[1]刁冰冰,梁 群.化纤胶囊Ⅱ号方治疗脓毒症急性肺损伤疗效及对患者血管内皮细胞功能、毛细血管渗漏指数的影响[J].陕西中医,2023,(1):45-49,59.[doi:DOI:10.3969/j.issn.1000-7369.2023.01.011]
　DIAO Bingbing,LIANG Qun.Efficacy of Huaxian capsule Ⅱ recipe in the treatment of sepsis acute lung injury and its effect on vascular endothelial cell function and capillary leakage index[J].,2023,(1):45-49,59.[doi:DOI:10.3969/j.issn.1000-7369.2023.01.011]
点击复制

化纤胶囊Ⅱ号方治疗脓毒症急性肺损伤疗效及对患者血管内皮细胞功能、毛细血管渗漏指数的影响
分享到：

《陕西中医》[ISSN:1000-7369/CN:61-1281/TN]

卷:
期数:
2023年1期
页码:
45-49,59
栏目:
临床研究
出版日期:
2023-01-05

文章信息/Info

Title:
Efficacy of Huaxian capsule Ⅱ recipe in the treatment of sepsis acute lung injury and its effect on vascular endothelial cell function and capillary leakage index
作者:
刁冰冰; 梁 群
(黑龙江中医药大学附属第一医院,黑龙江 哈尔滨150000)
Author(s):
DIAO Bingbing; LIANG Qun
(The First Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine,Harbin 150000,China)
关键词:
脓毒症急性肺损伤;  化纤胶囊Ⅱ号方;  中医症状积分;  病情严重程度;  血管内皮细胞功能;  毛细血管渗漏指数
Keywords:
Acute lung injury in sepsis;  Huaxian capsule Ⅱ recipe;  TCM symptom score;  Disease severity;  Vascular endothelial cell function;  Capillary Leakage Index
分类号:
R 631.1
DOI:
DOI:10.3969/j.issn.1000-7369.2023.01.011
文献标志码:
A
摘要:
目的:探讨化纤胶囊Ⅱ号方治疗脓毒症急性肺损伤疗效及对患者血管内皮细胞功能、毛细血管渗漏指数的影响。方法:选取80例脓毒症急性肺损伤患者并采用随机数字表法均分为对照组(n=40)和观察组(n=40)。对照组给予规范西医治疗,观察组在对照组基础上加用化纤胶囊Ⅱ号方治疗。对两组临床效果进行比较,并观察治疗前后病情严重程度[急性生理学和慢性健康状况评分(APACHEⅡ)和Murray 肺损伤评分(mlIS)]、中医症状积分、血气[动脉血氧分压(PaO2)、氧合指数(PaO2/FiO2)]及呼吸功能指标[血管外肺水指数(EVLWI)、肺血管通透指数(PVPI)]、血管内皮细胞功能[血清血管性假血友病因子(vWF)、血栓调节蛋白(TM)、内皮素-1(ET-1)]及毛细血管渗漏指数(CLI)。结果:两组临床总有效率(85.00%与65.00%)比较,观察组高于对照组(P<0.05); 治疗后,两组中医症状积分、APACHEⅡ和mlIS评分均低于治疗前(P均<0.05),但观察组中医症状积分、APACHEⅡ和mlIS评分均低于对照组(P<0.05); 治疗后,两组血气指标(PaO2、PaO2/FiO2)均明显上升、呼吸功能指标(EVLWI、PVPI)明显下降(P<0.05),且观察组血气、呼吸指标改善优于对照组(P<0.05); 治疗后,两组血管内皮细胞功能(vWF、TM、ET-1水平)及毛细血管渗漏指数(CLI)均明显下降(P<0.05),且观察组血清vWF、TM、ET-1水平及CLI均低于对照组(P<0.05)。结论:化纤胶囊Ⅱ号方可提高脓毒症急性肺损伤治疗效果,并可稳定病情,改善患者血气及呼吸指标,修复和保护血管内皮细胞功能,降低毛细血管渗漏指数。
Abstract:
Objective:To investigate the curative effect of Huaxian capsule Ⅱ recipe in the treatment of sepsis acute lung injury and its effect on vascular endothelial cell function and capillary leakage index.Methods:A total of 80 patients with sepsis acute lung injury were selected and divided into control group(n=40)and observation group(n=40)by random number table method.The control group was given standard western medicine treatment,and the observation group was additionally treated with Huaxian Capsule Ⅱ recipe on the basis of the control group.The clinical effects of the two groups were compared,and the severity of the disease [acute physiology and chronic health status score(APACHE Ⅱ)and Murray lung injury score(mlIS)],TCM symptom score,blood gas [arterial partial pressure of oxygen(PaO2)before and after treatment were observed,oxygenation index(PaO2/FiO2)] and respiratory function indexes [extravascular lung water index(EVLWI),pulmonary vascular permeability index(PVPI)],vascular endothelial cell function [serum von Willebrand factor(vWF),thrombomodulin(TM),endothelin-1(ET-1)] and capillary leakage index(CLI).Results:Compared with the total clinical effective rate(85.00% vs 65.00%)between the two groups,the observation group was higher than the control group(P<0.05),but the TCM symptom scores,APACHEⅡ and mlIS scores in the observation group were lower than those in the control group(P<0.05).PVPI were significantly decreased(P<0.05),and the improvement of blood gas and respiratory indexes in the observation group was better than that in the control group(P<0.05).After treatment,the vascular endothelial cell function(vWF,TM,ET-1 levels)in the two groups and Capillary Leakage Index(CLI)were significantly decreased(P<0.05),and the serum vWF,TM,ET-1 levels and CLI in the observation group were lower than those in the control group(P<0.05).Conclusion:Huaxian capsule Ⅱ recipe can improve the treatment effect of acute lung injury in sepsis,stabilize the condition,improve the blood gas and respiratory indexes,repair and protect the function of vascular endothelial cells,and reduce the capillary leakage index.

