清肺汤对ALI/ARDS患者呼出气冷凝液及血清中NO的影响  

Influence of nitric oxide by Qingfeitang on nitric oxide in exhaled breath condensate and serum of patients with ALI/ARDS

作　　者：顾言[1] 陈建荣[2] 邵峰[1] 高想[2] 唐艳芬[2] 徐志华[1] 李虹[2] 

机构地区：[1]南通大学第二附属医院急诊医学中心,江苏南通226001 [2]南通市中医院

出　　处：《临床急诊杂志》2014年第2期67-70,共4页Journal of Clinical Emergency

基　　金：江苏省中医药局科技项目(No:LZ11157);2012年南通市第四期"226工程"培养对象科研项目通委组发[2012]153号

摘　　要：目的:研究急性肺损伤(ALI)/急性呼吸窘迫综合征(ARDS)患者使用清肺汤治疗后呼出气冷凝液(EBC)和血清中一氧化氮(NO)改变的临床意义。方法:ICU行机械通气的ALI/ARDS患者54例,随机分为常规治疗组(给予机械通气、液体管理、抗炎、综合营养支持等)和清肺汤治疗组(在常规治疗基础上联用中药清肺汤)。ALI/ARDS患者在第1天及第5天采用改进的德国JAEGER公司Ecoscreen呼出气冷凝液收集器收集EBC标本。54例患者均同步抽取静脉血5ml,在室温下离心留取血清。以ELISA法测定EBC和血清中的NO浓度。同时进行APACHEⅡ评分,记录氧合指数及机械通气时间。结果:①清肺汤治疗组第5天,EBC和血清中NO[(26.71±9.32)μmol/L,(31.28±8.73)μmol/L]均低于常规治疗组[(34.27±9.96)μmol/L,(39.34±9.15)μmol/L],均P<0.05。②清肺汤治疗组治疗前后氧合指数差值(94.74±42.19)mmHg高于常规治疗组(68.41±35.21)mmHg,P<0.05;③清肺汤治疗组机械通气时间(225.06±74.79)h少于常规治疗组(296.42±96.25)h,P<0.05;④清肺汤治疗组APACHEⅡ评分(9.75±4.52)低于常规治疗组(13.02±5.31),P<0.05。结论:ALI/ARDS患者联用中药清肺汤有助于控制炎症反应,减轻肺损伤,可提高临床疗效。Objective：To observe the changes of nitric oxide （NO） in exhaled breath condensate （EBC） and se rum of patients with acute lung injury/acute respiratory distress syndrome （AIA/ARDS） during the treatment of Qingfeitang. Method：The study included 54 mechanical ventilation patients with ALI/ARDS in ICU, all the pa tients were randomly divided into Qingfeitang treatment group and control group. The EBC were co）.lected by im- proved EcoScreen condenser,in the first day and the fifth day after the diagnosis of ALI/ARDS, with the synchro nous collection of the venous blood. The levels of NO in the EBC and serum were measured by EIA. At the same time record APACHEⅡ score,oxygenation index and the duration of mechanical ventilation. Result：@After treat- ment,The levels of EBC-NO and blood serum-NO （26. 71 ± 9.32 μmol/L, 31.28±8. 73 μmol/L） in Qingfeitang treatment group were significantly lower than in the control group （34.27± 9.96μmol/L, 39.34± 9. 15 μmol/L）. @The oxygenation index in the two groups were all both increased. But the D-value of oxygenation index of the Qingfeitang treatment group （94.74 ±42.19） mmHg was significantly higher, compared with the control group （68.41±35.21） mmHg. @The duration of mechanical ventilation （225.06± 74. 79 h） of the Qingfeitang treat ment group was significantly less shorter than that of the control group（296.42±96.25 h）. @After treatment, the APACHE score （9.75±4.52） of the Qingfeitang treatment group was significantly lower than that of the con trol group （13.02 ±5.31 ）. Conclusion ： Qingfeitang could be an effective method complementary medicine for allevi ating acute lung iniurv.

关 键 词：清肺汤 急性肺损伤 急性呼吸窘迫综合征 呼出气冷凝液 一氧化氮 

分 类 号：R563.8[医药卫生—呼吸系统]