宣白承气加减方辅助改善脓毒症急性肺损伤的临床疗效观察

Clinical Observation of Xuanbai Chengqi Supplementing and Reducing Prescription in Improving Sepsis-Associated Acute Lung Injury

目的观察宣白承气加减方辅助改善脓毒症急性肺损伤(Sepsis-Associated Acute Lung Injury,S-ALI)的临床疗效。方法选取2020年1月~2021年12月北京中医药大学东直门医院收治的80例S-ALI患者作为研究对象,按照随机数表法随机分为治疗组和对照组,每组40例。对照组采用常规治疗,治疗组在常规治疗的基础上加用及宣白承气加减方,两组均治疗7 d。观察两组患者治疗前后氧合指数(PO_(2)/FiO_(2)),呼吸频率(R),24 h大便量,白细胞(WBC)、C反应蛋白(CRP)、谷丙转氨酶(ALT)、血肌酐(SCR)、急性生理与慢性健康评分(APACHEⅡ评分),血清铁离子(Fe)等指标的变化情况。结果治疗后第7 d,治疗组患者的氧合指数(PO2/FiO2)较对照组高,24 h大便量较对照组多,呼吸频率较对照组低,差异有统计学意义(P<0.05);治疗组WBC、CRP、APACHEⅡ评分、Fe较对照组低,差异有统计学意义(P<0.05);治疗组患者ALT、SCR与对照组相比,差异无统计学意义(P>0.05)。结论宣白承气加减方可以改善患者肺功能、胃肠功能,可辅助抑制炎症反应。同时,宣白承气加减方具备一定的肝、肾安全性。

Objective To observe the clinical efficacy of Xuanbai Chengqi decoction in improving(sepsis-associated acute lung injury,S-ALI).Methods A total of 80 S-ALI patients admitted to Dongzhimen Hospital of Beijing University of Chinese Medicine from January 2020 to December 2021 were selected as research subjects,and were randomly divided into treatment group and control group according to random number table method,with 40 patients in each group.The control group was treated with conventional treatment,and the treatment group was treated with Xuanbai Chengqi supplementing and reducing prescription on the basis of conventional treatment,both groups were treated for 7 days..The oxygenation index(PO_(2)/FiO_(2)),respiratory rate(R),24-hour stool volume of 2 groups were observed before and after treatment.Changes of white blood cell(WBC),C-reactive protein(CRP),alanine aminotransferase(ALT),serum creatinine(SCR),acute physiology and chronic health score(APACHEⅡscore),serum iron ion(Fe)and other indicators.Results On the 7th day of treatment,the oxygenation index(PO2/FiO2),24-hour stool volume and respiratory rate in the treatment group were higher than those in the control group and the differences were statistically significant(P<0.05);WBC,CRP,APACHEⅡscore and Fe in the treatment group were lower than those in the control group,the diff erence was statistically signifi cant(P<0.05).There were no signifi cant diff erences in ALT and SCR between the treatment group and the control group.Conclusion Xuanbai Chengqi supplementing and reducing prescription can help the patient to improve lung function,gastrointestinal function,and suppress the infl ammatory response.At the same time,the prescription has a certain security to liver and kidney.