参考文献/References:

[1] 王 芳,李明心.宣白承气汤合大陷胸丸加减治疗脓毒症致急性肺损伤的临床观察[J].中国中医急症,2021,30(4):707-710.
[2] Du B,An Y,Kang Y,et al.Characteristics of critically ill patients in ICUs in mainland China[J].Crit Care Med,2013,41(1):84-92.
[3] 赖 芳,曾瑞峰,张 燕,等.益气通腑泻热法治疗脓毒症致急性肺损伤/急性呼吸窘迫综合征的临床研究[J].中医药导报,2021,27(8):75-80.
[4] 孙德阳,杨 洋,梁 群.中医药治疗脓毒症急性肺损伤的研究进展[J].辽宁中医杂志,2019,46(5):1108-1110.
[5] 王西墨,余剑波,金胜威.脓毒症肺损伤中西医结合诊治专家共识[J].中国中西医结合外科杂志,2020,26(3):400-408.
[6] 朱文锋.中医诊断学[M].北京:中国中医药出版社,2002:200-201.
[7] 任新生.脓毒症的定义、诊断标准、中医证候诊断要点及说明(草案)[J].中华急诊医学杂志,2007,16(8):797-798.
[8] 曹 钰,柴艳芬,邓 颖,等.中国脓毒症/脓毒性休克急诊治疗指南(2018)[J].临床急诊杂志,2018,19(9):567-588.
[9] 中华医学会重症医学分会.急性肺损伤/急性呼吸窘迫综合征诊断与治疗指南(2006)[J].中华内科杂志,2007,46(5):430-435.
[10] 肖武强,董 磊,吴先正.急性胃肠损伤分级联合D-乳酸、内毒素水平测定对脓毒症患者预后的评估价值[J].陕西医学杂志,2020,49(12):1577-1579,1583.
[11] 孙传兴.临床疾病诊断依据治愈好转标准[M].北京:人民军医出版社,2002:126.
[12] Zambon M,Vincent JL.Mortality rates for patients with acute lung injury/ARDS have decreased over time[J].Chest,2008,133(5):1120-1127.
[13] 张 宇,卢笑晖,连新宝.脓毒症急性肺损伤的发生机制及治疗研究进展[J].解放军医学杂志,2021,46(11):1159-1164.
[14] 张天宇.化纤胶囊Ⅱ对气虚血瘀型脓毒症的临床疗效观察[D].哈尔滨:黑龙江中医药大学,2017.
[15] 李 彦,魏冯宁,顾承东.益气活血类中药治疗脓毒症的研究进展[J].中日友好医院学报,2016,30(2):97-99.
[16] 张育芳,张 谦,王忆梅.中医方剂在脓毒症辅助治疗中的辨证应用[J].陕西中医,2019,40(8):1105-1108.
[17] 蓝嘉欣.宣肺调肠方改善脓毒症ARDS患者毛细血管渗漏指数的疗效观察[D].广州:广州中医药大学,2021.
[18] 李永胜,梅华鲜,黄中会,等.毛细血管渗漏指数对脓毒症危险分层及预后评估的价值[J].临床急诊杂志,2017,18(5):362-365.
[19] 朱潇潇.黄芪多糖延缓血管内皮细胞衰老的作用及其机制探讨[D].北京:中国人民解放军医学院,2019.
[20] 崔云亮.大黄单体降低血管内皮细胞通透性及信号转导机制[D].上海:第二军医大学,2016.
[21] 李 红,张 云,付丙月,等.丹酚酸对ADP诱导的血小板聚集的影响[J].食品与药品,2021,23(1):52-55.
[22] 杨琳洁,杨凯丽,钟宛凌,等.基于网络药理学探讨川芎嗪与阿魏酸抗动脉粥样硬化的作用机制[J].药物评价研究,2021,44(12):2555-2562.

备注/Memo

备注/Memo:
基金项目:国家自然科学基金资助面上项目(81974557)
更新日期/Last Update: 2022-12-28