宣肺调肠方联合西药治疗老年脓毒症致急性呼吸窘迫综合征临床研究  

Clinical Study on Xuanfei Tiaochang Prescription Combined with Western Medicine for Acute Respiratory Distress Syndrome Caused By Sepsis in Elderly Patients

作　　者：胡孝刚 吴晗 魏燕斌 康润芳 HU Xiaogang;WU Han;WEI Yanbin;KANG Runfang(The Second People's Hosptial of Lishui,Lishui Zhejiang 323000,China)

机构地区：[1]丽水市第二人民医院,浙江丽水323000

出　　处：《新中医》2024年第6期68-72,共5页New Chinese Medicine

摘　　要：目的:观察宣肺调肠方联合西药治疗老年脓毒症致急性呼吸窘迫综合征(ARDS)饮停夹热证的临床疗效。方法:选取92例老年脓毒症致ARDS饮停夹热证患者,按照随机数字表法分为观察组和对照组,每组46例。对照组给予西医综合治疗,观察组在对照组基础上给予宣肺调肠方治疗。2组均治疗14d。比较2组临床疗效、中医证候积分、血气分析指标及炎症因子水平。结果:治疗后,观察组总有效率95.65%,高于对照组82.61%(P<0.05)。2组主症、次症积分及中医证候总分均较治疗前降低(P<0.05),观察组主症、次症积分及中医证候总分均低于对照组(P<0.05)。2组动脉血氧分压(PaO_(2))及PaO_(2)/吸入气中的氧浓度分数(FiO_(2))均较治疗前升高(P<0.05),动脉血二氧化碳分压(PaCO_(2))均较治疗前降低(P<0.05);观察组PaO_(2)及PaO_(2)/FiO_(2)均高于对照组(P<0.05),PaCO_(2)低于对照组(P<0.05)。2组血清白细胞介素-6(IL-6)、白细胞介素-10(IL-10)、肿瘤坏死因子-α(TNF-α)水平均较治疗前降低(P<0.05),观察组血清IL-6、IL-10、TNF-α水平均低于对照组(P<0.05)。结论:宣肺调肠方联合西药治疗老年脓毒症致ARDS饮停夹热证疗效确切,可有效改善患者的临床症状,提高氧合功能,减轻炎症反应程度。Objective:To observe the clinical effect of Xuanfei Tiaochang Pescription combined with western medicine for acute respiratory distress syndrome(ARDS)caused by sepsis in elderly patients with drinking cessation and heat retention syndrome.Methods:A total of 92 cases of elderly patients with ARDS caused by sepsis with drinking cessation and heat retention syndrome were selected and divided into the observation group and the control group according to the random number table method,with 46 cases in each group.The control group was treated with comprehensive western medicine treatment,and the observation group was additionally treated with Xuanfei Tiaochang Pescription based on the treatment of the control group.Both groups were treated for 14 days.The clinical effects,traditional Chinese medicine(TCM)syndrome scores,blood gas indexes,and inflammatory indexes were compared between the two groups.Results:After treatment,the total effective rate was 95.65%in the observation group,higher than that of 82.61%in the control group(P<0.05).The scores of main symptoms and secondary symptoms,and the total scores of TCM syndromes in the two groups were decreased when compared with those before treatment(P<0.05),and the scores of main symptoms and secondary symptoms,and the total scores of TCM syndromes in the observation group were lower than those in the control group(P<0.05).Arterial oxygen partial pressure(PaO_(2))and PaO_(2)/the fraction of inspired oxygen(FiO_(2))in the two groups were increased when compared with those before treatment(P<0.05),and the partial pressure of carbon dioxide(PaCO_(2))were decreased when compared with those before treatment(P<0.05);PaO_(2)and PaO_(2)/FiO_(2)in the observation group were higher than those in the control group(P<0.05),and PacO_(2)in the observation group was lower than that in the control group(P<0.05).The levels of interleukin-6(IL-6),interleukin-7(IL-7),and tumor necrosis factor-α(TNF-α)in serum in the two groups were decreased when compared with those before treatment(P<0.05

关 键 词：脓毒症 急性呼吸窘迫综合征 老年人 饮停夹热证 宣肺调肠方 血气分析 炎症反应 

分 类 号：R631[医药卫生—外科学]