丹红注射液联合无创正压通气治疗早期急性呼吸窘迫综合征轻度患者临床研究  

Clinical effect of Danhong injection combined with noninvasive positive pressure ventilation for patients with early mild acute respiratory distress syndrome

作　　者：张芷毓 刘源 杨浩 王大力 赵一鸣 董旭[2] ZHANG Zhiyu;LIU Yuan;YANG Hao;WANG Dali;ZHAO Yiming;DONG Xu(Hebei University of Chinese Medicine,Shijiazhuang,Hebei 050091;Department of Critical Care Medicine,The First Affiliated Hospital of Hebei University of Chinese Medicine,Shijiazhuang,Hebei 050011)

机构地区：[1]河北中医学院,河北石家庄050091 [2]河北中医学院第一附属医院重症医学科,河北石家庄050011

出　　处：《河北中医》2022年第7期1123-1127,1133,共6页Hebei Journal of Traditional Chinese Medicine

基　　金：河北省中医药管理局2019年度中医药类科研计划项目(编号:2019022,2019042)。

摘　　要：目的观察丹红注射液联合无创正压通气治疗早期急性呼吸窘迫综合征(ARDS)轻度患者的临床疗效。方法68例早期ARDS轻度患者按照随机数字表法分为2组,对照组34例予西医常规治疗,治疗组34例在对照组基础上予丹红注射液联合无创正压通气治疗。2组均治疗14 d后统计疗效,比较2组治疗后前后中医症状评分(包括喘息气促、胸闷、咳嗽咯痰、口唇紫绀、汗出烦躁及发热)、急性生理学与慢性健康状况评分表Ⅱ(APACHEⅡ)评分、血气指标{包括氧分压[p(O_(2))]、二氧化碳分压[p(CO_(2))、氧合指数(OI)及血氧饱和度(SaO_(2))}及炎症因子[包括白细胞介素6(IL-6)、降钙素原(PCT)、肿瘤坏死因子α(TNF-α)及IL-10]水平变化情况,比较2组治疗期间有创机械通气时间、ICU住院时间及呼吸机相关肺炎(VAP)发生情况。结果治疗组总有效率82.3%(28/34),对照组总有效率58.8%(20/34),治疗组疗效优于对照组(P<0.05)。与本组治疗前比较,2组治疗后中医症状喘息气促、胸闷、咳嗽咯痰、口唇紫绀、汗出烦躁评分及总分均降低(P<0.05),且治疗组治疗后中医症状喘息气促、胸闷、咳嗽咯痰、口唇紫绀、汗出烦躁评分及总分均低于对照组(P<0.05)。与本组治疗前比较,2组治疗后APACHEⅡ评分均降低(P<0.05),且治疗组治疗后APACHEⅡ评分低于对照组(P<0.05)。与本组治疗前比较,2组治疗后p(O_(2))、SaO_(2)及OI水平均升高(P<0.05),p(CO_(2))水平均降低(P<0.05),且治疗组治疗后p(O_(2))、SaO_(2)及OI水平均高于对照组(P<0.05),p(CO_(2))水平低于对照组(P<0.05)。与本组治疗前比较,2组治疗后IL-6、TNF-α及PCT水平均降低(P<0.05),IL-10水平均升高(P<0.05),且治疗组治疗后IL-6、TNF-α及PCT水平均低于对照组(P<0.05),IL-10水平高于对照组(P<0.05)。治疗组治疗期间有创机械通气时间及ICU住院时间均短于对照组(P<0.05),VAP发生率低于对照组(P<0.05)。结论丹红注射液联合无�Objective To observe the clinical effect of Danhong injection(DHI)combined with noninvasive positive pressure ventilation(NPPV)for patients with early mild acute respiratory distress syndrome(ARDS).Methods Totally 68 patients with early mild ARDS were randomly assigned into the treatment group(n=34)and the control group(n=34).All patients were managed by routine western medicine,and those in the treatment group were additionally treated with DHI combined with NPPV.The treatment continued 14 days to compare traditional Chinese medicine(TCM)symptom(wheezing,chest tightness,coughing,expectoration,lip cyanosis and fever)scores,acute physiology and chronic health evaluationⅡ(APACHEⅡ)score,blood gas indicators including the partial pressure of oxygen[p(O_(2))],partial pressure of carbon dioxide[p(CO_(2))],oxygenation index(OI),arterial oxygen saturation(SaO_(2));inflammatory factors(interleukin-6[IL-6],procalcitonin[PCT],tumor necrosis factor-α[TNF-α],IL-10);the duration of invasive mechanical ventilation in Intensive Care Units(ICU),ICU hospitalization time,ventilation-associated pneumonia(VAP)during the treatment;the curative effect was assessed.Results The overall effective rate was 82.3%(28/34)in the treatment group,higher than that of 58.8%(20/34)in the control group(P<0.05).After treatment,TCM symptom(wheezing,chest tightness,coughing,expectoration,lip cyanosis,sweating irritability)scores in groups were decreased(P<0.05),which were notably decreased in the treatment group compared with the control group(P<0.05);APACHEⅡscore in groups was decreased(P<0.05),the reduction in the treatment group was more prevalent(P<0.05);p(O_(2)),SaO_(2),OI in groups were increased(P<0.05),which were increased(P<0.05)in the treatment group relevant to the control group;p(CO_(2))in groups was decreased(P<0.05),the treatment group was more common(P<0.05);decreased levels of IL-6,TNF-α,PCT and increased levels of IL-10 were detected in groups after treatment(all P<0.05);lower IL-6,TNF-α,PCT levels,and higher IL-10 levels wer

关 键 词：呼吸窘迫综合征 成人 无创通气 中成药 丹红注射液 

分 类 号：R278[医药卫生—中医学] R563.8