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目的:观察大黄在急性呼吸窘迫综合征(ARDS)64例患者综合治疗中的应用效果。方法:64例ARDS患者随机分为两组,治疗组32例在常规综合治疗的基础上加用大黄经胃管鼻饲,对照组32例仅给予常规综合治疗。观察两组患者治疗前后氧合指数(PaO2/FiO2)、动脉血氧分压(PaO2)、血液中IL-6、IL-8浓度、机械通气时间、应激性溃疡发生率和病死率。结果:治疗组患者PaO2/FiO2、PaO2指数第3天开始上升(P<0.05或P<0.01),7天后明显改善(P<0.01);血液中IL-6、IL-8浓度较治疗前和对照组明显降低;机械通气时间、应急性溃疡的发生率及病死率优于对照组,差异均有显著性(P<0.05或P<0.01)。结论:大黄可以明显改善ARDS患者的氧合指数,在一定程度上抑制炎症介质的释放,缩短机械通气时间,降低应急性溃疡的发生率和病死率,可以作为临床救治ARDS的有效措施之一。
Objective: To observe the effect of rhubarb in the comprehensive treatment of 64 patients with acute respiratory distress syndrome (ARDS). Methods: Sixty-four patients with ARDS were randomly divided into two groups. The treatment group (32 cases) was given rhubarb via nasogastric tube feeding on the basis of conventional comprehensive treatment, while the control group (32 cases) was given conventional comprehensive treatment. PaO2 / FiO2, PaO2, IL-6, IL-8 in blood, mechanical ventilation time, the incidence of stress ulcer and case fatality were observed before and after treatment. Results: The PaO2 / FiO2 and PaO2 index of the treatment group began to increase on the third day (P <0.05 or P <0.01), and significantly improved on the 7th day (P <0.01). The concentrations of IL-6 and IL- The control group was significantly lower; the time of mechanical ventilation, the incidence of acute ulcer and mortality were better than the control group, the difference was significant (P <0.05 or P <0.01). Conclusion: Rhubarb can significantly improve the oxygenation index of patients with ARDS, which can inhibit the release of inflammatory mediators to a certain extent, shorten the duration of mechanical ventilation and reduce the incidence of acute ulcer and mortality, which can be used as one of the effective measures for clinical treatment of ARDS.