天王补心丹用于40例急性呼吸窘迫综合征机械通气患者镇静的临床观察

目的:观察中成药天王补心丹对急性呼吸窘迫综合征机械通气患者镇静的临床疗效。方法:采用随机对照试验方法,将82例急性呼吸窘迫综合征患者随机分为治疗组40例,对照组42例。2组均常规采用咪达唑仑、芬太尼镇静、镇痛,治疗组加用天王补心丹。观察两组镇静镇痛药物用量,机械通气(MV)时间,以及低血压、心动过缓、谵妄、恶心等副作用发生率。结果:治疗组和对照组均能使患者达到镇静及镇痛目标评分,治疗组更易唤醒及保持安静。与对照组相比,治疗组咪达唑仑用量(ug·kg-1·h-1)明显减少(P0.01),芬太尼用量(ug·kg-1·h-1)明显减少(P0.05),MV时间(d)明显缩短(P0.01),停用镇静剂后拔管时间(h)明显缩短(P0.05),低血压发生率、心动过缓发生率、谵妄发生率明显降低(P0.05)。组间疗效比较,差异有统计学意义(P0.05)。结论:天王补心丹用于急性呼吸窘迫综合征机械通气患者镇静效果满意,易唤醒,谵妄发生率低,可缩短MV时间、停用镇静剂后拔管时间,且给药途径方便,价格低,可作为理想的ICU中成药镇静剂推广到临床。

Sedative Effect of Tian Wang Buxin Dan for 40 cases of Acute Respiratory Distress Syndrome Patients Undergoing Mechanical Ventilation of Clinical Observation

Objective To observe the clinical sedative1efficacy of treating Acute Respiratory Distress Syndrome patients undergoing mechanical ventilation by Tian Wang Buxin Dan.Methods 80patients with Acute Respiratory Distress Syndrome patients undergoing mechanical ventilation were randonly divided into treatment group （40 cases）and control group （42 cases）.In both groups medazo-lam and fentanyl were given intravenously continually for sedation and analgesia,the treatment group were treated by Tian Wang Buxin Dan.We observed the sedation analgesic dosage,mechanical ventilation （MV） time,and hypotension,bradycardia,Heartbeat deliri-um,nausea and other side effects incidence.ResultIn all the patients in two groups expected sedative and analgesia scores were ob-tained.In the treatment group,the patients were aroused easier with adequate sedation and analgesia,and when compared with control group,dose of medazolam （ug.kg-1 .h-1 ） was significantly smaller （P〈0.05 ）,dose of fentanyl （ug.kg-1 .h-1 ） was signifi-cantly smaller （P〈0.05）,duration of MV （d）was clearly shorter （P〈0.01）,duration of disable sedatives for extubating （h） was clearly shorter,the rates of hypotension ,and brdycarcardia was significantly lower,the rates of deliriumwere clearly lower （P〈0.05 ）.There was Statistically significant （P〈0.05 ）by comparing the efficacy of the two groups.Conclusion Sedative effect of Tian Wang Buxin Dan is satisfactory for patients with Acute Respiratory Distress Syndrome undergoing mechanical ventilation,with the property of easier arousal,lower hypotension rates,lower brdycarcardia n rates,lower delirium rates nausea rates.However,it is very cheap and well-taken.