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目的:观察加味宣白承气汤配合西医综合疗法对ARDS患者的治疗效果。方法:以2014年6月~2015年6月在我院接受治疗的80例ARDS患者为观察对象,并将其随机分为对照组和观察组各40例。对照组给予抗感染、糖皮质激素等常规西医治疗,观察组在此基础上给予加味宣白承气汤治疗。观察两组机械通气时间、平均住院天数及病死率的差异;比较两组治疗前后的APACHEⅡ评分和Murray肺损伤评分、炎症细胞因子水平、呼吸循环指标的差异。结果:观察组机械通气时间、住院时间较对照组短,且病死率较对照组低(P<0.05);两组治疗前APACHEⅡ评分和Murray肺损伤评分无明显差异,治疗后两组APACHEⅡ评分和Murray肺损伤评分均降低,观察组降低更为明显;两组患者治疗前IL-6、IL-8、IL-10、hs-CRP和TNF-α水平无明显差别,治疗后两组上述指标水平均有所降低,但观察组降低更为明显;两组治疗前心率、呼吸、SBP、DBP、Pa O2/Fi O2无明显差别,治疗后两组心率、呼吸和Pa O2/Fi O2均有所改善,但观察组好于对照组;两组SBP、DBP较治疗前无明显差别,且两组间比较差异无统计学意义。结论:加味宣白承气汤配合西医综合疗法可有效改善患者的呼吸通气指标,降低机体炎症反应,明显降低肺损伤,对ARSD患者的预后具有积极影响。
Objective: To observe the therapeutic effect of Jiawei Xuanbai Chengqi Decoction combined with western medicine on patients with ARDS. Methods: Eighty ARDS patients treated in our hospital from June 2014 to June 2015 were selected as the observation subjects and randomly divided into control group and observation group of 40 cases. The control group was given anti-infection, glucocorticoid and other conventional Western medicine, the observation group on this basis to give flavored Xuanbai Chengqi Decoction treatment. The differences of mechanical ventilation time, average days of hospitalization and fatality rate between the two groups were observed. The differences of APACHEⅡscore, Murray’s lung injury score, inflammatory cytokines and respiration index before and after treatment were compared between the two groups. Results: The duration of mechanical ventilation and hospital stay in the observation group were shorter than those in the control group, and the mortality was lower than that in the control group (P <0.05). There was no significant difference between the two groups in the APACHEⅡ score and the Murray lung injury score before treatment. The levels of IL-6, IL-8, IL-10, hs-CRP and TNF-α in the two groups were not significantly different before and after treatment. The levels of these indexes in both groups after treatment , But the observation group decreased more obviously. The heart rate, respiration, SBP, DBP and Pa O2 / Fi O2 of the two groups had no significant difference before treatment, after treatment, heart rate, respiration and Pa O2 / Fi O2 But the observation group was better than the control group. There was no significant difference between the two groups in SBP and DBP before treatment, and there was no significant difference between the two groups. CONCLUSION: Jiawei Xuanbai Chengqi Decoction combined with western medicine can effectively improve the patient’s respiratory ventilation index, reduce the inflammatory reaction and significantly reduce the lung injury, which has a positive effect on the prognosis of ARSD patients.