通腑净化汤治疗创伤后急性呼吸窘迫综合征疗效观察  

Curative Observation of Using Tongfu Jinghua Decoction to Treat ARDS after Trauma

作　　者：王凤英[1,2] 唐辉[1,2] 常晖[1,2] 明松林[1,2] 焦瑞娜[1,2] 李良业[1,2] 

机构地区：[1]河南省洛阳正骨医院 [2]河南省骨科医院重症医学科,河南洛阳471002

出　　处：《四川中医》2014年第7期80-82,共3页Journal of Sichuan of Traditional Chinese Medicine

基　　金：河南省中医药科学研究专项课题(编号:2013ZY-02010)

摘　　要：目的:观察通腑净化汤治疗急性呼吸窘迫综合征(ARDS)的临床疗效。方法:48例创伤后ARDS患者,随机分为对照组(24例)和观察组(24例),对照组给予常规西医治疗,观察组在常规治疗的基础上加用通腑净化汤,比较两组的动脉血气指标、氧合指数(PaO2/FiO2)、C反应蛋白(CRP)、APACHEⅡ评分及病死率。结果:与同组治疗前比较,两组治疗后PH、PaCO2、PaO2/FiO2均升高(P<0.05),血浆CRP水平、APACHEⅡ评分降低(P<0.05);治疗后7天两组比较,观察组PaO2/FiO2高于对照组(P<0.05),CRP低于对照组(P<0.05);APACHEⅡ评分低于对照组(P<0.05);观察组病死率为20.83%(5/24)、对照组病死率为33.33%(10/24),差异无统计学意义(P>0.05)。结论:通腑净化汤能改善创伤后ARDS患者的血气指标,提高氧合指数,有效降低CRP等细胞因子的产生和释放,降低死亡率。Objective： Observing the clinical curative effect of Tongfu Jinghua Decoction in the treatment of ARDS. Methods： 48 cases of ARDS patients after trauma were randomly divided into controlled group （24 cases） and observation group （24 cases）. The controlled group were treated with conventional western medicine, the observation group were treated with Tongfu Jinghua Decoction on the basis of conventional treatment comparing the arterial blood gas index, oxygenation index （ P sO2/ FiO2）, c-reactive protein （CRP）, APACHE Ⅱ score and mortality of two groups. Results： Compared with the same group hefore treatment, the two groups after treatment of PH, PaCO2, PaO2/FiO2 are elevated （P 〈0. 05） , plasma CRP levels and APACHE Ⅱ score lower （P 〈0. 05） ; 7 days after treatment between two groups, PaO2/FiO2of observation group was higher than the conlrolled group （P 〈0. 05） , the CRP was lower than the controlled group （P 〈0. 05） ; APACHE Ⅱ score was lower than the controlled group （P 〈0. 05） ; the bservation group case fatality rate was 20. 83% （5/24）, the controlled group case fatality rate was 33. 33% （8/24） , there was no significant difference hetween the two groups （P 〉0. 05）. Conclusion： Tongfu Jinghua Decoction can improve the blood gas indexes and oxygenation index improve, effectively reduce the production and release of cytokines such as CRP and reduce the mortality rate in patients with ARDS after trauma.

关 键 词：急性呼吸窘迫综合征 通腑净化汤 机械通气 

分 类 号：R641[医药卫生—外科学]