甘草酸二铵与黄芪注射液治疗急性肺损伤疗效分析  

Effect of diammonium glycyrrhizinate and astragalus membranaceus injection on the comprehensive score of acute lung injury

作　　者：李峥[1] 黄华[1] 陈凤坤[1] 黄克刚[1] 梁耀元[2] 邱文燕[1] 陈帅[1] 梁裕积[1] 

机构地区：[1]广西医科大学第十附属医院钦州市第一人民医院ICU,广西钦州535000 [2]广西钦州市疾病预防控制中心,广西钦州535000

出　　处：《中国中西医结合急救杂志》2013年第4期213-215,共3页Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care

基　　金：广西壮族自治区中医药管理局项目

摘　　要：目的研究甘草酸二胺与黄芪注射液对急性肺损伤（ALI）患者临床综合评分的影响。方法采用前瞻性随机对照研究方法，将60例ALI患者按随机数字表法分为研究组和对照组，每组30例。对照组按照指南要求进行综合治疗，研究组在综合治疗基础上应用甘草酸二胺与黄芪注射液（甘草酸二胺150 mg＋黄芪20ml），每日1次，7d为1个疗程。分别于治疗前和治疗后3d、7d测定两组肺损伤评分、急性生理学与慢性健康状况评分系统Ⅱ（APACHEⅡ）评分、全身炎症反应综合征（SIRS）评分及呼吸机支持时间、病死率。结果两组治疗前和治疗后3 d肺损伤评分（分）、APACHEⅡ评分（分）、SIRS评分（分）比较差异均无统计学意义（均P＞0.05）；随治疗时间延长，两组治疗后7 d上述指标均较本组治疗前明显降低，且以研究组下降程度更显著（肺损伤评分：1.31±0.99比2.29±1.08，APACHEⅡ评分：18.43±8.17比24.23±6.98，SIRS评分：1.69±0.89比2.60±1.04，均P＜0.01）。研究组呼吸机支持时间（h）较对照组明显缩短（176.10±57.81比286.07±156.27，P＜0.01），但两组病死率比较差异无统计学意义（13.33%比16.67%，P＞0.05）。结论甘草酸二胺与黄芪注射液对ALI患者有改善肺损伤评分、APACHEⅡ评分、SIRS评分，减轻肺损伤的作用，有利于患者尽早脱机，对ALI有一定的治疗作用。Objective To explore the effect of diammonium glycyrrhizinate（DG） and astragalus membranaceus （AM） injection on the clinical comprehensive score in patients with acute lung injury （ALI）. Methods According to the random number table method,a prospective random controlled study was conducted in which 60 cases of patients with ALI were divided into a study group and a control group（each,30 cases）. Both groups received a comprehensive treatment based on the new guidelines,and the study group was additionally given DG and AM injection（DG 150 mg＋AM 20 ml）one time per day for 7 days. The scores of lung injury,acute physiology and chronic health evaluationⅡ（APACHEⅡ）and systemic inflammatory response syndrome（SIRS）were measured at baseline,3rd and 7th day after treatment,and ventilation support time and final disease mortality rate were also calculated in all the patients. Results There were no statistically significant differences between the two groups in the scores of lung injury,APACHEⅡand SIRS before treatment and after treatment for 3 days（all P〉0.05）,with prolonged treatment,the above indexes were significantly reduced compared with those before treatment in the two groups,and the decreases in scores of indexes in study group was more significant than those in control group after treatment（lung injury score：1.31±0.99 vs. 2.29±1.08,APACHEⅡscore：18.43±8.17 vs. 24.23±6.98,SIRS score：1.69±0.89 vs. 2.60±1.04,all P0.05）. Conclusion The results suggest that DG and AM injection improve the scores of lung injury,APACHEⅡand SIRS,and alleviate the lung injury,so that the injection is beneficial to the early weaning from the ventilator to support treatment in patients with acute lung injury,and has certain therapeutic effect on ALI.

关 键 词：甘草酸二铵 黄芪注射液 急性肺损伤 急性呼吸窘迫综合征 肺损伤评分 急性生理学与慢性健康状况评分系统Ⅱ 全身炎症反应综合征评分 

分 类 号：R259.414[医药卫生—中西医结合]