基于“肺与大肠相表里”理论的鼻饲大黄辅助治疗急性肺损伤的临床研究

蒋欢欢; 李志军

doi:10.16766/j.cnki.issn.1674-4152.001729

基于“肺与大肠相表里”理论的鼻饲大黄辅助治疗急性肺损伤的临床研究

doi: 10.16766/j.cnki.issn.1674-4152.001729

蒋欢欢¹,
李志军^2, ,

1.
温州市中西医结合医院呼吸内科，浙江温州 325000
2.
浙江医院呼吸内科，浙江杭州 310013

基金项目:

2018年度浙江省基础公益研究项目 LY18H290008

详细信息

通讯作者:
李志军, E-mail: lzj13575748493@sina.com

中图分类号: R243 R563
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- PDF下载量: 2
- 被引次数: 0
出版历程
- 收稿日期: 2020-05-19
- 网络出版日期: 2022-02-19

Clinical effect of the treatment of acute lung injury with rhubarb by nasal feeding based on the theory of 'lung and large intestine inside and outside'

JIANG Huan-huan¹,
LI Zhi-jun^{2
, ,}

1.
Department of Respiratory Medicine, Wenzhou Integrated Traditional Chinese and Western Medicine Hospital, Wenzhou, Zhejiang 325000, China

摘要

摘要: 目的观察鼻饲大黄辅助治疗对急性肺损伤(acute lung injury，ALI)患者临床症状及预后水平的改善作用。方法以2018年2月—2020年2月温州市中西医结合医院收治的128例ALI患者为研究对象，按照随机数字表法分为对照组(64例)和研究组(64例)，对照组患者给予常规治疗，研究组患者在此基础上予以鼻饲大黄辅助治疗，检测患者治疗前后血清hs-CRP、TNF-α、IL-6和IL-8水平，记录机械通气时间，统计治疗前后呼吸频率、动脉血氧分压和氧合指数，观察患者治疗期间急性呼吸窘迫综合征(ARDS)和死亡发生情况。结果研究组治疗后血清hs-CRP，TNF-α、IL-6和IL-8含量均显著低于对照组(均P < 0.05)；研究组治疗后呼吸频率[(24.81±2.64)次/min]显著低于对照组[(27.64±2.79)次/min]，而PaO₂[(78.35±6.63)mm Hg，1 mm Hg=0.133 kPa]和氧合指数(314.20±42.17)高于对照组[(70.26±6.21) mm Hg，263.07±39.60，均P < 0.05]；研究组机械通气时间[(4.27±1.39)d]显著短于对照组[(6.95±1.81)d，t=-4.971，P＜0.001]；研究组ARDS发生率和死亡率(18.75%、3.12%)显著低于对照组(39.06%、14.06%，χ²=6.425、4.873，P=0.011、0.027)。结论鼻饲大黄辅助治疗可有效抑制ALI患者炎症反应，促进呼吸功能及血气指标恢复，防止病情恶化。
- 急性肺损伤 /
- 鼻饲 /
- 大黄 /
- 肺与大肠相表里 /
- 炎症反应 /
- 临床疗效
Abstract: Objective To observe the effect of nasal feeding rhubarb on the improvement of clinical symptoms and prognosis of patients with acute lung injury (ALI). Methods A total of 128 patients with ALI were selected as the research subjects. All subjects were divided into the control group (n=64) and the research group (n=64) using the random number table method. The patients in the control group were given routine treatment, whereas the patients in the research group were given adjuvant treatment of rhubarb by nasal feeding on the basis of routine treatment. The hs-CRP, TNF-α, IL-6 and IL-8 levels were measured before and after treatment. The time of mechanical ventilation and hospitalisation were recorded. The changes of respiratory frequency, arterial oxygen partial pressure and oxygenation index were counted before and after treatment, and the incidence of ARDS and death was observed during the treatment. Results After treatment, the hs-CRP, TNF-α, IL-6 and IL-8 levels in the research group were significantly lower than those in the control group (all P < 0.05). The respiratory rate in the research group [(24.81±2.64) times/min] was significantly lower than that in the control group [(27.64±2.79) times/min], whereas PaO₂ and oxygenation index in the research group [(78.35±6.63) mm Hg and (314.20±42.17) mm Hg, respectively] were significantly higher than those in the control group [(70.26±6.21) mm Hg and (263.07±39.60) mm Hg, respectively; all P < 0.05]. The duration of mechanical ventilation in the study group [(4.27±1.39) days] was significantly shorter than that in the control group [(6.95±1.81) days, t=-4.971; P < 0.001]. The incidence and mortality of ARDS in the study group (18.75% and 3.12%) were significantly lower than those in the control group (39.06% and 14.06%, χ²=6.425, 4.873; all P < 0.05). Conclusion Rhubarb by nasal feeding can inhibit the inflammatory response of patients with ALI, promote the recovery of respiratory function and blood gas index and prevent the deterioration of the disease.
- Acute lung injury /
- Nasal feeding /
- Rhubarb /
- Lung and large intestine inside and outside /
- Inflammatory reaction /
- Clinical effect

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表 1 2组急性肺损伤患者一般资料比较(x±s)

组别	例数	年龄 (岁)	性别(例)		体重指数	原发病因(例)
组别	例数	年龄 (岁)	男性	女性	体重指数	突发性创伤	重症手术	胰腺炎	胆管炎	中毒
研究组	64	50.69±5.92	36	28	23.27±2.53	24	8	16	12	4
对照组	64	51.07±6.14	39	25	23.39±2.44	26	9	15	11	3
统计量		-0.444^a	0.290^b		-0.361^a	0.357^b
P值		0.658	0.590		0.719	0.986
注：^a为t值，^b为χ²值。

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表 2 2组急性肺损伤患者治疗前后血清炎症相关因子水平比较(x±s)

组别	例数	hs-CRP(mg/L)		TNF-α(ng/L)		IL-6(ng/L)		IL-8(ng/L)
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
研究组	64	28.11±4.92	3.52±1.27^a	66.33±6.64	35.26±5.15^a	30.62±6.51	11.81±2.12^a	90.15±7.90	53.71±6.82^a
对照组	64	27.83±5.03	6.46±2.25^a	65.79±6.21	43.62±5.73^a	31.29±7.14	17.14±3.38^a	91.36±8.23	76.31±8.28^a
t值		0.462	-9.623	0.494	-8.551	-0.555	-10.648	-0.728	-16.948
P值		0.645	＜0.001	0.622	＜0.001	0.580	＜0.001	0.468	＜0.001
注：与治疗前比较，^aP < 0.05。

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表 3 2组急性肺损伤患者治疗前后PaO₂、呼吸频率和氧合指数比较(x±s)

组别	例数	PaO₂(mm Hg)		呼吸频率(次/min)		氧合指数
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
研究组	64	57.31±5.07	78.35±6.63^a	32.93±3.16	24.81±2.64^a	239.43±19.40	314.20±42.17^a
对照组	64	56.79±5.93	70.26±6.21^a	32.75±3.28	27.64±2.79^a	238.58±20.65	263.07±39.60^a
t值		0.625	7.123	-0.381	-5.813	-0.256	7.130
P值		0.540	＜0.001	0.704	＜0.001	0.798	＜0.001
注：与治疗前比较，^aP < 0.05。

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