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附苏合剂(温肾潜阳法)对脓毒症诱导的急性呼吸窘迫综合征的影响。

Effects of Fusu mixture (Wen-Shen-Qian-Yang Method) on sepsis-induced acute respiratory distress syndrome.

作者信息

Zhang Li, Long Kunlan, Wang Chunxia, Zhang Xuemei, Yang Hongjing, Chen Jun, Li Xue, Gao Peiyang, Zhang Song

机构信息

Department of Critical Care Medicine.

Department of Respiratory Medicine, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China.

出版信息

Medicine (Baltimore). 2020 Jul 17;99(29):e21066. doi: 10.1097/MD.0000000000021066.

Abstract

INTRODUCTION

Sepsis is the most common etiology of acute lung injury (ALI) or acute respiratory distress syndrome (ARDS). Capillary leakage caused by lung endothelial injury is the central cause of ARDS. The results of research in modern medicine in reducing endothelial damage and restoring endothelial functions are limited. In the previous clinical observations, we found that the Fusu mixture not only improves the clinical symptoms but also reduces the leakage of pulmonary capillaries. Therefore, the purpose of this study is to determine the clinical efficacy of the Fusu mixture combined with Western medicine in the treatment of ARDS caused by sepsis and to explore the mechanism of traditional Chinese medicine.

METHODS

This is a prospective, single-center, randomized, single-blind, and controlled clinical study involving 620 eligible patients. The patients will be randomly divided into 2 groups: the Western medicine treatment group and the combination of Chinese and Western medicine treatment group. After 14 days of intervention, the clinical efficacy and safety of the Fusu mixture on sepsis-induced ARDS patients will be observed. The primary outcome will be measured as 28-day mortality. The secondary outcome indices include inflammatory markers (CRP, PCT, IL-6, TNF - α), APACHE II score, SOFA score, days without a ventilator, blood gas analysis (Lac, PaO2 / FiO2), intensive care unit hospital stay time, intensive care unit mortality. Simultaneously, the analysis of the exploratory results will be carried out to analyze the possible mechanism of Fusu mixture in the treatment of sepsis-induced ARDS by the high-throughput sequencing and bioinformatics.

DISCUSSION

The purpose of this study is to evaluate the clinical efficacy of Fusu mixture in the treatment of sepsis-induced ARDS and explore its possible mechanism of action. If successful, it will provide evidence-based adjuvant therapy for the clinical treatment of ARDS.

摘要

引言

脓毒症是急性肺损伤(ALI)或急性呼吸窘迫综合征(ARDS)最常见的病因。肺内皮损伤导致的毛细血管渗漏是ARDS的核心病因。现代医学在减少内皮损伤和恢复内皮功能方面的研究成果有限。在之前的临床观察中,我们发现复素合剂不仅能改善临床症状,还能减少肺毛细血管渗漏。因此,本研究的目的是确定复素合剂联合西药治疗脓毒症所致ARDS的临床疗效,并探讨其作用机制。

方法

这是一项前瞻性、单中心、随机、单盲、对照的临床研究,纳入620例符合条件的患者。患者将被随机分为两组:西药治疗组和中西医结合治疗组。经过14天的干预后,观察复素合剂对脓毒症所致ARDS患者的临床疗效和安全性。主要结局指标为28天死亡率。次要结局指标包括炎症标志物(CRP、PCT、IL-6、TNF-α)、APACHE II评分、SOFA评分、无呼吸机天数、血气分析(Lac、PaO2 /FiO2)、重症监护病房住院时间、重症监护病房死亡率。同时,将进行探索性结果分析,通过高通量测序和生物信息学分析复素合剂治疗脓毒症所致ARDS的可能机制。

讨论

本研究的目的是评估复素合剂治疗脓毒症所致ARDS的临床疗效,并探讨其可能的作用机制。如果研究成功,将为ARDS的临床治疗提供循证辅助治疗方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7726/7373504/4a32b932d336/medi-99-e21066-g001.jpg

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