大承气汤辅助治疗ARDS患者对其pH、PaO2/FiO2和氧化应激状态的影响

目的:观察大承气汤辅助治疗ARDS患者对其pH、氧合指数(PaO_2/FiO_2)及氧化应激状态的影响。方法:选择2014年8月~2016年8月于成都中医药大学临床医学院就诊的82例ARDS患者,按治疗方式的不同随机分为对照组与实验组,对照组接受常规治疗,实验组在对照组的基础上联合大承气汤治疗,两组均持续用药7天。观察两组ICU住院时间、机械通气时间、不良反应的发生情况、治疗前后pH、PaO_2/FiO_2、血气超氧化物歧化醇(SOD)、谷胱甘肽过氧化物酶(GSH-Px)、丙二醇(MDA)水平的变化。结果:实验组ICU住院时间、机械通气时间及不良反应的发生率均显著短于或低于对照组(P0.05)。治疗前,两组pH、PaO_2/FiO_2、血清SOD、GSH-Px、MDA水平比较差异无统计学意义(P0.05);治疗后,两组pH、PaO_2/FiO_2、血清SOD、GSH-Px水平均较治疗前显著上升,且实验组PaO_2/FiO_2、血清SOD、GSH-Px水平明显高于对照组,两组血清MDA水平均较治疗前明显降低,且实验组血清MDA水平显著低于对照组(P0.05)。结论:大承气汤辅助治疗ARDS能够有效改善患者pH、PaO_2/FiO_2,缓解氧化应激状态,利于患者恢复。

Influence of Dachengqi Decoction Adjuvant Therapy on pH, PaO2/FiO2 and Oxidative Stress Status of Patients with ARDS

ABSTRACT Objective: To observe the influence of dachengqi decoction adjuvant therapy on the ph, PaO₂/FiO₂ and oxidative stress status of patients with ARDS. Methods: 82 patients with ARDS admitted in Chengdu university of traditional Chinese medicine clinical medicine from August 2014 to August 2016 were selected and randomly divided into the control group and the experimental group according to different treatment methods, the control group was treated by conventional methods, while the experimental group was treated by Dachengqi Decoction based on the control group, both groups were continuously treated for 7 days. The mechanical ventilation, length of ICU hospitalization time, and incidence of adverse reactions, changes of pH, PaO₂/FiO₂, superoxide disproportionation alcohol (SOD), glutathione peroxidase (GSH-Px), propylene glycol (MDA) levels before and after treatment were compared between two groups. Results: The ICU hospitalization time, mechanical ventilation time and incidence rate of adverse reactions in the experimental group were significantly shorter or less than those of the control group(P<0.05). After treatment, the pH, PaO₂/FiO₂, serum levels of SOD, GSH-Px of both groups were all rised than those before treatment, the PaO₂/FiO₂, serum levels of SOD, GSH-Px of experimental group were obviously higher than those of the control group, the serum levels of MDA of both groups were significantly decreased than those before the treatment, which was lower in the experimental group than that of the control group(P<0.05). Conclusion: Dachengqi Decoction auxiliary treatment of patients with ARDS could effectively improve the pH, PaO₂/FiO₂, relieve the oxidative stress status.