葶苈大枣泻肺汤加减治疗肺挫伤并发急性呼吸窘迫综合征临床疗效观察  

Clinical Observation on Effect of Tingli Dazao Xiefei Decoction in Treating Pulmonary Contusion with Acute Respiratory Distress Syndrome

作　　者：于克静 邱志新[2] 

机构地区：[1]河北省沧州市中西医结合医院重症医学科,沧州061001 [2]河北省沧州市中西医结合医院脑病二科,沧州061001

出　　处：《世界中医药》2016年第9期1711-1713,共3页World Chinese Medicine

基　　金：沧州市科技计划项目(编号:141302089)

摘　　要：目的:探讨葶苈大枣泻肺汤加减治疗肺挫伤并发急性呼吸窘迫综合征临床疗效。方法:选取因胸部外伤后急性呼吸窘迫综合征的住院患者200例,采用随机、单盲分组方法,将患者分为观察组和对照组,对照组给予常规治疗方法治疗。观察组在给予葶苈大枣泻肺汤加减治疗。对比分析2组临床治疗效果。结果:观察组患者治疗总有效率明显高于对照组患者,差异有统计学意义(P<0.05);2组患者治疗后TNF-α、IL-1、IL-6、CRP等检测结果明显下降,差异均有统计学意义(P<0.05),观察组患者下降的效果明显优于对照组患者,差异均有统计学意义(P<0.05);2组患者RR、PaO_2、PaCO_2和PaO_2/FiO_2监测结果较治疗前明显改善改善(P<0.05),观察组患者与对照组患者相比较,观察组RR、PaO_2、PaCO_2和PaO_2/FiO_2优于对照患者(P<0.05);观察组患机械通气时间明显短于对照组患者,差异有统计学意义(P<0.05),2组患者转出ICU时间和28 d病死率差异无统计学意义(P<0.05)。结论:葶苈大枣泻肺汤加减能治疗肺挫伤并发急性呼吸窘迫综合征,可降低炎性反应递质水平,抑制炎性反应,有效的改善氧合,提高患者生存率,降低死亡率。Objective： To investigate the clinical curative effect of Tingli Dazao Xiefei Decoction in the treatment of pulmonary contusion complicated with acute respiratory distress syndrome. Methods： Two hundred patients with acute respiratory distress syndrome were randomly divided into the observation group and control group. Patients in the control group received routine treatment while patients in the observation group were given Tingli Dazao Xiefei decoction. Clinical therapeutic effects of the two groups were compared. Results： Total efficacy of patients in the observation group was significantly higher than that of the control group（ P〈0. 05）; IL-1,IL-6,TNF-α and CRP of both the two groups were significantly decreased with statistically significant difference（ P〈0. 05）. The patients in the observation group received better results compared with the control group（ P〈0. 05）,which showed statistically significant difference. The RR,PaCO2,PaCO2 and PaO2/ FiO2 of the two groups were improved（ P〈0. 05） and the observation group were more significantly improved compared with those of the control group（ P〈0. 05）. There was no significant difference in ICU transformation time and 28 d case fatality rate between the two groups（ P〈0. 05）. Conclusion： Tingli Dazao Xiefei Decoction in the treatment of pulmonary contusion with acute respiratory distress syndrome may reduce the levels of inflammatory mediators,inhibit inflammatory reaction and effectively improve oxygenation,improving patient survival rate and reducing mortality.

关 键 词：葶苈大枣泻肺汤加减 创伤 急性呼吸窘迫综合征 炎性递质 

分 类 号：R285.6[医药卫生—中药学]