摘要
目的评价肺肠同治法治疗轻中度急性呼吸窘迫综合征(ARDS)患者的疗效及对血清涎液化糖链抗原(KL-6)、二胺氧化酶(DAO)水平的影响。方法采用随机数字表法,将2019年12月—2023年9月在陕西中医药大学附属医院呼吸与危重症医学科确诊的84例轻中度ARDS患者分为2组,对照组42例予以常规西医治疗,治疗组42例予以常规西医治疗及基于肺肠同治法组方的中药治疗,2组均连续治疗10 d。比较2组患者治疗前及治疗10 d后的中医证候积分和治疗1 d、5 d、10 d的急性生理与慢性健康评分(APACHEⅡ评分)、Murray肺损伤评分、氧合指数、血清KL-6及DAO水平,统计2组临床疗效及不良反应发生情况。结果2组治疗后壮热烦躁、咳嗽、咳痰、气促、口干欲饮、腹胀便秘评分及总分均明显降低(P均<0.05),且治疗组均明显低于对照组(P均<0.05)。与治疗1 d比较,2组治疗5 d、10 d的APACHEⅡ评分、Murray肺损伤评分及血清KL-6、DAO水平均明显降低,且各指标随治疗时间延长而逐渐降低,差异均有统计学意义(P均<0.05);2组氧合指数均明显升高,且随治疗时间延长而逐渐升高,差异均有统计学意义(P均<0.05);组间比较,治疗组治疗5 d、10 d的APACHEⅡ评分、Murray肺损伤评分及血清KL-6、DAO水平均明显低于同期对照组(P均<0.05),氧合指数均明显高于同期对照组(P均<0.05)。治疗组总有效率明显高于对照组[90.48%(38/42)比78.57%(33/42),P<0.05]。2组均未出现明显不良反应。结论肺肠同治法能明显减轻ARDS患者肺肠症状和肺损伤,改善肺氧合功能和肠黏膜屏障功能,促进患者康复,且安全。
Objective It is to evaluate the clinical efficacy of co-lung-intestinal therapy in the treatment of patients with mild to moderate acute respiratory distress syndrome(ARDS),and to observe its effects on serum levels of krebs von den lungen-6(KL-6)and diamine oxidase(DAO).Methods Eighty-four patients with mild-to-moderate ARDS diagnosed in the Department of Respiratory and Critical Care Medicine of Affiliated Hospital of Shaanxi University of Chinese Medicine from December 2019 to September 2023 were randomly divided into 2 groups according to random number table.42 cases of patients in the treatment group were treated with conventional western medicine,while 42 cases of patients in the treatment group were treated with conventional western medicine combined with Chinese drug decoction made based on co-lung-intestinal therapy.Both groups were treated continuously for 10 days.The TCM syndrome scores before treatment and after 10 days of treatment,the APACHEⅡscores,Murray lung injury scores,oxygenation index,serum levels of KL-6 and DAO after 1,5,10 days of treatment were compared between the two groups.The clinical efficacy and occurrence of adverse reactions in the two groups were evaluated or counted.Results The scores of fever,cough,sputum,shortness of breath,dry mouth and desire to drink,abdominal distension and constipation,and total scores of the two groups were significantly decreased after treatment compared with those before treatment(all P<0.05),and these scores of the treatment group were significantly lower than those of the control group(all P<0.05).Compared with those after 1 days of treatment,the APACHEⅡscores,Murray lung injury scores and serum levels of KL-6 and DAO of the two groups after 5,10 days of treatment were significantly decreased,and each index gradually was decreased with the prolongation of treatment time,and the differences were statistically significant(all P<0.05);the oxygenation index of both groups were significantly increased,and gradually increased with the prolongation of treatment time,and the differences were statistically significant(P<0.05).The APACHEⅡscores,Murray lung injury scores and serum levels of KL-6 and DAO of the treatment group were significantly lower,while the oxygenation index was significantly higher than that of the control group after 5 and 10 days of treatment(all P<0.05).The total effective rate of the treatment group was significantly higher than that of the control group[90.48%(38/42)VS.78.57%(33/42),P<0.05].No significant adverse reactions were observed in both groups.Conclusion Co-lung-intestinal therapy can significantly reduce pulmonary and intestinal symptoms and lung injury,improve pulmonary oxygenation function and intestinal mucosal barrier function in ARDS patients,and promote their recovery with good safety.
作者
寇育乐
谭曦舒
王旭红
李向文
史捷
陈方园
KOU Yule;TAN Xishu;WANG Xuhong;LI Xiangwen;SHI Jie;CHEN Fangyuan(Affiliated Hospital of Shaanxi University of Chinese Medicine,Xianyang 712000,Shaanxi,China;The Second Affiliated Hospital of Shaanxi University of Chinese Medicine,Xianyang 712000,Shaanxi,China)
出处
《现代中西医结合杂志》
CAS
2024年第17期2390-2394,2407,共6页
Modern Journal of Integrated Traditional Chinese and Western Medicine
基金
陕西省自然科学基础研究计划面上项目(2021JM-473)
咸阳市重点研发计划项目(2020k02-99)
陕西中医药大学学科创新团队建设项目(2019-YL05)。
关键词
急性呼吸窘迫综合征
肺肠同治法
涎液化糖链抗原
二胺氧化酶
acute respiratory distress syndrome
co-lung-intestinal therapy
krebs von den Lungen-6
diamine oxidase
