Effect of Tanreqing injection on levels of inflammatory mediators in patients with acute lung injury / 中国中西医结合急救杂志

ABSTRACT

Objective To investigate the effect of Tanreqing injection on the concentrations of serum inflammatory mediators in patients with acute lung injury (ALI). Methods One hundred and thirty-six patients with ALI by clinical diagnosis admitted to Xinxiang Central Hospital from December 2013 to December 2017 were enrolled, they were randomly divided into a conventional treatment group and a Tanreqing treatment group, 68 cases in each group; in the mean time, 50 healthy subjects having undertaken physical examinations in this hospital were assigned in the healthy control group. In the conventional and Tanreqing treatment groups, the primary diseases of patients were treated, combined with corticosteroid and antiseptic drugs to combat against infection, and nutrition support, fluid supplement and symptomatic therapy were also used. The patients in the Tanreqing treatment group beside received conventional treatment, additionally they were treated with Tanreqing injection 20 mL in 0.9% Sodium Chloride solution or 5% Glucose 250 mL intravenous drip in 2 hours, once daily. And, the difference of each index was evaluated on the 7th day after the patient entering the group. The concentrations of serum interleukin (IL-1, IL-6) and tumor necrosis factor-α (TNF-α) were detected for the patients in two groups and controls by using the enzyme linked immunosorbent assay (ELISA) and radioimmunoassay (RIA), respectively. Meanwhile, the changes of arterial partial pressure of oxygen (PaO2), arterial partial pressure of carbon dioxide (PaCO2), oxygenation index (PaO2/FiO2), pH value, systemic vascular resistance (SVR) and pulmonary vascular resistance (PVR) were observed in the conventional and Tanreqing treatment groups. Results The concentrations of serum IL and TNF-α in the conventional and Tanreqing treatment groups before treatment were significantly higher than those in healthy controls [IL-1 (ng/L) 128.45±27.91, 131.12±26.26 vs. 24.55±6.12, IL-6 (ng/L) 65.77±7.21, 64.08±7.05 vs. 19.13±4.55, TNF-α (ng/L) 41.24±7.01, 40.07±6.76 vs. 10.62±2.65, all P ＜ 0.05]. Moreover, the levels of IL-1, IL-6, TNF-α, PaCO2, SVR and PVR in the conventional and Tanreqing treatment groups after treatment were significantly lower than those before treatment, and the levels of PaO2 and PaO2/FiO2were obviously increased compared with those before treatment, and the changes of the above indicators were more significant in the Tanreqing treatment group [IL-1 (ng/L) 75.67±18.58 vs. 101.22±21.13, IL-6 (ng/L)42.05±5.31 vs. 54.02±6.89, TNF-α (ng/L) 19.63±5.19 vs. 30.35±4.55, PaO2(mmHg, 1 mmHg = 0.133 kPa)93.06±7.95 vs. 72.66±8.04, PaCO2(mmHg) 42.32±2.44 vs. 50.25±3.43, PaO2/FiO2(mmHg) 316.28±16.73 vs. 256.33±14.25, SVR (kPa·s·L-1) 0.73±0.09 vs. 0.81±0.10, PVR (kPa·s·L-1) 0.08±0.02 vs. 0.10±0.02, all P ＜0.05]. The pH value was restored to normal (conventional treatment group was 7.37±0.27, Tanreqing treatment group was 7.41±0.31). Conclusion Tanreqing injection can reduce the concentrations of serum inflammatory mediators, significantly improve the blood gas and hemodynamic indexes, and reduce inflammatory reaction in the patients with ALI.