中西医结合治疗脓毒症致急性呼吸窘迫综合征32例
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摘要
目的:观察中西医结合治疗脓毒症致急性呼吸窘迫综合征(acute respiratory distress syndrome,ARDS)的临床疗效。方法:选取2014年3月—2015年3月在本院住院治疗的脓毒症并发ARDS患者64例,随机分为研究组和对照组,每组32例。对照组给予西医常规基础治疗,研究组在对照组的基础上加用中药复苏合剂治疗。观察两组患者治疗有效率,测定两组动脉血氧分压(Pa O2)、动脉血二氧化碳分压(Pa CO2)、氧合指数(Sa O2)。结果:研究组有效率为87.5%,对照组有效率为71.8%,研究组优于对照组(P<0.05);研究组治疗后中医症状积分优于对照组(P<0.05);治疗24 h后,研究组Pa O2、Sa O2、Pa CO2均优于对照组(P<0.05)。结论:中西医结合治疗脓毒症致ARDS疗效显著。
Objective: To observe the clinical curative effect of combined therapy of traditional Chinese and Western medicine on acute respiratory distress syndrome( ARDS) due to sepsis. Methods: Sixty-four patients with ARDS due to sepsis who were treated in our hospital between March of 2014 and March of 2015 were chosen and randomly divided into the control group and the research group,with 32 cases in each group. The ones in the control group were given routine Western medicine treatment,while the ones in the research group were added traditional Chinese medicine revival mixture based on the treatment of the control group.Then the two groups' clinical curative effects were observed. Their Pa O2,Pa CO2,and Pa CO2 were measured. Results: The effective rate of the research group was 87. 5%,while that of the control group was 71. 8%; The research group was better than the control group( P < 0. 05). After the treatment,the research group's TCM symptomatic score was better than that of the control group( P <0. 05). And 24 hours later after the treatment,the research group's Pa O2,Pa CO2,and Pa CO2 were all better than those of the control group( P < 0. 05). Conclusion: Combined therapy of traditional Chinese and Western medicine has a remarkable clinical curative effect on acute respiratory distress syndrome due to sepsis.
Objective: To observe the clinical curative effect of combined therapy of traditional Chinese and Western medicine on acute respiratory distress syndrome( ARDS) due to sepsis. Methods: Sixty-four patients with ARDS due to sepsis who were treated in our hospital between March of 2014 and March of 2015 were chosen and randomly divided into the control group and the research group,with 32 cases in each group. The ones in the control group were given routine Western medicine treatment,while the ones in the research group were added traditional Chinese medicine revival mixture based on the treatment of the control group.Then the two groups' clinical curative effects were observed. Their Pa O2,Pa CO2,and Pa CO2 were measured. Results: The effective rate of the research group was 87. 5%,while that of the control group was 71. 8%; The research group was better than the control group( P < 0. 05). After the treatment,the research group's TCM symptomatic score was better than that of the control group( P <0. 05). And 24 hours later after the treatment,the research group's Pa O2,Pa CO2,and Pa CO2 were all better than those of the control group( P < 0. 05). Conclusion: Combined therapy of traditional Chinese and Western medicine has a remarkable clinical curative effect on acute respiratory distress syndrome due to sepsis.
引文
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[12]赵鹤龄,任珊,申丽旻.辛伐他汀预处理对脓毒症大鼠凝血功能及肝脏C-反应蛋白的影响[J].中国急救医学,2012,32:718-721.
[13]Grommes J,Vijayan S,Drechsler M,et al.Simvastatin reduces endotoxin induced acute lung injury by decreasing neutrophil recruitment and radical formation[J].PLo S One,2012,7(6):e38917.
[14]The ARDS Definition Task Force.Acute respiratory distress syndrome the berlin definition[J].JAMA,2012,307(23):2526.
[15]韩云,赖芳,林燕钊,等.刘伟胜教授治疗脓毒症致ALI/ARDS经验介绍[J].新中医,2011,43(4):135-136.
[16]ARDS Definition Task Force,Ranieri V M,Rubenfeld G D,et al.Acute respiratory distress syndrome:the Berlin Defini-tion[J].JAMA,2012,307(23):2526-2533.
[17]邓宁,常为民,王春全,等.急性呼吸窘迫综合征患者血管外肺水的动态变化与预后的关系[J].中国呼吸与危重监护杂志,2012,11(6):528-531.
[2]任天.脓毒症肺损伤(ALI/ARDS)患者的免疫失衡及中西医结合治疗[D].大连:大连医科大学,2012.
[3]尚德永.血清s TREM-1、PCT和CRP在脓毒症肺损伤(ALI/ARDS)患者中的动态变化及中西医结合治疗的双盲随机对照研究[D].大连:大连医科大学,2013.
[4]Bellinger R P,Levy M M,Rhodes A,et al.Surviving Sepsis Campaign:international guidelines for management of severe sepsis and septic shock,2012[J].Intensive care medicine,2013,39(2):165-228.
[5]高戈,冯喆,常志刚,等.2012国际严重脓毒症及脓毒性休克诊疗指南[J].中华危重病急救医学,2013,25(8):501-505.
[6]郭小刚,冷建春,王卫星,等.中药复方治疗脓毒症患者疗效观察及对部分细胞因子和免疫学因子的影响[J].云南中医中药杂志,2011,32(2):13-15.
[7]韩云,赖芳,麦舒桃,等.中医药疗法治疗脓毒症所致ALI、ARDS的临床及实验研究进展[C].北京:中国医师协会中西医结合医师大会论文集,2011.
[8]Zhou MT,Chen CS.ALI and ARDS in acute pancreatitis:mechanisms and potential intervention[J].World J Gastroenterol,2010,16(17):2094-2099.
[9]田雨,李杨.ARDS患者全身炎症反应及其治疗研究进展[J].临床肺科杂志,2014,19(2):340-342.
[10]张仲慧,胡寒冰.肺部感染合并ARDS应用呼吸机治疗及护理[J].中国实用医药,2012,7(9):206-207.
[11]Zhang L N,Sun J P,Xue X Y,et al.Exogenous pulmonary surfactant for acute respiratory distress syndrome in adults:A systematic review and meta-analysis[J].Exp Ther Med,2013,5(1):237-242.
[12]赵鹤龄,任珊,申丽旻.辛伐他汀预处理对脓毒症大鼠凝血功能及肝脏C-反应蛋白的影响[J].中国急救医学,2012,32:718-721.
[13]Grommes J,Vijayan S,Drechsler M,et al.Simvastatin reduces endotoxin induced acute lung injury by decreasing neutrophil recruitment and radical formation[J].PLo S One,2012,7(6):e38917.
[14]The ARDS Definition Task Force.Acute respiratory distress syndrome the berlin definition[J].JAMA,2012,307(23):2526.
[15]韩云,赖芳,林燕钊,等.刘伟胜教授治疗脓毒症致ALI/ARDS经验介绍[J].新中医,2011,43(4):135-136.
[16]ARDS Definition Task Force,Ranieri V M,Rubenfeld G D,et al.Acute respiratory distress syndrome:the Berlin Defini-tion[J].JAMA,2012,307(23):2526-2533.
[17]邓宁,常为民,王春全,等.急性呼吸窘迫综合征患者血管外肺水的动态变化与预后的关系[J].中国呼吸与危重监护杂志,2012,11(6):528-531.