急性呼吸窘迫综合征应用自拟通腑泄肺方联合西药治疗的临床效果观察  

Clinical study on self-made Tongfu Xiefei Recipe in the treatment of patients with acute respiratory distress syndrome

作　　者：赵亚娟 李伟 崔娜 董妍 杨明华 ZHAO Ya-juan;LI Wei;CUI Na(Department of Pulmonary Oncology,Langfang Hospital of Traditional Chinese Medicine,Langfang Hebei 065000,China;Department of Emergency,Langfang Hospital of Traditional Chinese Medicine,Langfang Hebei 065000,China;Department of Critical Care Medicine,Langfang Hospital of Traditional Chinese Medicine,Langfang Hebei 065000,China)

机构地区：[1]廊坊市中医医院肺病肿瘤科,河北廊坊065000 [2]廊坊市中医医院急诊科,河北廊坊065000 [3]廊坊市中医医院重症医学科,河北廊坊065000 [4]河北省中医院重症医学科,河北石家庄050000 [5]河北省中医院护理部,河北石家庄050000

出　　处：《临床和实验医学杂志》2022年第5期479-483,共5页Journal of Clinical and Experimental Medicine

基　　金：廊坊市科技计划项目(编号:2019013158);河北省中医药管理局科研计划项目(编号:2022065)。

摘　　要：目的观察急性呼吸窘迫综合征(ARDS)应用自拟通腑泄肺方联合西药治疗的临床效果。方法前瞻性选取廊坊市中医医院2019年9月至2020年9月收治的80例ARDS患者为研究对象,按照随机数字表法分成对照组和观察组,每组各40例。对照组采用单纯西药治疗,观察组采用西药联合自拟通腑泄肺方治疗。比较两组临床疗效、机械通气时间、ICU住院时间、中医证候评分、血气指标[血氧分压(PaO_(2))、动脉血氧饱和度(SaO_(2))、氧合指数(FiO_(2)/PaO_(2))]、炎症指标[中性粒细胞数-淋巴细胞数比值(NLR)、白细胞介素-6(IL-6)、肿瘤坏死因子α(TNF-α)、降钙素原(PCT)]、免疫指标与远期预后。结果观察组治疗总有效率为95.00%,高于对照组(85.00%),差异有统计学意义(P<0.05)。观察组机械通气时间、ICU住院时间均短于对照组,差异均有统计学意义(P<0.05)。治疗后,两组中医症候评分较治疗前显著降低,且观察组中医症候积分低于对照组,差异均有统计学意义(P<0.05)。治疗后,两组血气指标和免疫指标较治疗前显著升高,炎症指标较治疗前降低,观察组PaO_(2)、SaO_(2)、FiO_(2)/PaO_(2)均高于对照组,NLR、IL-6、TNF-α、PCT水平均低于对照组,CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)均高于对照组,差异均有统计学意义(P<0.05)。随访1年,观察组药物并发症总发生率及病死率分别为12.50%、5.00%,均低于对照组(25.00%、20.00%),差异均有统计学意义(P<0.05)。结论自拟通腑泄肺方可有效缓解ARDS患者的临床症状,改善血气指标,缩短机械通气时间与住院时间,减轻炎症反应,增强免疫功能,远期预后更佳。Objective To study the clinical application value of self-made Tongfu Xiefei Recipe in the treatment of patients with acute respiratory distress syndrome(ARDS).Methods A total of 80 patients with ARDS admitted to Langfang Hospital of Traditional Chinese Medicine from September 2019 to September 2020 were prospectively selected as the research objects,and they were divided into control group and observation group according to the random number table method,with 40 cases in each group.The control group was treated with pure western medicine,and the observation group was treated with western medicine combined with self-made Tongfu Xiefei Recipe.The clinical efficacy,mechanical ventilation time,ICU stay time,TCM syndrome scores,blood gas indicators[partial pressure of oxygen(PaO_(2)),arterial oxygen saturation(SaO_(2)),oxygenation index(FiO_(2)/PaO_(2))],inflammatory indicators[neutrophil count-lymphocyte count ratio(NLR),interleukin-6(IL-6),tumor necrosis factor alpha(TNF-α),procalcitonin(PCT)],immune indicators,and long-term prognosis were compared between the two groups.Results The total effective rate of treatment in the observation group was 95.00%,which was higher than that in the control group(85.00%),and the difference was statistically significant(P<0.05).The mechanical ventilation time and ICU stay time in the observation group were shorter than those in the control group,and the differences were statistically significant(P<0.05).After treatment,the TCM symptom scores in the two groups were significantly lower than those before treatment,and the TCM symptom scores in the observation group were lower than those in the control group,the differences were statistically significant(P<0.05).After treatment,the blood gas indexes and immune indexes in the two groups were significantly increased compared with those before treatment,and the inflammatory indexes were decreased compared with those before treatment,the levels of PCT were lower than those in the control group,and the levels of CD4^(+),CD8^(+),and CD4^(+

关 键 词：急性呼吸窘迫综合征 自拟通腑泄肺方 西药 临床效果 

分 类 号：R563.8[医药卫生—呼吸系统]