CAJ | 학술논문

目的探讨雷公藤、七叶皂苷钠联合治疗创伤后急性肺损伤(acute lung injury,ALI)的效果及其机制. 方法 120例创伤后ALI患者按随机数字表法分为4组:雷公藤联合七叶皂苷钠组(联合组)、雷公藤组、七叶皂苷钠组和对照组,每组30例.4组常规治疗相同,联合组从入院后第1天开始每天口服或胃管注入雷公藤多苷片,同时静脉滴注七叶皂苷钠,连续12 d.雷公藤组、七叶皂苷钠组分别仅加用雷公藤、七叶皂苷钠治疗,方法同联合组.观察各组患者治疗前后的血气分析指标、ICU停留时间、ARDS发生率及病死率,并分别在用药后4,8,12 d测定TNF-α、IL-1、IL-6和IL-8等炎症介质水平变化. 结果各治疗组ICU停留时间均明显短于对照组(P＜0.05),ARDS发生率及12 d病死率均明显低于对照组,以联合组为佳(P＜0.05);各治疗组呼吸频率、Pa02、氧合指数(Pa02/Fi02)改善程度均优于对照组,且以联合组为佳(P＜0.05);各治疗组血浆TNF-d、IL-1、IL-6及IL-8水平均低于对照组(P＜0.05). 结论雷公藤和七叶皂苷钠对创伤后ALI患者有治疗作用,两种药物联合使用有协同作用,效果更佳.
목적 탐토뢰공등、칠협조감납연합치료창상후급성폐손상(acute lung injury,ALI)적효과급기궤제. 방법 120례창상후ALI환자안수궤수자표법분위4조:뢰공등연합칠협조감납조(연합조)、뢰공등조、칠협조감납조화대조조,매조30례.4조상규치료상동,연합조종입원후제1천개시매천구복혹위관주입뢰공등다감편,동시정맥적주칠협조감납,련속12 d.뢰공등조、칠협조감납조분별부가용뢰공등、칠협조감납치료,방법동연합조.관찰각조환자치료전후적혈기분석지표、ICU정류시간、ARDS발생솔급병사솔,병분별재용약후4,8,12 d측정TNF-α、IL-1、IL-6화IL-8등염증개질수평변화. 결과 각치료조ICU정류시간균명현단우대조조(P＜0.05),ARDS발생솔급12 d병사솔균명현저우대조조,이연합조위가(P＜0.05);각치료조호흡빈솔、Pa02、양합지수(Pa02/Fi02)개선정도균우우대조조,차이연합조위가(P＜0.05);각치료조혈장TNF-d、IL-1、IL-6급IL-8수평균저우대조조(P＜0.05). 결론 뢰공등화칠협조감납대창상후ALI환자유치료작용,량충약물연합사용유협동작용,효과경가.
Objective To investigate the effect and mechanism of tripterygium wilfordii combined with aescine in treatment of acute lung injury (ALI) following trauma.Methods A total of 120 patients with posttraumatic ALI were divided into four groups:tripterygium wilfordii + aescine group (combined group),tripterygium wilfordii group,aescine group,and control group according to random number table,with 30 patients per group.Regardless of the same conventional therapy,the patients in combined group were treated by orally or gastrically administered tripterygium wilfordii multiglycoside as well as aescine intravenously,once a day for 12 days; on the contrary,the same method but only with tripterygium wilfordii or aescine was respectively performed in tripterygium wilfordii and aescine groups.Blood gas analysis before and after treatment,length of ICU stay,fatality rate and incidence of ARDS in each group were observed.Changes in levels of inflammatory mediators (TNF-oα,IL-1,IL-6 IL-8,etc)were detected at days 4,8,and 12 after medication.Results Shorter length of ICU stay and lower ARDS incidence as well as 12-day fatality rate were detected in each treatment group as compared with control group,especially in combined group (P ＜ 0.05).Respiratory rate,PaO2 and oxygenation index (PaO2/FiO2) in each treatment group presented better amelioration than those in control group and especially better results were observed in combined group (P ＜ 0.05).Plasma levels of TNF-α,IL-1,IL-6,and IL-8 in each treatment group were lower than those in control group (P ＜ 0.05).Conclusions Tripterygium wilfordii and aescine havetherapeutic effect on posttraumatic ALI.Moreover,synergetic use of the two drugs achieves synergistic effect and better outcome.