通腑泻热方对胸科急性肺损伤患者细胞因子的影响  

Effect of Tongfu Xiere Recipe on Cytokine Level in Patients with Acute Lung Injury Due to Surgery Disease of Chest

作　　者：谢晓华[1] 杨银芬[1] 张晓清[1] 李刚[1] 

机构地区：[1]广州中医药大学第一附属医院外科,广东广州510405

出　　处：《广州中医药大学学报》2008年第4期294-297,共4页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：广东省科技计划项目(编号:2007B031403001);国家中医药管理局中医药科学技术研究专项课题(编号:06-07ZB01)

摘　　要：【目的】观察中药通腑泻热方配合常规治疗方法对胸科急性肺损伤患者细胞因子的影响。【方法】将58例胸科急性肺损伤患者随机分为治疗组30例和对照组28例,两组均按"急性肺损伤/急性呼吸窘迫综合征诊断治疗指南(2006)"给予常规治疗,治疗组在常规治疗基础上给予通腑泻热方(由大黄、芒硝、山栀子、忍冬藤、地胆头、蒲公英、莱菔子、葶苈子、虎杖、赤芍、枳实、厚朴等组成)治疗5d,或至氧合指数恢复正常。观察两组临床疗效和治疗前后血中肿瘤坏死因子α(TNF-α)、白介素-6(IL-6)、白介素-8(IL-8)的变化情况。【结果】两组治疗后TNF-α、IL-6、IL-8水平均降低(与治疗前比较,P<0.01),其中治疗组降低更显著(与对照组比较,P<0.01);治疗组氧合指数恢复正常时间及住院时间与对照组比较均缩短(P<0.05);治疗组急性呼吸窘迫综合征(ARDS)发生人数和死亡人数有下降趋势,但与对照组比较差异无显著性意义(P>0.05)。【结论】中西医结合治疗胸科急性肺损伤疗效优于单纯西医常规治疗,辨证运用通腑泻热方能降低胸科急性肺损伤患者血中TNF-α、IL-6、IL-8水平,具有免疫调节、减轻肺部的炎症反应及肺组织损害作用,从而提高临床疗效。Objective To observe the effect of Tongfu Xiere Recipe （TXP） combined with routine treatment on cytokine level in patients with acute lung injury due to surgery disease of chest. Methods Fifty eight patients with acute lung injury due to surgery disease of chest were randomized into two groups. The two groups received routine treatment subjecting to the Guideline （2006） for Diagnosis and Treatment of Acute Lung Injury/Acute Respiratory Distress Syndrome. The treatment group additionally received TXP （mainly composed of Radix et Rhizoma Rhei, Natrii Sulfas, Fructus Gardeniae, Caulis Lonicerae, Herba Taraxaci, Semen Raphani, Semen Lepidii seu Descurainiae, Rhizoma Polygoni Cuspidati, Radix Paeoniae Rubra, Fructus Aurantii Immaturus, and Cortex Magnoliae Officinalis） for 5 days or till oxygenation index recovered to the normal. The therapeutic effect was evaluated after treatment, and the changes of blood tumor necrosis factor α （ TNF-α）, interleukin 6 （IL-6） and interleukin 8 （IL-8） levels were observed before and after treatment. Results The serum levels of TNF-α, IL-6 and IL-8 in the two groups after treatment were decreased （ P 〈 0.01 compared with those before treatment） , and the decrease was obvious in the treatment group （ P 〈 0.01 compared with the control group ）. The time of oxygenation index recovering to the normal and hospitalization time were shortened in the treatment group （ P 〈 0.05 compared with the control group ）. The number of patients with acute respiratory distress syndrome and death patients exerted a decreasing trend in the treatment group, but the difference between the two groups was insignificant （P 〉 0. 05 ）. Conclusion The therapeutic effect of traditional Chinese medicine integrated with western medicine is superior to the western medicine only for acute lung injury due to surgery disease of chest. TXP can regulate the immune function and relieve the pulmonary inflammation and injury by decreasing the blood levels of TNF-α, IL-

关 键 词：急性肺损伤/中西医结合疗法 通腑泻热方/治疗应用 肿瘤坏死因子/血液 白细胞介素6/血液 白细胞介素8/血液 

分 类 号：R655.3[医药卫生—外科学]