摘要
目的:探讨宣白承气汤保留灌肠在ICU脓毒症肺损伤患者的临床应用效果,旨在为临床提供一种可靠的中西医结合治疗方法。方法:选取2015年8月-2016年12月我院ICU收治的脓毒症肺损伤患者48例,采用随机数字法将研究对象分为对照组和观察组,每组24例。对照组患者接受抗感染、激素、祛痰、纠正水、电解质紊乱和酸碱平衡、胃肠减压和机械通气等对症综合处理措施,观察组患者在此基础上宣白承气汤保留灌肠治疗,两组均持续治疗1周,对比分析两组患者治疗前后的炎性指标、动脉血气指标变化以及临床疗效。结果:与对照组患者相比,观察组患者治疗1周后的血清白细胞数、中性粒细胞、PCT和CRP等炎性指标水平均明显降低,差异有统计学意义(P<0.05);经过治疗后,观察组患者的动脉血酸碱度、氧分压(PO2)、二氧化碳分压(PCO2)、氧合指数(Pa O2/Fi O2)、动脉血氧饱和度(Sa O2)等血气指标比对照组改善的程度更显著(P<0.05);观察组患者的治疗总有效率为87.50%,明显高于对照组患者的62.50%,差异有统计学意义(P<0.05)。结论:在常规西药治疗的基础上联用宣白承气汤灌肠治疗能够明显改善脓毒症肺损伤患者的呼吸功能,减轻炎症反应,进而提高临床治疗效果,是一种值得推广应用的中西医结合治疗手段。
Objective: To explore the clinical efficacy of the Xuanbai Chengqi decoction retention enema on acute lung injury of sepsis in ICU and provide a reliable method of the integrated medicine. Methods: 48 cases of acute lung injury of sepsis treated in ICU in our hospital from August 2015 to December 2016 were selected and randomly divided into the control group and the observation group, with 24 cases in each group. The control group received anti-infection, hormone, expectorant, correction of water and electrolyte disorders, acid-base balance, gastrointestinal decompression and mechanical ventilation and other symptomatic comprehensive treatment measures, patients in the observation group additionally received the Xuanbai Chengqi decoction enema treatment; after 2 weeks of continuous treatment, the levels of serum inflammatory factors, the changes of the arterial blood-gas index and clinical curative effect before and after treatment in two groups were compared. Results: Compared with the control group, the serum inflammatory factors including the serum leukocyte, neutrophil, PCT and CRP levels were significantly decreased in the observation group after 2 weeks' treatment, the difference was statistically significant(P<0.05). After treatment, the arterial blood-gas index including the arterial blood PH, PO2, PCO2, Pa O2/Fi O2 and Sa O2 in the observation group improved more significantly than those in the control group(P<0.05). The total effective rate in the treatment group was 87.50%, which was significantly higher than 62.50% in the control group; the difference was statistically significant(P<0.05). Conclusion: The combination treatment of western therapy with the Xuanbai Chengqi decoction retention enema could significantly improve the respiratory function of patients with acute lung injury of sepsis, reduce inflammation, and improve the clinical treatment effect; the combination treatment of TCM and western medicine was worthy of popularization and application in clinic.
出处
《中医临床研究》
2017年第36期66-68,共3页
Clinical Journal Of Chinese Medicine
基金
2015年韶关市科技计划项目
项目编号:2015CX/K56
项目名称:早期持续性血液滤过联合宣白承气汤治疗脓毒症肺损伤的临床研究
关键词
宣白承气汤
灌肠
脓毒症肺损伤
炎症反应
临床疗效
The Xuanbai Chengqi decoction
Retention enema
Pulmonary injury of sepsis
Inflammatory Reaction
Clinical efficacy
