Observation Of Therapeutic Effect Of Mechanical Ventilation With Assistance Of Jiawei-Liang-Ge-San In ALI/ARDS

ObjectiveAcute lung injury /Acute respiratory distress syndrome(ALI /ARDS) is a severe disease in critical care unit,whose fatality rate as high as 40%.The pathogenesis of ALI/ARDS is very complex,at present,a fairly concordant viewponit of which is the body of the results of out-of-control inflammatory response.Various kinds of etiological factory can cause inflammatory response.When it happens a large number of inflammatory factors are released,then complicated cascade response happens and leads to tissue damage and organ dysfunction.From the beginning of 90's,last century,a large number of animal experimental studies have shown that cytokine antagonists can significantly reduce lung tissue damage,but in clinical trials have failed. At present,the treatment of western medicine is mainly directed against the primary disease,as well as support the functions of various organs,but have no means to interrupt the developmental link of disease in clinical,so the effect of them isn't satisfied.Domestically,chinese herbal drugs are used in treatment of ALI/ARDS,has achieved some results,show that traditional chinese medicine is a unique role in treating of ALI/ARDS.Modern studies have shown that traditional chinese medicine have an advantage of controlling Inflammation.Therefore,it is important to seek more effective chinese herbal drugs for prevention and treatmen ALI/ARDS.In this study,based on traditional Chinese medicine pathogenesis characteristics and″the relationships of the lung and large intestine,″the theory of Chinese medicine and modern pharmacological research,we choose Jiawei-Liang-Ge-San with western medicine to treat ALI/ARDS.Observe the mortality rate of patients,the duration of ventilation,Lung injury score, acute physiology and chronic health evaluationⅡscore,peripheral blood levels of cytokines,,explore it' s clinical efficacy and mechanism to prove that Jiawei-Liang-Ge-San is effective in treatment of ALI/ARDS.MethodsThis is a random,control study.According to the standard diagnosis of AIL/ARDS,27 patients were involved in ICU of the first affiliated hospitalof Guangzhou University of Traditional Chinese Medicine from2003-2007.The patients were randomly divided into two groups.Under the same use of mechanical ventilation,one groups were treated with Jiawei-Liang-Ge-San,the other have no traditional chinese drugs.To observe APACHEII score and the Murray lung injury score in each groups,measure TNF-a,IL-6,CRP levers of phrenicd blood in patients before and after treatment and calculate the group mortality and duration of ventilation,then campared them.SPSS13.0 statistic system were used to analyze date.All count datas are described by mean±standard deviation(X±S) and use t tests to campare;pearson correlation analysis is applied in correlation analysis;chi square test is utilised to campare measurement data;P＜0.05 express for difference,P＜0.01 for extremely differences.Results1.The duration of ventilation in Chinese-Western group is shorten than the Western group.(P＜0.05);2.The number of deaths and the mortality rate in the Chinese-Western group are have a downward trend compared with the Western Group,but the difference was not statistics significance(P＞0.05).3.The APACHEⅡscores and Murray lung injury scores of after treatment were lower than before treatment(P＜0.05),and in which Chinese- Western medicine group reduced significantly(compared with the Western group,P＜0.01).4.The levels of IL-6,TNF-a,CRP after treatment were less than before treatment(P＜0.05),and in which Chinese-Western medicine group less significantly(compared with the Western group,P＜0.01).Conclusion1.Mechanical ventilation with the assistance of Jiawei-Liang-Ge-San can significantly shorten the duration of ventilation of ALI/ ARDS patients, campared with merely mechanical ventilation.It may be related to reduce inflammatory mediators,reduce the inflammatory damage,and protect the damaged lung tissue.2.Mechanical ventilation with the assistance of Jiawei-Liang-Ge-San can cut down the levers of IL-6,TNF-a and reduce the level of CRP.May be Jiawei-Liang-Ge-San can inhibit phrenic scattered inflammatory response, reduce the injury of lung and other organs,so to improve the condition of disease..