自拟复方大黄制剂治疗急性呼吸窘迫综合征的临床作用探讨  

A clinical study on effects of self-made compound rhubarb preparation for treatment of patients with acute respiratory distress syndrome

作　　者：董晨明[1] 宋瑞霞[1] 张红松[1] 张虹[1] 杨朝辉[1] 冯芳[1] 齐艳[1] 

机构地区：[1]兰州大学第二医院重症医学一科,甘肃兰州730030

出　　处：《中国中西医结合急救杂志》2011年第6期337-339,共3页Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care

基　　金：基金项目：甘肃省科学事业基金项目（QS031-C33-14）

摘　　要：目的 探讨复方大黄制剂在救治急性呼吸窘迫综合征（ARDS）中的作用.方法 采用前瞻性研究方法,选择ARDS病例50例,按就诊时间的先后顺序分为中药治疗组（25例）和对照组（25例）.两组均采用常规综合治疗,治疗组在常规综合治疗基础上加用中药复方大黄制剂.观察两组患者治疗后机械通气时间、住院时间、动脉血氧分压（PaO2）、氧合指数（OI）的变化,以及并发症和预后情况.结果 中药治疗组治疗后24、36、48、72 h动脉血气分析结果较对照组明显改善（均P＜ 0.05）.与对照组比较,中药治疗组机械通气时间（d：7.32±3.07比9.18±4.47）、住院时间（d：10.20±2.27比12.04±3.79）、并发症发生率[12％（3/25）比20％（5/25）]和病死率[ 8％（ 2/25）比16％（4/25）]均明显降低（均P＜0.05）.结论 采用复方大黄制剂与机械通气及药物综合治疗ARDS,可明显减低肺气压伤等并发症发生率,使机械通气治疗时间缩短,易于脱机;同时ARDS的抢救成功率显著提高,病死率降低.Objective To investigate the therapeutic effect of compound rhubarb preparation for treatment of patients with acute respiratory distress syndrome （ ARDS ）. Methods A prospective method was used to study 50 patients with ARDS, and according to the successive visiting order, they were divided randomly into two groups： a control group （ 25 cases ） treated with the routine western medicine and a treatment group （ 25 cases ） treated with medicine as above combined with the compound rhubarb preparation. The changes of duration of mechanical ventilation, hospitalization time, artery partial pressure of oxygen （ PaO2 ）, oxygenation index （ OI ）, the incidence of complications and prognosis were observed and compared between the two groups after treatment. Results After treatment with the compound rhubarb preparation for 24, 36, 48 and 72 hours, the blood gas analyses were improved significantly （all P 〈 0.05） compared to those of the control group; in treatment group, the patients＇ duration of mechanical ventilation （days： 7.32 ± 3.07 vs. 9.18 ± 4.47 ）, hospitalization time （days： 10.20 ± 2.27 vs. 12.04 ± 3.79）, the rate of complications [12% （3/25） vs. 20% （5/25）] and the mortality [ 8% （2/25） vs. 16% （4/25）] were obviously lower than those of the control group after treatment （ all P 〈 0.05 ）. Conclusions The combined therapy of compound rhubarb preparation, mechanical ventilation and conventional medicine can effectively reduce the incidence of complications such as the barotrauma of lung, shorten the duration of mechanical ventilation; in the mean time, the therapy can significantly improve the successful rate of rescue and decrease the mortality of the patients with ARDS.

关 键 词：复方大黄制剂 急性呼吸窘迫综合征 机械通气 中西医结合疗法 

分 类 号：R285.6[医药卫生—中药学] R563.8[医药卫生—中医学]