通腑理肺汤结肠透析联合纤维支气管镜肺泡灌洗对肺炎合并脓毒症患者HMGB-1、IL-10水平影响  

The influence of colon dialysis and fiberoptic bronchoscopy alveolar lavage for the HMGB-1,IL-10 levels of patients with pneumonia complicated sepsis

作　　者：陈立[1] 李兰[1] 韩悦[2] 吕波[1] 李慧侠 邹素昭 

机构地区：[1]贵州省中医院/贵阳中医学院第一附属医院重症医学科,贵阳550001 [2]贵州省中医院/贵阳中医学院第一附属医院产科,贵阳550001

出　　处：《重庆医学》2016年第25期3485-3487,共3页Chongqing medicine

基　　金：贵州省中医药管理局项目(QZYY2013-36);贵州省卫生厅科学技术基金项目(gzwkj2012-1-030);贵州省科技计划项目(黔科合中药字[2012]LKZ7057号);贵州省科技合作计划项目(黔科合LH字[2015]7291号)

摘　　要：目的探讨通腑理肺汤结肠透析联合纤维支气管镜肺泡灌洗对肺炎合并脓毒症患者高迁移率蛋白(HMGB-1)、白细胞介素(IL)-10水平的影响。方法将90例患者分为治疗组A、治疗组B、对照组,每组30例。治疗组A在常规治疗基础上给予通腑理肺汤结肠透析联合纤维支气管镜肺泡灌洗治疗,治疗组B在常规治疗基础上给予温水结肠透析联合纤维支气管镜肺泡灌洗治疗,对照组在常规治疗基础上给予温水结肠透析治疗。于治疗前,治疗后1周末、2周末留取肺泡灌洗液检测HMGB-1、IL-10水平。结果 HMGB-1水平:3组患者治疗前差异无统计学意义(P>0.05);治疗后1周末,治疗组A明显低于治疗组B及对照组;治疗后2周末,治疗组A、治疗组B水平均低于对照组,且治疗组A降低最为明显,差异有统计学意义(P<0.05)。IL-10水平:3组患者治疗前差异无统计学意义(P>0.05);治疗后1周末、2周末3组患者均有不同程度升高,治疗组A、治疗组B均高于对照组,且治疗组A水平升高最为明显,差异有统计学意义(P<0.05)。结论通腑理肺汤结肠透析联合纤维支气管镜肺泡灌洗能显著降低患者HMGB-1水平,提高IL-10水平,调节患者促炎/抗炎因子的平衡,减轻炎症反应和组织损伤,改善患者预后。Objective To explore the influence of colon dialysis and fiberoptic bronchoscopy alveolar lavage for the HMGB- 1,IL-10 levels of patients with pneumonia complicated sepsis. Methods Totally 90 patients were randomly divided into treatment group A. treatment group B, control group, 30 cases in each group. Treatment group A were given Tong Fu Li Fei Soup colon dial- ysis combined fiberoptie bronchoscopy alveolar lavage on the＇basis of conventional treatment ; Treatment group B were given the a- mount of warm water colon dialysis combined fiberoptic bronchoscopy alveolar lavage on the basis of conventional treatment;The control, group were given the amount of warm water colon dialysis on the basis of conventional treatment. We collected the HMGB- 10, IL-10 levels before the treatment,one weekend and the second weekend, SPSS17.0 was used for statistical analysis. Results HMGB-1 ：There were no statistical difference on the HMGB-1 level of the three groups before the treatmem（P〉0.05）. Treatment group A was significantly lower than the treatment group B and control group on one weekendl After two weeks, treatment group A and group B were lower than control group, and the treatment group A was significantly lowest in the three groups（P〈0.05）. IL- 10：There were no statistical difference on the IL-10 level of the three groups before the treatment（P〉0.05）. The level of IL-10 in three groups were different higher after one week and two weeks＇ treatment, treatment group A and group B were higher than con- trol group,and the treatment group A was significantly highest in three groups（P〈0.05）. Conclusion Tong Fu Li Fei Soup colon dialysis combined fiberoptic bronchoscopy alveolar lavage can significantly alleviate the HMGB-1 level,increase the IL-10 level, reg- ulate the balance of pro-inflammatory/anti-inflammatory factors, reduce inflammation reactions and tissue damage, improve the prognosis of the patients.

关 键 词：脓毒症 白细胞介素10 肺泡灌洗 高迁移率蛋白 通腑理肺汤 结肠透析 

分 类 号：R563.1[医药卫生—呼吸系统]