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目的:观察通腑净化汤治疗急性呼吸窘迫综合征(ARDS)的临床疗效。方法:48例创伤后ARDS患者,随机分为对照组(24例)和观察组(24例),对照组给予常规西医治疗,观察组在常规治疗的基础上加用通腑净化汤,比较两组的动脉血气指标、氧合指数(PaO2/FiO2)、C反应蛋白(CRP)、APACHEⅡ评分及病死率。结果:与同组治疗前比较,两组治疗后PH、PaCO2、PaO2/FiO2均升高(P<0.05),血浆CRP水平、APACHEⅡ评分降低(P<0.05);治疗后7天两组比较,观察组PaO2/FiO2高于对照组(P<0.05),CRP低于对照组(P<0.05);APACHEⅡ评分低于对照组(P<0.05);观察组病死率为20.83%(5/24)、对照组病死率为33.33%(10/24),差异无统计学意义(P>0.05)。结论:通腑净化汤能改善创伤后ARDS患者的血气指标,提高氧合指数,有效降低CRP等细胞因子的产生和释放,降低死亡率。
Objective: To observe the clinical efficacy of Tongfu Purification Decoction in the treatment of acute respiratory distress syndrome (ARDS). Methods: Forty-eight patients with post-traumatic ARDS were randomly divided into control group (24 cases) and observation group (24 cases). The control group was given conventional western medicine. The observation group was given Tongfu Purification Decoction on the basis of routine treatment. Arterial blood gas indexes, oxygenation index (PaO2 / FiO2), C-reactive protein (CRP), APACHEⅡscore and mortality were recorded. Results: Compared with the same group before treatment, PH, PaCO2 and PaO2 / FiO2 in both groups were significantly increased (P <0.05), plasma CRP level and APACHEⅡ score decreased after treatment (P <0.05) PaO2 / FiO2 in observation group was higher than that in control group (P <0.05), CRP was lower than that in control group (P <0.05), APACHEⅡscore was lower than that in control group (P <0.05), and mortality in observation group was 20.83% , The case fatality rate of control group was 33.33% (10/24), the difference was not statistically significant (P> 0.05). Conclusion: Tongfu Purifying Decoction can improve the blood gas index of traumatic ARDS patients, increase the oxygenation index, effectively reduce the production and release of cytokines such as CRP, and reduce the mortality rate.