加味血府逐瘀汤治疗急性肺挫伤的临床分析

目的: 观察加味血府逐瘀汤对急性肺挫伤的临床疗效及对内皮素-1(ET-1)、白细胞介素-8(IL-8)和C-反应蛋白(CPR)的影响。 方法: 84例肺挫伤患者随机分为观察组和对照组各42例。对照组采用西医常规对症支持治疗。观察组加服加味血府逐瘀汤,1剂/d。观察临床症状,监测血气分析,记录需行机械通气率、肺部感染发生率、急性呼吸窘迫综合征(ARDS)发生率和病死率,检测血清ET-1,IL-8及CPR水平。 结果: 治疗后观察组病情分级轻于对照组(P<0.05);观察组氧分压(PO₂),二氧化碳分压(PCO₂)及氧合指数(PO₂/FiO₂)上升较对照组更为显著(P<0.05,P<0.01);观察组发生机械通气例数及肺感染例数少于对照组,但差异无显著性;观察组ET-1,IL-8,CRP下降较对照组更明显(P<0.05,P<0.01)。 结论: 加味血府逐瘀汤能减轻急性肺挫伤临床症状,降低血浆ET-1,IL-8,CRP,升高PO₂,PCO₂及PO₂/FiO₂,改善肺功能,促进肺挫伤后肺功能的恢复。

Clinical Analysis on Modified Xuefu Zhuyu Decoction in Treatment of Acute Pulmonary Contusion

Objective: To describe the efficacy of Modified Xuefu Zhuyu decoction (MXZD) on patients with acute pulmonary contusion and its effect on endothelin (ET-1), interlukin-8 (IL-8) and C-reactive protein (CRP). Method: Eighty-four patients with acute pulmonary contusion were divided into two groups randomly: observation group and control group (n=42 each). In control group, the patients were treated only with routine therapy. In observation group, they were prescribed with MXZD (one dose daily). Clinical symptom, blood gas, mechanical ventilation rate, lung infection rate, acute respiratory distress syndrome (ARDS) rate, death rates and serum ET-1, IL-8 and CRP were observed and analyzed. Result: After treatment, the clinical stages of the observation group were lower than that of control group (P<0.05). PO₂, PCO₂ and PO₂/FiO₂ in the observation group were significantly higher than those in control group (P<0.05, P<0.01). Compared with the control group, the mechanical ventilation rate and lung infection rate in the observation group were lower without a statistical significance, while ET-1, IL-8 and CRP in the observation group were significantly lower (P<0.05, P<0.01). Conclusion: MXZD can diminish clinical symptoms of acute pulmonary contusion, decrease plasma ET-1, IL-8 and CRP, increase PO₂, PCO₂ and PO₂/FiO₂, and improve the recovery of pulmonary function caused by pulmonary contusion.