肺外源性急性呼吸窘迫综合征伴腹腔高压患者益气解毒通腑汤保留灌肠对血气、呼吸、腹压及胃肠功能的影响  

Effects of Retention Enema with Yiqi Jiedu Tongfu Decoction(益气解毒通腑汤)on Blood Gas,Breathing,Intra-Abdominal Pressure and Gastrointestinal Function in Patients with Exogenous Pulmonary ARDS with Intra-abdominal Hypertension

作　　者：逯珍花[1] 梁波涛 吴佳[1] 李瑞林[1] 陈红梅[1] LU Zhenhua;LIANG Botao;WU Jia;LI Ruilin;CHEN Hongmei(Tianshui Hospital of Traditional Chinese and Western Medicine,Tianshui 741020,Gansu,China)

机构地区：[1]天水市中西医结合医院,甘肃天水741020

出　　处：《中华中医药学刊》2023年第5期48-51,共4页Chinese Archives of Traditional Chinese Medicine

基　　金：国家中医药管理局中医药行业科研项目(201908790032)。

摘　　要：目的探讨肺外源性急性呼吸窘迫综合征(ARDS)伴腹腔高压患者益气解毒通腑汤保留灌肠对血气、呼吸、腹压及胃肠功能的影响。方法选取重症监护室入住的外源性ARDS伴腹腔高压患者120例,随机分为对照组与观察组,每组60例,两组均给予综合治疗,观察组在综合治疗基础上给予益气解毒通腑汤高位保留灌肠治疗7 d,观察两组患者治疗前后动脉血氧分压(partial pressure of oxygen,PO_(2))、动脉血二氧化碳分压(Partial pressure of carbon dioxide,PCO_(2))、氧合指数(OxygenationIndex,PO_(2)/FiO_(2))、气道峰压(Peak inspiratory pressure,PIP)、气道阻力压(Airway resistance pressure,PRaw)、平台压(Plateau pressure,Pplat)、呼气末正压(Positive end-expiratory pressure,PEEP)、腹压变化,观察患者中医证候食少纳呆、恶心呕吐、肠结便秘、脘腹胀痛评分及胃肠功能障碍相关并发症发生情况。结果两组患者治疗前PO_(2)、PCO_(2)、PO_(2)/FiO_(2)水平比较差异无统计学意义(P>0.05),PO_(2)和PO_(2)/FiO_(2)治疗后较治疗前升高(P<0.05),且观察组升高程度大于对照组(P<0.05),PCO_(2)治疗后较治疗前下降(P<0.05),且观察组下降程度大于对照组(P<0.05);两组患者治疗前PIP、PRaw、Pplat、PEEP水平比较差异无统计学意义(P>0.05),治疗后较治疗前下降(P<0.05),且观察组下降程度大于对照组(P<0.05);两组患者治疗前腹压水平比较差异无统计学意义(P>0.05),治疗后较治疗前下降(P<0.05),且观察组下降程度大于对照组(P<0.05);两组患者治疗前食少纳呆、恶心呕吐、肠结便秘、脘腹胀痛证候评分比较差异无统计学意义(P>0.05),治疗后较治疗前评分下降(P<0.05),且观察组下降程度大于对照组(P<0.05);观察组患者胃肠功能障碍相关并发症腹腔感染、应激性溃疡、肠麻痹、胃肠功能衰竭发生率分别为6.67%、13.33%、16.67%、6.67%,低于对照组26.67%、46.67%、43.33%、26.67%,差异有统计学意义(P<0.05)Objective To investigate the effects of retention enema with Yiqi Jiedu Tongfu Decoction(益气解毒通腑汤)on blood gas,breathing,intra-abdominal pressure and gastrointestinal function in patients with exogenous pulmonary acute respiratory distress syndrome(ARDS)with intra-abdominal hypertension.Methods A total of 120 cases with exogenous pulmonary ARDS and intra-abdominal hypertension were randomly divided into control group and observation group,60 cases in each group.The two groups received comprehensive treatment.The observation group was given Yiqi Jiedu Tongfu Decoction for high retention enema treatment for 7 days on the basis of comprehensive treatment.The changes of arterial partial pressure of oxygen(PO_(2)),partial pressure of carbon dioxide in artery(PCO_(2)),PO_(2)/FiO_(2),peak inspiratory pressur(PIP),mean airway pressure(PRaw),platform pressure(Pplat),positive end-expiratory airway pressure(PEEP)and intra-abdominal pressure before and after treatment in the two groups were observed and the scores of TCM symptoms including poor appetite,nausea and vomiting,constipation,abdominal distention pain score and complications related to gastrointestinal dysfunction were observed.Results There were no statistical significance in the levels of PO_(2),PCO_(2) or PO_(2)/FiO_(2) between the two groups before treatment(P>0.05),and PO_(2) and PO_(2)/FiO_(2) increased after treatment(P<0.05),and the degree of increase in the observation group was grea-ter than that in the control group(P<0.05).PCO_(2) decreased after treatment(P<0.05)and the decrease degree of the observation group was greater than that of the control group(P<0.05).There were no statistical significance in the levels of PIP,PRaw,Pplat or PEEP between the two groups before treatment(P>0.05).They were decreased after treatment(P<0.05)and the decrease degree of the observation group was greater than that of the control group(P<0.05).There was no statistical significance in the levels of intra-abdominal hypertension between the two groups before tr

关 键 词：肺外源性急性呼吸窘迫综合征 腹腔高压 益气解毒通腑汤 保留灌肠 血气 呼吸 胃肠功能 

分 类 号：R259.638[医药卫生—中西医结合]