血府逐瘀汤经直肠滴注对胸外伤并发ARDS患者血清VEGF、炎症因子水平的影响及临床疗效研究

Effect of Xuefu Zhuyu Decoction Rectal Drip on Serum Levels of VEGF and Inflammatory Factor for Thoracic Trauma Complicated with ARDS and Its Clinical Effect

目的:观察研究血府逐瘀汤经直肠滴注对胸外伤并发ARDS患者血清VEGF、炎症因子水平的影响及临床疗效。方法:选取2018年1月至2019年1月我院收治的胸外伤并发ARDS患者60例,采用数字随机方法分为对照组和研究组,每组各30例。对照组给予常规治疗,研究组在此基础上给予血府逐瘀汤直肠滴注。结果:对照组的有效率为70.00%,研究组的有效率为90.00%。两组患者的有效率比较有显著性差异(P<0.05)。与治疗前比较,两组患者治疗后的PO2、PCO2以及PO2/FiO2高于治疗前(P<0.05),两组患者治疗后的血清VEGF和TNF-α、IL-6、IL-8水平以及APACHEⅡ评分低于治疗前。与对照组相比,研究组患者治疗后的PO2、PCO2以及PO2/FiO2高于对照组(P<0.05),研究组患者治疗后的血清VEGF和TNF-α、IL-6、IL-8水平以及APACHEⅡ评分明显低于对照组。且研究组患者的机械通气、ICU住院时间、肺部感染、ARDS发生率和病死率均明显低于对照组(P<0.05)。结论:血府逐瘀汤经直肠滴注可降低胸外伤并发ARDS患者血清VEGF、炎症因子水平、肺部感染、ARDS发生率和病死率,改善患者肺氧合情况,减少机械通气和ICU住院时间,提高临床疗效。

Objective: To investigate the effect of Xuefu Zhuyu Decoction(XFD) rectal drip on serum levels of vascular endothelial growth factor(VEGF) and inflammatory factor(IF) for thoracic trauma complicated with ARDS patients and its clinical efficacy.Methods: 60 patients with thoracic trauma complicated with ARDS were selected and randomly divided into controlled group and research group with 30 cases in each group from January 2018 to January 2019.The controlled group was given routine treatment, and the research group was given Xuefu Zhuyu Decoction rectal drip on this basis.Results: The effective rate of the controlled group was 70.00%,and that of the study group was 90.00%.There was a significant difference in the effective rate between the two groups(P < 0.05).Compared with before treatment, the levels of PO2,PCO2 and PO2/FiO2 in the two groups after treatment were higher than those before treatment(P < 0.05).The levels of serum VEGF,TNF-α, IL-6,IL-8 and APACHE II in the two groups after treatment were lower than those before treatment.Compared with the controlled group, the levels of PO2,PCO2 and PO2/FiO2 in the study group after treatment were higher than those in the controlled group(P < 0.05).The levels of serum VEGF,TNF-α, IL-6,IL-8 and APACHE II in the study group after treatment were significantly lower than those in the controlled group.The mechanical ventilation, length of stay in ICU,pulmonary infection, incidence of ARDS and mortality in the study group were significantly lower than those in the controlled group(P < 0.05).Conclusion: Xuefu Zhuyu Decoction can reduce serum levels of vascular endothelial growth factor, inflammatory factors, pulmonary infection, incidence of ARDS and mortality in patients with thoracic trauma complicated with ARDS,improve pulmonary oxygenation, reduce the duration of mechanical ventilation and ICU hospitalization, and improve clinical efficacy.