加味宣白承气汤对急性呼吸窘迫综合征机械通气患者的临床疗效  

Clinical Efficacy of Jiawei Xuanbai Chengqi Tang on Patients with Mechanical Ventilation in ARDS

作　　者：江涛[1] 高冰[1] 周莉[1] 张江[1] 

机构地区：[1]自贡市中医医院,四川自贡643000

出　　处：《中国实验方剂学杂志》2013年第7期300-303,共4页Chinese Journal of Experimental Traditional Medical Formulae

摘　　要：目的:针对急性呼吸窘迫综合征(ARDS),运用加味宣白承气汤配合西医综合疗法,观察加味宣白承气汤对ARDS机械通气患者的临床疗效并探讨其作用机制。方法:31例ARDS患者,随机分为治疗组(16例)和对照组(15例),对照组予机械通气(小潮气量加PEEP),治疗组同时管喂加味宣白承气汤。比较两组患者治疗前及治疗后24,48 h动脉血气指标:动脉血酸碱度(pH)、氧分压(PO2),二氧化碳分压(PCO2);通气指标:气道峰压(Ppeek)、平台压(Pplat)、呼气末正压(PEEP)、氧浓度(FiO2)等指标;并比较机械通气时间及住ICU时间、因为ARDS导致的死亡率。结果:治疗组与对照组比较,31例患者治疗前血气及通气指标无统计学差异;治疗后24,48 h与治疗前比较,pH,PO2,PCO2改善(P<0.05);治疗后24,48 h两组患者pH,PO2,PCO2无统计学差异;治疗后24,48 h Ppeek,Pplat,PEEP,FiO2均较治疗前改善(P<0.05);治疗后24 h两组比较无统计学差异;治疗后24 h与治疗后48 h通气指标比较,治疗组通气指标改善(P<0.05);两组机械通气时间、住ICU时间及死亡率比较,治疗组预后更佳(P<0.05)。结论:加味宣白承气汤能有效改善急性呼吸窘迫综合征机械通气患者血气、通气指标,减少机械通气时间及留住ICU时间,加强对ARDS机械通气患者的保护,改善患者预后。Objective： Response to acute respiratory distress syndrome （ARDS）, using the Jiawei Xuan bai Chengqi tang together with western medicine therapy, observation of Jiawei Xuanbai Chengqi tang on patients with mechanical ventilation in ARDS clinical curative effect and its mechanism of action. Method： Thirty-one patients with ARDS, were randomLy divided into the treatment group （16 cases） and control group （15 cases）, the control group received mechanical ventilation （tidal volume plus PEEP）, treatment group at the same time tube feeding on Jiawei Xuanbai Chengqi tang. Comparison of two groups of patients before treatment and after treatment of 24 hour, 48 hour arterial blood gas indicators： arterial blood pH （pH）, oxygen partial pressure （PO2 ）, partial pressure of carbon dioxide （ PCO2 ） ; ventilatory parameters ： peak airway pressure （ Ppeek）, platform pressure （Pplat） , positive end expiratory pressure （PEEP）, oxygen concentration （FiO2） ; and to compare the duration of mechanical ventilation and ICU time, ARDS causes mortality. Result： The treatment group compared with the control group, 31 cases of patients before treatment of blood gas and ventilation index showed no statistically significant difference; 24 and 48 hours after treatment compared with those before treatment, pH, PO2, PCO2, Parameter improvement, P 〈 0.05 ; 24 hours and 48 hours after treatment, pH, PO2, PCO2 had no significant difference; Ppeek, Pplat, PEEP, FiO2 treatment after 24 hours, 48 hours were improved after treatment （P 〈 0.05 ） ; 24 hours after treatment in two groups showed no statistically significant difference ; after treatment for 24 hours and 48 hours comparison, treatment group ventilatory parameters improved indexes （P 〈 O. 05） ; two group of mechanical ventilation time, ICU time and mortality comparison of prognosis, treatment group better （P 〈 0.05）. Conclusion： Modified Jiawei Xuanbai Chengqi tang can effectively improve the acute respiratory distre

关 键 词：加味宣白承气汤 急性呼吸窘迫综合征 小潮气量机械通气 

分 类 号：R287[医药卫生—中药学]