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1、提要目的:本研究旨在探讨参麦注射液对急性肺损伤血管内皮细胞功能的调节,期望为急性肺损伤的防治提供新的途径和依据。方法:在确立严格的诊断标准、纳入标准、排除标准和疗效性观察标准的基础上,采用随机、均衡、对照的原则,将80例合格受试对象随机分为A、B两组,每组40例。A组为西药常规治疗加参麦注射液组(简称参麦组),给予5%葡萄糖注射液250ml+参麦注射液50ml静脉滴注,一日一次,其余为西药常规治疗;B组为西药常规治疗组(简称西药组),给予西药常规治疗。以上两组治疗均以10日为1个疗程,将治疗前后患者临床症状及实验室检查指标做观察比较。结果:与西药组相比,参麦组能明显改善
2、患者呼吸频率、血气PaO2、PaCO2、PaO2/FiO2指标,明显降低ET-1、ICAM-l、NO水平,无创正压平均通气时间明显缩短,有创机械通气例数减少,肺损伤评分优于西药组。治疗后,西药组显效5例,有效17例,无效18例,总有效率55%;参麦组显效8例,有效23例,无效9例,总有效率77.5%,两组总有效率比较其差异有显著性,参麦组总有效率明显高于西药组。结论:参麦注射液能明显改善急性肺损伤患者的呼吸频率,提高血氧分压,改善氧合指数,降低急性肺损伤患者血浆ET-1、ICAM-l、NO的水平,改善肺损伤患者的预后。说明参麦注射液对急性肺损伤的保护作用,能减少在应激状
3、态下ET-1、ICAM-l、NO的过度合成与释放,对血管内皮细胞功能有一定的调节作用。关键词参麦注射液;急性肺损伤;内皮细胞功能TheclinicalstudyoftheeffectsofShenmaiinjectiononregulatingacutelunginjuryinvascularendothelialcellfunctionSpeciality:InternalMedicineofTCMAuthor:CaobinTutor:Prof.HanNingAbstractObjective:ThisstudyaimedtoinvestigateshenmaiInj
4、ectionregulationofvascularendothelialcellfunctioninacutelunginjury,expectationsfortheacutelunginjurypreventionandcontroltoprovideanewwayandbasis.Methods:Toestablishstrictdiagnosticcriteria,inclusioncriteria,exclusioncriteriaandefficacyobservationbasedonthestandard,usingarandomized,balanc
5、ed,thecontrolprinciple,80casesofeligiblesubjectswererandomlydividedintoA,Btwogroup,40casesineachgroup.TheAgroupwastreatedwithroutineWesternmedicinescombinedwithShenmaiinjectiongroup(referredtoasShenmaigroup),giving5%glucoseinjection250mlwithShenmaiinjection50mlintravenousinfusion,onceada
6、y,fortherestofconventionaltreatmentofWesternmedicine;groupBastheconventionaltreatmentofWesternmedicinegroup(referredtoastheWesternmedicinegroup),givingtheconventionaltreatmentofWesternmedicine.Theabovetwogroupsoftreatmentwere10to1coursesoftreatment,Thebeforeandaftertreatmentinpatientswit
7、hclinicalsymptomsandlaboratoryindexeswerecompared.Results:Comparedwiththewesternmedicinegroup,theShenmaigroupimprovedsignificantlyinpatientswithrespiratoryrate,bloodgasthePaO2,PaCO2,thePaO2/FiO2isindex,significantlyreducedthelevelofET-1,ICAM-landNO,noninvasivepositivepres