Effect of modified Shengxian Decoction on extravascular lung water index and lung injury prediction score of patients with acute respiratory distress syndrome caused by sepsis / 国际中医中药杂志

ABSTRACT

Objective:To observe the effect of modified Shengxian Decoction on extravascular lung water index (EVLWI) and lung injury prediction score (LIPS) in patients with acute respiratory distress syndrome (ARDS) caused by sepsis.Methods:Prospective cohort study. A total of 200 patients with ARDS caused by sepsis who were hospitalized in Baoshan Branch, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine from January 2019 to May 2021 were selected and divided into the observation group and control group by random number table method, with 100 in each group. The patients in the control group were given rountin western medicine treatment according to the guidelines, and the patients in the observation group were treated with modified Shengxian Decoction on the basis of the treatment in the control group. Both groups were treated for 7 days as a course of treatment. The PH value, oxygen volume index (FiO 2), oxygen partial pressure (PaO 2), arterial carbon dioxide partial pressure (PaCO 2) of the two groups before and after treatment, calculate the oxygenation index (PaO 2/FiO 2) were observed and compared. The C-reactive protein (hs-CRP), interleukin-6 (IL-6) levels were observed by ELISA, the procalcitonin (PCT) levels was detected by double antibody sandwich immunoluminescence method. The APACHE Ⅱ score and LIPS score, EVLWI and cardiac index (CI) of the two groups were observed and compared. The mechanical ventilation time and ICU hospitalization time of the two groups were compared. Results:After treatment, the PaCO 2 level [(37.15 ± 5.42) mmHg vs. (38.24 ± 3.24) mmHg, t=2.03] of the observation group was significantly lower than that of the control group, and the oxygenation index (292.34 ± 78.91 vs. 236.54 ± 70.58, t=5.27) was significantly higher than that of the control group ( P<0.05). After treatment, the levels of hs-CRP [(35.21 ± 6.73) mg/L vs. (48.97 ± 8.52) mg/L, t=12.67], IL-6 [(40.57 ± 8.51) ng/L vs. (47.61 ± 9.97) ng/L, t=5.37] and PCT [(0.75 ± 0.21) μg/L vs. (1.14 ± 0.38) μg/L, t=8.98] in the observation group were significantly lower than those in the control group ( P<0.01). After treatment, the APACHE Ⅱscore (11.14 ± 0.54 vs. 14.67 ± 0.89, t=33.91], LIPS score (2.21 ± 0.73 vs. 4.59 ± 0.88, t=20.82), and EVLWI [(6.19 ± 0.42) ml/kg vs. (8.24 ± 0.78) ml/kg, t=23.14) of the observation group were significantly lower than those in the control group, and the CI level [(4.49 ± 1.27) L/(min?m 2) vs. (3.61 ± 0.88) L/(min?m 2), t=5.70] was significantly higher than that of the control group ( P<0.01). The mechanical ventilation time and ICU stay in the observation group were shorter than those in the control group ( t=3.66, 5.74, P<0.01). Conclusion:The modified Shengxian Decoction can reduce the level of inflammation indexes in patients with ARDS caused by sepsis, reduce EVLWI and LIPS scores, improve blood gas analysis indexes, and shorten the time of mechanical ventilation and ICU hospitalization.