益气泻浊活血法干预急性肺损伤高危患者的临床研究

Clinical Research on Effect of Yiqi Xiezhuo Huoxue Method on High-risk Patients of Acute Lung Injury

目的观察益气泻浊活血法对急性肺损伤(ALI)高危患者的有效性及安全性并探讨其作用机制。方法59例患者随机分为观察组29例与对照组30例。对照组予西医常规治疗,观察组在西医治疗基础上联合益气泻浊活血法中药汤剂。比较两组治疗前后呼吸、血氧分压、动脉血氧饱和度、氧合指数及炎症、免疫等指标变化情况。结果观察组治疗后呼吸、血氧分压、血氧饱和度(Sa O2)、氧合指数均较治疗前改善(均P<0.05或P<0.01),对照组治疗前后呼吸、血氧分压、SaO2、氧合指数比较,差别均不大(均P>0.05)。两组治疗后呼吸、血氧分压、SaO2、氧合指数指标比较,差别均不大(均P>0.05)。两组治疗后白细胞计数(WBC)、C反应蛋白(CRP)、降钙素原(PCT)均较治疗前改善善(均P<0.01),但两组治疗后上述指标比较,差别均不大(均P>0.05)。两组治疗后血IgA、血C3、CH50均较治疗前改善(均P<0.05或P<0.01),且观察组治疗后血C3、CH50高于对照组(均P<0.05)。两组治疗后ALI发生率、28 d生存率、住院总天数及住院总治疗费用比较,均差别不大(均P>0.05)。结论益气泻浊活血法虽未改善ALI高危患者的住院7 d ALI发病率与28 d生存率,但无负性影响;益气泻浊活血法对ALI高危患者免疫功能具有一定改善作用,可改善患者呼吸、氧合情况,从而改善短期内病情,可能是ALI高危患者一个潜在有效的中医切入方案。

Objective:To observe the safety and efficacy of Yiqi Xiezhuo Huoxue method in high-risk patients of acute lung injury(ALI).Methods:59 high-risk patients of ALI were randomly divided into the experimental(29 cases)and the control groups(30 cases).The control group were treated with conventional Western medicine,the experimental group with Yiqi Xiezhuo Huoxue method combined with conventional Western medicine.The changes of respiration,partial pressure of blood oxygen,arterial oxygen saturation,oxygenation index,inflammation and immunity were compared between the two groups before and after treatment.Results:After treatment,respiration,partial pressure of blood oxygen,SaO2 and oxygenation index in the experimental group were improved compared with those before treatment(all P<0.05 or P<0.01).There were no significant differences in the control group(P>0.05).After treatment,there was no significant difference in respiration,partial pressure of blood oxygen,SaO2 and oxygenation index between the two groups(all P>0.05).After treatment,WBC,CRP and PCT in both groups improved better than before(all P<0.01),but there was no significant difference in the above indexes between the two groups after treatment(all P>0.05).After treatment,the levels of serum IgA,C3 and CH50 in the two groups were improved compared with those before treatment(all P<0.05 or P<0.01),and the increase of blood C3 and CH50 in the experimental group was higher than that in the control group(all P<0.05).There was no significant difference in the incidence of ALI,28-day survival rate,total hospitalization days and total cost of hospitalization between the two groups(all P>0.05).Conclusion:Although Yiqi Xiezhuo Huoxue method doesn′t improve ALI incidence rate of 7 days after hospitalization and 28-day survival rate,it has no negative impact.It has a particular regulatory effect on immunosuppression in high-risk patients of ALI.Furthermore,it shows the trend of improving the respiratory and oxygenation of patients,so as to improve the condition in a short time.It may be a potentially effective TCM treatment for high-risk patients of ALI.