The effect of Dachengqi decoction combined withβ-aescine on pulmonary function in patients with acute lung injury after chest trauma / 中国中西医结合急救杂志

ABSTRACT

Objective To observe the effect of Dachengqi decoction combined with β-aescine on pulmonary function in patients with acute lung injury (ALI) after chest trauma.Methods Ninety-five patients with ALI after chest trauma admitted to the Department of Thoracic Cardiothoracic Surgery of Dingxi People's Hospital of Gansu from April 2013 to May 2016 were enrolled, and they were divided into a Dachengqi decoction group (47 patients) and a control group (48 patients) by random number table. The control group patients were treated with conventional therapy and β-aescine 0.4 mg/kg+ 10% Glucose (250 mL) intravenous drip, while the Dachengqi decoction group patients were additionally treated with Dachengqi decoction on the treatment of the control group (rhubarb 12 g, magnolia officinalis 24 g, fructus aurantii immaturus 12 g, mirabilite 9 g), one dose daily, taken twice in a day, once in the morning and once in the evening orally, both groups were treated for one week. Before and after treatment, the changes of esophageal pressure, respiratory dynamics, the indexes of pulmonary function and blood gas analysis were observed. Results Compared with those before treatment, the levels of plateau pressure (Pplat), mean airway pressure (mPaw), airway resistance (Raw) and arterial partial pressure of carbon dioxide (PaCO2) of the two groups after treatment were significantly reduced, but the levels of lower esophageal sphincter pressure (LESP), peak airway pressure (PIP), the first second forced expiratory volume (FEV1), forced vital capacity (FVC), peak expiratory flow rate (PEF), the mean maximum expiratory flow (MMEF), pulse oxygen saturation (SpO2), arterial partial pressure of oxygen (PaO2), oxygenation index (PaO2/FiO2) were all increased significantly; the changes of the above indexes in the Dachengqi decoction group were more significant than those in the control group [LESP (mmHg, 1 mmHg = 0.133 kPa)18.64±2.79 vs. 15.46±3.09, Pplat (cmH2O, 1 cmH2O = 0.098 kPa) 14.27±1.68 vs. 16.00±1.87, PIP (cmH2O) 40.23±5.03 vs. 32.19±4.45, mPaw (cmH2O) 8.57±0.67 vs. 9.41±1.23, Raw (cmH2O·L-1·s-1) 6.76±1.01 vs. 9.31±1.43, FEV1 (L) 1.73±0.27 vs. 1.46±0.25, FVC (3.95±0.51)% vs. (3.30±0.46)%, PEF (L/s) 3.81±0.47 vs. 3.11±0.38, MMEF (L/s) 0.93±0.16 vs. 0.77±0.12, SpO2 0.96±0.06 vs. 0.91±0.05, PaO2 (mmHg) 97.82±10.13 vs. 74.73±8.02, PaCO2 (mmHg) 36.49±4.28 vs. 47.13±5.46, PaO2/FiO2 (mmHg) 362.47±20.82 vs. 259.79±17.61, allP < 0.05]. Conclusion Dachengqi decoction combined with β-aescine can reduce the respiratory intensity of patients with ALI after chest trauma and improve the lung function and blood oxygen level.