血府逐瘀汤辅助治疗重症闭合性胸外伤临床观察

目的 观察血府逐瘀汤辅助治疗重症闭合性胸外伤的疗效。方法 将60例重症闭合性胸外伤患者随机分为治疗组和对照组，每组30例。对照组在西医常规对症治疗的基础上进行纤维气管镜肺泡灌洗，治疗组在对照组疗法的基础上加服血府逐瘀汤。采用视觉模拟量表(visual analogue scale，VAS)评价患者的胸痛程度，通过检测外周血白细胞(white blood cell, WBC)及血清C-反应蛋白(C-reactive protein, CRP)水平评价炎症程度，采用血气分析评价肺通气和换气功能。结果 治疗组患者治疗后VAS评分降低程度显著大于对照组（P<0.05）。治疗组患者住院时间较对照组明显缩短（P<0.05）。治疗第3、7、12天末，治疗组患者血pH值、动脉血氧分压、血氧饱和度均显著高于对照组（P<0.05），动脉血二氧化碳分压、外周血WBC计数、血清CRP水平均显著低于对照组（P<0.05）。治疗组临床疗效明显优于对照组（P<0.05）。结论 血府逐瘀汤能提高重症闭合性胸外伤患者肺泡的通透性，改善肺组织的通气及换气功能，降低炎症反应。

Clinical Effect of Xuefu Zhuyu Decoction as Adjuvant Therapy for Severe Closed Chest Trauma

Objective To investigate the clinical effect of Xuefu Zhuyu Decoction as the adjuvant therapy for severe closed chest trauma. Methods A total of 60 patients with severe closed chest trauma were randomly divided into treatment group and control group, with 30 patients in each group. The patients in the control group were treated with routine symptomatic treatment and bronchoscopic alveolar lavage, and those in the treatment group were given Xuefu Zhuyu Decoction in addition to the treatment in the control group. Visual Analogue Scale (VAS) was used to evaluate the degree of chest pain; white blood cell count (WBC) and C-reactive protein (CRP) in peripheral blood were measured to evaluate the degree of inflammation; blood gas analysis was performed to evaluate pulmonary ventilation and gas exchange functions. Results Compared with the control group, the treatment group had a significantly greater reduction in VAS score after treatment (P<0.05). The treatment group had a significantly shorter length of hospital stay than the control group (P<0.05). Compared with the control group at the end of days 3, 7, and 12 of treatment, the treatment group had significantly higher blood pH value, arterial partial pressure of oxygen, and blood oxygen saturation (P<0.05) and significantly lower arterial partial pressure of carbon dioxide, peripheral blood WBC, and serum CRP (P<0.05). The treatment group had a significantly better clinical outcome than the control group (P<0.05). Conclusion In patients with severe closed chest trauma, Xuefu Zhuyu Decoction can increase alveolar permeability, improve pulmonary ventilation and gas exchange functions, and reduce inflammatory response.