改善患者呼吸功能。

Objective To explore the effect of Shenfu injection combined with continuous hemoperfusion on lung injury of paraquat poisoning patients. Methods From April 2016 to April 2019,46 patients with paraquat poisoning were selected and divided into two groups according to the random number table method. The patients in the control group were treated with conventional drugs combined with continuous hemoperfusion,and the patients in the observation group were treated with Shenfu Injection on this basis. Before and after treatment,the levels of procollagen Ⅲ peptide(P Ⅲ NP),nitric oxide(no),nitric oxide synthetase(NOS),inducible nitric oxide synthetase(i NOS)and respiratory function parameters were observed. Results The total effective rate of the observation group(95.65%)was higher than that of the control group(69.57%)(P<0.05);Compared with that before treatment,the levels of P Ⅲ NP,no,NOS and i NOS in the two groups increased after 3 days of treatment(P<0.05);Compared with that after 3 days of treatment,the levels of no,NOS and i NOS in the two groups decreased after 7 days of treatment(P<0.05),and P Ⅲ NP increased(P<0.05);the above indexes in the observation group were lower than those in the control group(P<0.05). After treatment,the parameters of RR and peep in the observation group were lower than those in the control group,and the VT index was higher than that in the control group,the difference was statistically significant(P<0.05). Conclusion Shenfu injection combined with continuous hemoperfusion is effective in the treatment of paraquat poisoning,and can effectively reduce the degree of lung function damage,improve the respiratory function of patients.