清肺汤对急性呼吸窘迫综合征患者呼出气冷凝液中一氧化氮和8－异前列腺素的影响  

Effect of Qingfei Decoction on Nitric Oxide and 8-iso PG in Exhaled Breath Condensate of ARDS Patients

作　　者：邵峰[1,2] 陈建荣[3] 高想[3] 唐艳芬[3] 顾言[1] 李虹[3] 徐志华[1] 

机构地区：[1]南通大学第二附属医院急诊科,江苏226001 [2]南通市第三人民医院急诊科,江苏226001 [3]南通市中医院呼吸科,江苏226001

出　　处：《中国中西医结合杂志》2015年第5期541-544,共4页Chinese Journal of Integrated Traditional and Western Medicine

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

摘　　要：目的研究中药清肺汤治疗急性呼吸窘迫综合征(acute respiratory distress syndrome,ARDS)患者呼出气冷凝液(EBC)中一氧化氮(NO)和8-异前列腺素(8-isoprostane,8-iso PG)水平变化的临床意义。方法48例ICU行机械通气的ARDS患者,按照随机数字表法分为清肺汤组和对照组。在诊断ARDS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。采用ELISA法测定EBC中NO和8-iso PG浓度。同时记录氧合指数、APACHEⅡ评分。结果 (1)清肺汤组病死率(8.3%,2/24)低于对照组(37.5%,9/24),差异有统计学意义(P<0.05)。(2)治疗后,清肺汤组患者EBC中NO[(34.49±5.67)μmol/L]和8-iso PG[(30.09±7.89)ng/L]低于对照组[(39.78±9.27)μmol/L、(35.65±8.90)ng/L],差异有统计学意义(均P<0.05);(3)治疗后,清肺汤组患者氧合指数改善值(120.88±35.16)高于对照组(101.50±37.70)(P<0.05);APACHEⅡ评分[(6.21±3.51)分]低于对照组[(10.26±4.33)分](P<0.05)。结论中药清肺汤治疗ARDS患者有助于控制炎症反应,减轻肺损伤,提高临床疗效。Objective To observe the clinical significance of nitric oxide （NO） and 8-isoprostane （8-isoPG） changes in exhaled breath condensate （EBC） of acute respiratory distress syndrome （ARDS） patients after treated by Qingfei Decoction （QD）. Methods Totally 48 ARDS patients receiving mechanical ventilation were equally assigned to the QD treatment group and the control group by random digit table. EBC specimens were collected by modified Ecoscreen breath condensate collector （German JAEGER Company） on the first day and the fifth day after confirmed diagnosis of ARDS. Concentrations of NO and 8-isoPG in EBC were measured by ELISA. The oxygenation index and APACHE Ⅱ scores were recorded at the same time. Results （1） The fatality rate in the QD treatment group was lower than that in the control group （8.3% vs 37.5%, P 〈0.05）. （2） After treatment NO and 8-isoPG concentrations in EBC were lower in the QD treatment group （34.49 ±5.67 μmol/L, 30.09 ±7.89 ng/L） than in the control group （39.78 ±9.27 μmol/L, 35.65 ±8.90 ng/L; P 〈0.05）. （3） After treatment improved oxygenation index value was higher in the QD treatment group than in the control group （120.88 ± 35.16 vs 101.50 ± 37. 70, P 〈0.05）. After treatment APACHEⅡ scores was lower in the QD treatment group than in the control group （6.21±3.51 vs 10.26±4.33,P〈0.05）.Conclusion Treatment of ARDS patients by QDwas favorable in controlling inflammation, alleviating lung injury, and improving clinical efficacy.

关 键 词：清肺汤 急性呼吸窘迫综合征 呼出气冷凝液 一氧化氮 8-异前列腺素 

分 类 号：R259[医药卫生—中西医结合]