小陷胸汤加减联合血液净化治疗脓毒症合并急性呼吸窘迫综合征痰毒蕴肺证的临床观察  

Clinical Analysis on Modified Xiaoxianxiong Decoction Combined with Blood Purification on Sepsis with ARDS

作　　者：廖杨 易琼[2] 丁灿 戴飞跃[2] LIAO Yang;YI Qiong;DING Can;DAI Feiyue(Hunan University of Chinese Medicine,Hunan Changsha 410208,China;The First Affiliated Hospital of Hunan University of Chinese Medicine,Hunan Changsha 410007,China)

机构地区：[1]湖南中医药大学,湖南长沙410208 [2]湖南中医药大学第一附属医院,湖南长沙410007

出　　处：《中医药临床杂志》2021年第11期2188-2191,共4页Clinical Journal of Traditional Chinese Medicine

基　　金：湖南省科技厅科研项目(2020SK3036)。

摘　　要：目的:研究小陷胸汤加减联合血液净化治疗脓毒症合并急性呼吸窘迫综合征(acute respiratory distress syndrome,ARDS)痰毒蕴肺证患者的临床疗效。方法:将60例脓毒症合并ARDS痰毒蕴肺证且具备接受连续性肾脏替代治疗指征的患者随机分为对照组和联合组,对照组予以西医常规治疗+连续肾脏替代疗法,联合组在对照组基础上联合使用加减小陷胸汤中药汤剂,疗程为7d,比较两组患者临床疗效。结果:联合组治疗第5天、治疗第7天的氧合指数较前显著好转,且与对照组比,经治疗后任意时间监测点差异均有统计学意义(P<0.05);联合组治疗第3天、治疗第5天、治疗第7天的PCT、IL-6水平均低于对照组(P<0.05);联合组患者机械通气时间和重症监护时间均短于对照组(P<0.05)。结论:小陷胸汤加减联合血液净化可有效改善脓毒症并ARDS患者氧合指数、减轻炎症反应、缩短机械通气时间和重症监护时间。Objective:To study the clinical efficacy of Xiaoxianxiong decoction combined with CRRT in the treatment of sepsis patients with ARDS syndrome of accumulation of phlegm toxin.Methods:Sixty patients with sepsis combined with ARDS with syndrome of accumulation of phlegm and toxin in the lungs and with indications for continuous renal replacement therapy were randomly divided into a control group and a combined group.The control group received conventional Western medicine + continuous renal replacement therapy,combined group On the basis of the control group,the Chinese medicine decoction of Xiaoxianxiong decoction was used in combination,and the treatment course was 7 days.The clinical efficacy of the two groups of patients was compared.Results:The oxygenation index of the combination group on the 5th and 7th day of treatment was significantly better than before,and compared with the control group,the difference in monitoring points at any time after treatment was statistically significant (P<0.05);treatment in the combination group The levels of PCT and IL-6 on the 3rd,5th,and 7th day of treatment were lower than those of the control group (P<0.05);the mechanical ventilation time and intensive care time of the combined group were shorter than those of the control group (P<0.05).Conclusion:Xiaoxianxiong decoction combined with blood purification can effectively improve the oxygenation index of patients with sepsis and ARDS,reduce inflammation,and shorten the time of mechanical ventilation and intensive care.

关 键 词：脓毒症 急性呼吸窘迫综合征 小陷胸汤 

分 类 号：R256.19[医药卫生—中医内科学]