摘要
目的:研究宣白承气汤对急性呼吸窘迫综合征患者炎性因子肿瘤坏死因子-α(TNF-α)、白介素-1β(IL-1β)的调控及力学指标的影响及其作用机制。方法:随机选取2016年1-8月入住重症医学科急性呼吸窘迫综合征机械通气患者60例,依随机表对照法随机分为对照组30例和治疗组30例,均给予常规治疗并辅以机械通气,治疗组加用宣白承气汤。均持续治疗1周后比较治疗前后两组TNF-α、IL-1β和白介素-10(IL-10)等炎性因子,气道峰压(PIP)、平台压(Pplat)、用力肺活量(FVC)、1秒用力呼气量(FEV1)、氧合指数(Pa O2/Fi O2)等呼吸力学指标的变化差异。结果:治疗组治疗后的TNF-α、IL-1β水平明显下降,IL-10水平上升,且不良反应较少,患者改善情况明显优于对照组,差异具有统计学意义(P<0.05)。且治疗组PIP、Pplat等改善也很显著,差异有统计学意义(P<0.05)。治疗组产生的不良反应较少。结论:宣白承气汤能改善机械通气患者呼吸力学指标及肺功能,减轻炎症的反应,效果显著。
Objective To study the effects of Xuanbaichengqi decoction on the regulation of inflammatory factors TNF-α and IL-1β in patients with acute respiratory distress syndrome （ARDS） and its mechanism. Methods 60 patients with ARDS who had been hospitalized from January 2016 to August 2016 were randomly selected and then assigned to a control group （30 patients） and a study group （30 patients）. Both groups received routine therapies and mechanical ventilation, and the study group received additional Xuanbaichengqi decoction. Levels of TNF-α, IL-1β and IL-10, and peak inspiratory pressure （PIP）, plateau airway pressure （Pplat）, PVC, forced vital capacity （FVC）, forced expiratory volume in one second （FEV1）, and oxygenation index （PaO2/FiO2） were detected before and after treatment. Results Levels of TNF-α and IL-1βwere significantly lower in the study group than in the control group （P 〈 0.05）. IL-10 level was significantly higher in the study group than in the control group （P 〈 0.05）. And the improvement in PIP and Pplat was also significant in the study group （P 〈 0.05）. Less adverse reactions occurred in the study group. Conclusions Xuanbaichengqi decoction can improve the indexes for respiratory mechanics and pulmonary function in patients on mechanical ventilation and reduce the inflammatory response, having a significant effect.
出处
《实用医学杂志》
CAS
北大核心
2017年第8期1337-1340,共4页
The Journal of Practical Medicine
基金
河南省中医药科学研究专项课题(编号:2014ZY02029)
关键词
急性呼吸窘迫综合征
宣白承气汤
呼吸力学
炎症因子
Acute respiratory distress syndrome
Xuanbaichengqi decoction
Respiratory mechanics
Inflammatory factors
