调气利水汤治疗中度急性呼吸窘迫综合征患者的临床研究

Clinical Efficacy of Tiaoqi Lishui Decoction on Patients with Moderate Acute Respiratory Distress Syndrome

目的观察调气利水汤对中度急性呼吸窘迫综合征(ARDS)患者的临床疗效及肺血管通透性、肺顺应性及血清肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、白细胞介素-8(IL-8)相关指标变化情况。方法选取入住山东中医药大学附属医院ICU及急诊科60例中度ARDS患者,按随机数字表法分为两组各30例。结果治疗组与对照组患者治疗后比治疗前的APACHEⅡ评分、静态肺顺应性(Cst)、氧分压(PaO2)、氧合指数(PaO2/FiO2)、肺泡动脉氧分压差(PA-aDO2)、血清TNF-α、IL-6、IL-8相关指标差异有统计学意义(P<0.05)。治疗4 d后,组间血管外肺水指数(ELWI)比较差异有统计学意义(P<0.01);组间肺血管通透性指数(PVPI)比较差异有统计学意义(P<0.05)。治疗7 d后组间比较,以上相关指标均优于对照组差异有统计学意义(P<0.05)。结论调气利水汤可显著改善中度ARDS患者临床症状及肺血管通透性、肺顺应性,也可改善炎症指标,有确切临床疗效。

Objective:To observe the clinical efficacy of Tiaoqi Lishui Decoction on patients with moderate acute respiratory distress syndrome(ARDS),and the changes in pulmonary vascular permeability,pulmonary compliance and serum tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),interleukin-8(IL-8).Methods:A total of 60 patients with moderate ARDS were selected from the ICU and emergency department of the Affiliated Hospital of Shandong University of Traditional Chinese Medicine.According to the random number table,there were 30 cases in the control group and 30 cases in the treatment group.Results:The differences in APACHEⅡscore,static lung compliance(Cst),partial pressure of oxygen(PaO2),oxygenation index(PaO2/FiO2),alveolar arterial partial pressure of oxygen(PA-aDO2),serum tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),interleukin-8(IL-8)in the two groups after treatment were statistically significant compared with before treatment(P<0.05).After 4 days of treatment,there was a statistically significant difference in extravascular pulmonary water index(ELWI)between the groups(P<0.01);there was a statistically significant difference in pulmonary vascular permeability index(PVPI)between the groups(P<0.05).After 7 days of treatment,the above related indexes in the treatment group were better than those of the control group,and the difference was statistically significant(P<0.05).Conclusion:Tiaoqi Lishui Decoction can significantly improve the clinical symptoms,pulmonary vascular permeability and pulmonary compliance of patients with moderate ARDS;it can also improve inflammatory indexes and have definite clinical curative effect.