宣白承气汤加味联合甲泼尼龙琥珀酸钠治疗急性呼吸窘迫综合征饮停夹热证临床研究

Clinical Study on Modified Xuanbai Chengqi Tang Combined with Methylprednisolone Sodium Succinate for Acute Respiratory Distress Syndrome with Fluid Retention with Heat Syndrome

目的:观察宣白承气汤加味联合甲泼尼龙琥珀酸钠治疗急性呼吸窘迫综合征(ARDS)饮停夹热证的临床疗效。方法:选取63例ARDS饮停夹热证患者,按随机数字表法分为治疗组33例与对照组30例。对照组给予注射用甲泼尼龙琥珀酸钠治疗,治疗组在对照组基础上加用宣白承气汤加味治疗,2组均治疗7 d。比较2组临床疗效;比较2组治疗前后中医证候评分、炎症因子及血气分析指标水平。结果:治疗组总有效率84.85%,高于对照组60.00%(P<0.05)。治疗后,2组中医证候评分均较治疗前降低(P<0.05),治疗组中医证候评分低于对照组(P<0.05)。治疗后,2组C-反应蛋白(CRP)、白细胞介素-6 (IL-6)水平均较治疗前降低(P<0.05),治疗组CRP、IL-6水平均低于对照组(P<0.05)。治疗后,2组动脉血氧分压(PaO_(2))、氧合指数(PaO_(2)/FiO_(2))均较治疗前升高(P<0.05),动脉血二氧化碳分压(PaCO_(2))均较治疗前降低(P<0.05);治疗组PaO_(2)、PaO_(2)/FiO_(2)均高于对照组(P<0.05),PaCO_(2)低于对照组(P<0.05)。结论:宣白承气汤加味联合甲泼尼龙琥珀酸钠治疗ARDS饮停夹热证,可有效缓解患者的临床症状,减轻炎症反应,改善血气分析指标。

Objective:To observe the clinical effect of modified Xuanbai Chengqi tang combined with methylprednisolone sodium succinate for acute respiratory distress syndrome(ARDS) with fluid retention with heat syndrome. Methods:A total of 63 cases of ARDS patients with fluid retention with heat syndrome were selected and divided into the treatment group and the control group according to the random number table method,with 33 and 30 cases in each group respectively. The control group was treated with methylprednisolone sodium succinate for injection,and the treatment group was additionally treated with modified Xuanbai Chengqi tang based on the treatment of the control group. Both groups were treated for seven days.Clinical effects was compared between the two groups. Before and after treatment,Chinese medicine syndrome scores,inflammatory factors and blood gas analysis indexes were compared between the two groups. Results:The total effective rate was 84.85% in the treatment group,higher than that of 60.00% in the control group(P<0.05). After treatment,Chinese medicine syndrome scores were decreased when compared with those before treatment(P<0.05), and the score in the treatment group was lower than that in the control group(P<0.05). After treatment,levels of C-reactive protein(CRP) and interleukin-6(IL-6) in the two groups were decreased when compared with those before treatment(P<0.05),and the above two levels in the treatment groups were lower than those in the control group(P<0.05). After treatment, arterial partial pressure of oxygen(PaO_(2)) and oxygenation index(PaO_(2)/FiO_(2)) in the two groups were increased when compared with those before treatment(P<0.05),and the above two indexes in the treatment group were higher than those in the control group(P<0.05);arterial partial pressure of carbon dioxide(PaCO_(2)) in the two groups were decreased when compared with those before treatment(P<0.05), and PaCO_(2)in the treatment group was lower than that in the control group(P<0.05). Conclusion:Modified Xuanbai Chengqi tang combined with methylprednisolone sodium succinate for ARDS with fluid retention with heat syndrome can effectively relieve clinical symptoms and inflammatory responses, and improve blood gas analysis indexes.