盐酸氨溴索联合参附注射液在老年急性呼吸窘迫综合征患者中的治疗意义

程风卫 鞠风玲

【摘要】 目的 探討盐酸氨溴索联合参附注射液对老年急性呼吸窘迫综合征（ARDS）患者动脉血气及呼出气冷凝液中相关因子的影响。方法 选取2019年3月至2020年3月收治的老年ARDS患者112例，随机分为对照组（56例）与研究组（56例），所有患者均根据病情予脱水、吸痰、营养支持、机械通气等治疗，在此基础上对照组患者予盐酸氨溴索治疗，研究组在对照组基础上联合参附注射液，连续治疗1周，比较两组患者治疗前后动脉血气指标[氧合指数（PaO2/FiO2）、动脉血氧分压（PaO2）、血氧饱和度（SaO2）]与呼出气冷凝液中相关因子[内皮素-1（ET-1）、一氧化氮（NO）、8-异前列腺素（8-isoPG）]及不良反应。结果 治疗前两组患者动脉血气与呼出气冷凝液中相关指标差异无统计学意义（P>0.05），治疗后两组患者PaO2/FiO2、PaO2、SaO2均明显提高，且研究组患者各指标明显高于对照组（P<0.001）;治疗后两组患者ET-1、NO、8-isoPG均明显下降，且研究组患者各指标明显低于对照组（P<0.001）;治疗期间两组患者均未出现不良反应。结论 对老年ARDS患者采取盐酸氨溴索联合参附注射液治疗可有效改善患者动脉血气指标，控制炎症反应，临床疗效良好，且不会增加治疗不良反应，安全性较高。

【关键词】 盐酸氨溴索;参附注射液;老年;急性呼吸窘迫综合征;治疗效果

中图分类号：R563.8 文献标志码：A DOI：10.3969/j.issn.1003-1383.2021.01.012

【Abstract】 Objective To investigate the effect of ambroxol hydrochloride combined with Shenfu injection on related factors in arterial blood gas and exhaled breath condensate in elderly patients with acute respiratory distress syndrome （ARDS）.Methods 112 elderly patients with ARDS admitted to our hospital from March 2019 to March 2020 were randomly divided into control group （56 cases） and study group （56 cases）. All patients were given dehydration， sputum suction， nutritional support， mechanical ventilation and other treatments according to their conditions. On this basis， the control group were treated with ambroxol hydrochloride， and the study group were treated with Shenfu injection on the basis of the control group. Both groups were continuously treated for one week. And then， arterial blood gas indexes （PaO2/FiO2， PaO2 and SaO2） and related factors in exhaled breath condensate [endothelin-1 （ET-1）， nitric oxide （NO） and 8-isoprostaglandin （8-isoPG）] before and after treatment as well as adverse reactions were compared between the two groups.Results Before treatment， there was no statistically significant difference in arterial blood gas indexes and related factors in exhaled breath condensate between the two groups（P > 0.05）. After treatment， PaO2/FiO2， PaO2 and SaO2 of the two groups significantly increased， and each index of the study group was significantly higher than that of the control group （P < 0.001）. After treatment， ET-1， NO， 8-isoPG of the two groups significantly decreased， and each index of the study group was significantly lower than that of the control group （P < 0.001）. There were no adverse reactions in the two groups during treatment.Conclusion Ambroxol hydrochloride combined with Shenfu injection can effectively improve arterial blood gas indexes and control inflammatory reactions in elderly patients with ARDS. The clinical effect is good， and it will not increase the adverse reaction of treatment， with high safety.

【Key words】 ambroxol hydrochloride; Shenfu injection; elderly patients; ARDS; therapeutic effect

急性呼吸窘迫综合征（acute respiratory distress syndrome，ARDS）是由肺内、肺外多种致病因素引起的以肺泡毛细血管损伤为主要表现的急性低氧性呼吸功能不全或衰竭，是临床急危重症，病死率高达40%，严重危害人类健康[1]。目前临床多采取机械通气、脱水、吸痰等常规干预措施联合抗炎药物治疗ARDS。盐酸氨溴索是一种具有多种生物学效应的黏液溶解剂，有抗氧化、抗炎作用，可在一定程度上阻断ARDS进展，但由于老年ARDS患者生理功能减退，且多伴随心脑血管等不稳定性疾病，增加了治疗难度和风险[2～3]。近年来，中西医联合……