防己黄芪汤对单肺通气患者的保护作用

目的:观察防己黄芪汤对开胸单肺通气患者术中肺再灌注损伤的保护作用.方法:46例食道癌择期开胸手术患者,分级属美国麻醉医师协会Ⅰ～Ⅱ级,随机分为2组,每组23例:A组为中药干预+常规治疗组,术前连续7d口服防己黄芪汤;B组为常规治疗对照组.术中及术后分别在麻醉诱导后双肺通气时(T1)、单肺通气后1h(T2)、单肺通气后2 h(T3)及术后2 h(T4)时段,采外周动脉血3 mL进行分析,测定患者动脉氧分压(PaO2)、动脉氧饱和度(SpO2)、血浆超氧化物歧酶( SOD)、丙二醛(MDA)及中性粒细胞(PMN)计数的数值.结果:A组PaO2和SpO2在T2,T3,T4时段较B组高,有显著差异(P＜0.01).麻醉后,两组血浆SOD均下降,MDA及PMN升高.在T1,T2,T3,T4时段,A组SOD下降的程度明显小于B组(P＜0.01);在T2,T3,T4时段,A组MDA升高的程度较小,与B组比较有显著差异(P＜0.01);在T1,T2,T3,T4时段,A组PMN升高的程度较小,与B组比较有显著差异(P＜0.01).结论:中药防己黄芪汤对单肺通气、肺缺血再灌注(LIRI)所致的肺损伤,有较好保护作用.

Protective Effects of Fangji Huangqi Tang on Patients Undergoing One-lung Ventilation

Objective:To observe the effects of Fangji Huangqi tang on arterial blood-gas analysis and cytokines of patients undergoing one-lung ventilation.Method: Forty-six patients with esophageal cancer undergoing open thoracic operation,American standards association(ASA) level Ⅰ-Ⅱ,were randomLy divided into two groups(n=23).Group B,the control group,were given routine treatment,while group A were given the traditional Chinese medicine(TCM) intervention in addition,by taking Fangji Huangqi tang in 7 days preoperational orally.3 mL peripheral blood samples were taken from the radial artery while bilateral-lungs ventilation after anesthesia induction(T1),60 mins after one lung ventialation(OLV)(T2),120 mins after OLV(T3) and 120 mins after the operation(T4) for PaO2,SpO2 and assay of plasma superoxide dismutase(SOD),malondialdehyde(MDA) and pdymorphonuclears(PMN) value.Result: PaO2 and SpO2 of group A were significantly higher than group B when T2,T3 and T4(P<0.01).After anesthesia,the SOD values decreased while the MDA and PMN values increased in both two groups.In T1,T2,T3 and T4 periods,the decline of SOD value in group A was significantly less than that of group B(P<0.01);while in T2,T3,T4 periods,the increase of MDA value in group A was significantly less than that of the control group(P<0.01);while in T1,T2,T3 and T4 periods,the increase of PMN value in group A was significantly less than that of the control group(P<0.01).Conclusion: The TCM intervention of Fangji Huangqi tang can effectively protect the lung function from the damages caused by OLV and ischemia reperfusion injury lung(LIRI).