摘要
目的探讨通腑宣肺汤治疗脓毒症急性肺损伤患者的临床价值。方法选取陕西中医药大学第二附属医院86例脓毒症急性肺损伤患者,按照治疗方案分组,各43例。对照组给予常规西医治疗,观察组在此基础上联合通腑宣肺汤治疗。对比两组临床疗效、治疗不同时段血清炎性因子水平、呼吸功能[氧合指数(PaO2/FiO2)]参数、病情程度(APACHEII评分)改善情况及安全性。结果观察组总有效率高于对照组(P<0.05);治疗3 d、7 d后观察组血清IL-1β、IL-18、NF-κB水平低于对照组(P<0.05);治疗3d、7d后观察组PaO2/FiO2参数高于对照组(P<0.05);治疗3 d、7 d后观察组APACHEII评分低于对照组(P<0.05);治疗期间观察组不良反应发生率14.29%与对照组12.20%比较无显著差异(P>0.05)。结论通腑宣肺汤治疗脓毒症急性肺损伤患者疗效显著,可明显改善呼吸功能,减轻病情程度,且不增加药物不良反应,作用机制可能与降低血清炎性因子IL-1β、IL-18、NF-κB水平相关。
Objective To investigate the clinical value of Tongfu Xuanfei Decoction in the treatment of patients with acute lung injury caused by sepsis.Methods 86 patients with acute lung injury with sepsis were enrolled in our hospital.According to the treatment plan,43 cases were included.The control group was treated with conventional western medicine,and the observation group was treated with Tongyu Xuanfei Decoction on this basis.The clinical efficacy,serum inflammatory factor levels,respiratory function[Oxygenation Index(PaO2/FiO2)]parameters,disease severity(APACHE II score)improvement and safety were compared between the two groups.Results The total effective rate of the observation group was higher than that of the control group(P<0.05).The levels of serum IL-1β,IL-18 and NF-κB in the observation group were lower than those in the control group after 3 and 7 days of treatment(P<0.05).The PaO2/FiO2 parameters of the observation group were higher than those of the control group after 3 and 7 days of treatment(P<0.05).The APACHE II score of the observation group was lower than that of the control group after 3 and 7 days of treatment(P<0.05).The incidence of adverse reactions was 14.29%and there was no significant difference between the observation group and the control group at 12.20%(P>0.05).Conclusion Tongfu Xuanfei Decoction is effective in the treatment of acute lung injury caused by sepsis.It can significantly improve respiratory function,reduce the degree of disease,and does not increase adverse drug reactions.The mechanism may be related to the reduction of serum inflammatory factors IL-1βand IL-18.NF-κB levels are related.
作者
荆志强
张莉
赵苗苗
谷俊
JING Zhi-qiang;ZHANG Li;ZHAO Miao-miao;GU Jun(The Second Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine,Xianyang 712000;Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine,Xianyang712000,China)
出处
《延安大学学报（医学科学版）》
2019年第4期8-13,共6页
Journal of Yan'an University:Medical Science Edition
基金
陕西省中医药管理局课题(JCPT044)
关键词
脓毒症
急性肺损伤
通腑宣肺汤
呼吸功能
病情程度
炎性因子
Sepsis
Acute lung injury
Tongyu Xuanfei decoction
Respiratory function
Degree of disease
Inflammatory factor
