摘要
目的:观察针灸疗法联合个体化机械通气治疗急性呼吸窘迫综合征(ARDS)的临床疗效。方法:按随机数字表法将96例ARDS患者分为对照组与观察组各48例。对照组采取个体化机械通气治疗,观察组在对照组基础上联合针灸治疗。比较2组临床疗效及治疗前后动脉血气、呼吸参数、肺损伤以及炎症反应指标。比较2组脱机时间、脱离重症监护室(ICU)时间、呼吸机相关性肺炎(VAP)发生率及病死率。结果:观察组总有效率93.75%,高于对照组79.17%(P<0.05)。治疗后,2组呼气末二氧化碳分压(PETCO_(2))、氧合指数(PaO2/FiO2)、肺静态顺应性(Cst)均较治疗前升高,动脉二氧化碳分压(PaCO_(2))、气道平台压(Pplat)、呼气终末正压(PEEP)均较治疗前降低(P<0.05)。治疗后,2组肺表面活性蛋白D(SP-D)、白细胞介素-8(IL-8)、超敏C-反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)水平均低于治疗前(P<0.05),且观察组炎症因子水平低于对照组(P<0.05)。观察组脱机时间、脱离ICU时间早于对照组(P<0.05)。2组VAP发生率及病死率比较,差异无统计学意义(P>0.05)。结论:针灸联合个体化机械通气治疗可减少患者炎症反应及肺损伤,改善患者预后,提高临床疗效。
Objective:To observe the clinical effect of acupuncture and moxibustion combined with individualized mechanical ventilation for acute respiratory distress syndrome(ARDS).Methods:A total of 96 cases of ARDS patients were divided into the control group and the observation group according to the random number table method,with 48 cases in each group.The control group was treated with individualized mechanical ventilation,and the observation group was additionally treated with acupuncture and moxibustion based on the treatment of the control group.The arterial blood gas,respiration parameters,lung injury and indexes of inflammatory responses before and after treatment and the clinical effects in the two groups were compared.The offline time,time of leaving intensive care unit(ICU),incidence of ventilator-associated pneumonia(VAP)and mortality in the two groups were compared.Results:The total effective rate was 93.75%in the observation group,higher than that of 79.17%in the control group(P<0.05).After treatment,the end-expiratory carbon dioxide partial pressure(PETCO_(2)),oxygenation index(PaO2/FiO2)and static compliance in the two groups were increased when compared with those before treatment,and the carbon dioxide partial pressure(PaCO_(2)),plateau pressure(Pplat)and positive end-expiratory pressure(PEEP)were decreased(P<0.05).After treatment,the levels of pulmonary surfactant protein D(SP-D),interleukin-8(IL-8),high-sensitivity C-reactive protein(hs-CRP)and tumor necrosis factor-α(TNF-α)in the two groups were lower than those before treatment(P<0.05),and the levels of inflammatory factors in the observation group were lower than those in the control group(P<0.05).The offline time and time of leaving ICU in the observation group were earlier than those in the control group(P<0.05).There was no significant difference being found in the comparison of VAP incidences and mortality between the two groups(P>0.05).Conclusion:Acupuncture and moxibustion combined with individualized mechanical ventilation can reduce infla
作者
叶亚萍
郏丽萍
陈沙沙
YE Yaping;JIA Liping;CHEN Shasha
出处
《新中医》
CAS
2022年第13期168-172,共5页
New Chinese Medicine
关键词
急性呼吸窘迫综合征
针灸
机械通气
个体化
肿瘤坏死因子-Α
Acute respiratory distress syndrome
Acupuncture and moxibustion
Mechanical ventilation
Individualization
Tumor necrosis factor-α
