清胰通腑调肺饮联合西药治疗重症急性胰腺炎合并急性呼吸窘迫综合征临床研究
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R576;R56

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Keywords:Severe acute pancreatitis;Acute respiratory distress syndrome;Qingyi Tongfu Tiaofei yin;Inflammatory factors;Blood gas analysis


Clinical Study on Qingyi Tongfu Tiaofei Yin Combined with Western Medicine for Severe Acute Pancreatitis Complicated with Acute Respiratory Distress Syndrome
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    摘要:

    目的:观察清胰通腑调肺饮联合西药治疗重症急性胰腺炎(SAP)合并急性呼吸窘迫综合征(ARDS)的临床疗效及对患者炎症因子、血气分析指标的影响。方法:将 80 例 SAP 合并 ARDS 患者按随机数字表法分为对照组和观察组各 40 例。对照组给予西药治疗,观察组在对照组基础上加服清胰通腑调肺饮,2 组均治疗 10 d。比较 2 组临床疗效及治疗前后炎症因子、血气分析指标水平,记录 2 组胃肠道功能恢复时间、机械通气时间及重症监护室 (ICU) 住院时间。结果:观察组总有效率为90.0%,高于对照组的 67.5%(P<0.05)。治疗后,2 组白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、肿瘤坏死因子-α(TNF-水平均较治疗前降低(P<0.05),观察组 IL-6、IL-8、TNF-α 水平均低于对照组(P<0.05)。治疗后,2 组动脉血二氧化碳分压(PaCO2)、动脉血氧分压 (PaO2) 水平及氧合指数 (PaO2/FiO2) 均较治疗前升高 (P<0.05),观察组 PaCO2、PaO2 水平及 PaO2/FiO2均高于对照组(P<0.05)。治疗后,观察组腹痛缓解时间、肛门排气时间、首次排便时间、机械通气时间及 ICU 住院时间均短于对照组 (P<0.05)。结论:清胰通腑调肺饮联合西药治疗 SAP 合并 ARDS,能减轻患者的炎症反应,改善其血气分析指标,促进胃肠道功能恢复,缩短住院时间。

    Abstract:

    Abstract: Objective: To observe the clinical effect of Qingyi Tongfu Tiaofei yin combined with western medicine for severe acute pancreatitis(SAP) complicated with acute respiratory distress syndrome(ARDS) and its effect on inflammatory factors and indexes of blood gas analysis. Methods:A total of 80 cases of patients with SAP complicated with ARDS were divided into the control group and the observation group according to the random number table method,40 cases in each group. The control group was given western medicine, and the observation group was additionally given the oral administration of Qingyi Tongfu Tiaofei yin based on the treatment of the control group. Both groups were treated for ten days. The clinical effect was compared between the two groups. Levels of inflammatory factors and indexes of blood gas analysis before and after treatment were compared between the two groups. The recovery time of gastrointestinal function, mechanical ventilation time, and the hospitalization time in intensive care unit(ICU) were recorded. Results: The total effective rate was 90.0% in the observation group,higher than that of 67.5% in the control group(P<0.05). After treatment, levels of interleukin-6(IL-6),interleukin-8(IL-8),and tumor necrosis factor-α(TNF-α) in the two groups were decreased when compared with those before treatment(P<0.05),and the three levels above in the observation group were lower than those in the control group(P<0.05). After treatment,levels of partial pressure of carbon dioxide(PaCO2) and partial pressure of oxygen(PaO2) in arterial blood,as well as the ratio of partial pressure of oxygen in arterial blood to fractional concentration of inspiratory oxygen(PaO2/FiO2) in the two groups were increased when compared with those before treatment(P<0.05);the two levels above and the ratio in the observation group were higher than those in the control group(P<0.05). After treatment, the remission time of abdominal pain,the time of anal exsufflation,the time of first defecation,the time of mechanical ventilation,and the hospitalization time in ICU in the observation group were shorter than those in the control group(P<0.05). Conclusion: In the treatment of SAP complicated with ARDS, the therapy of Qingyi Tongfu Tiaofei yin combined with western medicine can relieve inflammatory response, improve indexes of blood gas analysis, promote recovery of gastrointestinal function,and shorten the hospitalization time.

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邵兴,童洪杰,向晶,朱秀琪,陈琨.清胰通腑调肺饮联合西药治疗重症急性胰腺炎合并急性呼吸窘迫综合征临床研究[J].新中医,2021,53(7):81-84

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  • 在线发布日期: 2021-04-08
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