通腑净化汤对创伤后急性呼吸窘迫征呼吸力学和气体交换影响  

Effects of Tongfu Jinghua Decoction on Post-Traumatic Respiratory Mechanics and Gas Exchange in Patients with ARDS

作　　者：尤莉莉[1,2] 李良业[1,2] 王凤英[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：《辽宁中医杂志》2015年第10期1832-1835,共4页Liaoning Journal of Traditional Chinese Medicine

基　　金：河南省科技厅成果(豫科鉴字[2013]第345号);河南省中医药科学研究专项课题(2013zy02010)

摘　　要：目的:观察中药干预治疗对创伤后急性呼吸窘迫综合征(ARDS)患者呼吸力学和气体交换的影响。方法:60例患者随机分入中药组和对照组。中药组采用通腑净化汤和西医常规治疗,对照组仅采用西医常规治疗。观察治疗前和治疗后第3、7天呼吸力学和气体交换相关指标。结果:与本组治疗前比较,组各时间点呼吸力学指标变化除对照组治疗后3 d潮气量均有明显改善,而两组各时间点各项气体交换指标除Pa CO2和对照组治疗后3 d每分钟通气量均有明显改善,差异有统计学意义(P<0.05)。与对照组同期比较,中药组呼吸力学指标改善明显,差异有统计学意义(P<0.05);中药组在各时间点氧合功能及通气功能中Vd/Vt、肺顺应性指标均有改善,差异有统计学意义(P<0.05)。结论:通腑净化汤联合西医常规治疗创伤后ARDS,能有效改善呼吸力学和气体交换功能,缩短呼吸机使用时间,提高疗效。Objective： To observe the effects of Tongfu Jinghua Decoction on the post- traumatic respiratory mechanics and gas exchange in patients with post- traumatic ARDS. Methods： Sixty patients were randomly divided into the Chinese medicine group and control group. The patients in Chinese medicine group were treated with Tongfu Jinghua Decoction and conventional western medicine and control group only with conventional treatment. Observe improvements in respiratory mechanics and gas exchange after 3 and 7 days of treatment. Results： After treating 3 and 7 d,Chinese medicine group＇ s tidal volume,lung volume,peak airway pressure,plateau pressure and mean airway pressure improved significantly and the differences were more obvious（ P〈0. 05）than that of the control group. Chinese medicine group and the control group can effectively improve patients＇ oxygenation index,reduce high blood ratio of alveolar ventilation,dead space- like ventilation,high minute ventilation,improve pulmonary shunt and pulmonary compliance,maintain Pa CO2 normal,but both contrast,traditional Chinese medicine group was significantly better than the control group（ P〈0. 05）. Conclusion： Treatment with Tongfu Jinghua Decoction combined conventional Western medicine treatment of traumatic ARDS can effectively improve respiratory mechanics and gas exchange function,shorten ventilator time and improve efficacy.

关 键 词：通腑净化汤 急性呼吸窘迫综合征 呼吸力学 气体交换 中医药治疗 

分 类 号：R563.8[医药卫生—呼吸系统]