| BackgroundAcute lung injury/Acute respiratory distress syndrome (ALI/ARDS) is a severe disease in critical care unit commonly, the domestic fatality rate as high as 68.5% or so.The pathogenesis of ALI/ARDS is so complex, at pre-sent, a fairly concordant viewpoint of which is the result of uncontrolled in flammatory response,but also involved in coagulation and fibrinolysis disorders in which both induction and strengthen eath other, eventually 1-eading to tissue damage and organ dysfunction. However, apart from mechani-cal ventilation, the present large number of animal experiments and clini-cal trials show that no part of blocking the onset of specific treatment. Thus, modern medical treatment is mainly directed against the primary dis-ease and the function of each organ support therapy. In recent years,the domestic physicians has used Chinese Medicine on the prevention and treat ment for ALI/ARDS,and the integrative medicine has made some progress,dis played that Chinese Medicine was the unique advantage of multi-target th-erapy in intervention on ALI/ARDS.Many animal experiments and pharmacolo-gical studies show that Modified Liangge San inhibit inflammation, improve microcirculation, anti-endotoxin, immune regulation,and role in the treatm-ent of ALI/ARDS has certain advantage.ObjectivesTo observed the clinical efficacy of Modified Liangge San treating AL I/ARDS and its effect on the coagulation and fibrinolysis dysfunction, and to prove that Modified Liangge San is effective in treatment of ALI/ARDS.MethodsThis was a random, control study. According to the standard diagnosis of AIL/ARDS and is in line with the criteria for inclusion in this trial, 29 patients were involved in ICU and Breath internal medicine department of the first affiliated hospital of Guangzhou University of Traditional Chinese Medicine from 2008-2011.The patients were randomly divided into the Integrative Medicine group and Western Medicine group. Under the same use of conventional Western medicine, one group was in according to clini-cal symptoms of addition and subtraction using Modified Liangge San, the other have conventional Western medicine. To observe APACHEⅡscore and the Murray lung injury score in each group 7 days before and after treat-ment. To investigate the levels of oxygenation index,respiratory mechanics monitoring indicators (peak airway pressure, plateau pressure, mean airway pressure, static lung compliance, dynamic lung compliance), and calculate The mortality statistics in each group and duration of mechanical venti-lation 7 days before and after reatment. In the treatment of 7 days before and after, the determination of blood plasma protein C activity, antithro-mbin III activity, D-dimer, platelets, prothrombin time, thrombin time, activated partial thromboplastin time, fibrinogen level were all collect, then campared them. SPSS17.0 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.Result1. After treatment, the oxygenation index were up, but compared with the western medicine, the oxygenation index of patients in the group which ba-sed on western medicine combining with the treatment of the Modified Lia-ngge San was significantly higher (P<0.05);2. After treatment, the peak airway pressure, plateau pressure and mean airway pressure were decreased, but compared with the western medicine, the plaeau pressure of patients in the group which based on western medicine combining with the treatment of the Modified Liangge San were significant ly lower (P<0.05), and peak airway pressure, mean airway pressure before and after treatment was not significant (P>0.05);3. After treatment, the static lung compliance and dynamic pulmonary compliance were improved, but compared with the western medicine, the stat-ic lung compliance of patients in the group which based on western medic-ine combining with the treatment of the Modified Liangge San were signifi cantly improve (P<0.05), and dynamic pulmonary compliance before and after treatment was not significant (P>0.05);4. Compared with western medicine, mechanical ventilation of patients in the group which based on western medicine combining with the treatment of the Modified Liangge San can be significantly shortened(P<0.05);5.Mortality in the Integrative Medicine group were lower than the We-stern Medicine group, but the difference was not statistics significance between the two groups (P>0.05);6.After treatment, the APACHEⅡscore and the Murray lung injury score was lower than before treatment, but compared with the western medicine, the APACHEⅡscore of patients in the group which based on western medic-ine combining with the treatment of the Modified Liangge San was signifi-cantly reduced (P<0.05), while the Murray lung injury score compared with western medicine was no significant difference (P>0.05)7.After treatment, the plasma protein C activity, antithromb-inⅢacti vity of patients than those before treatment was increased, and in the In-tegrative Medicine group after treatment, they increased greatly, but the two groups of no difference between before and after treatment were sign-ificant(P>0.05);8.Platelets was increased and D-dimer decreased after treatment in b-oth groups, but all of them in the two groups before and after treatment showed no significant (P>0.05)9.After treatment, prothrombin time, activated partial thromboplastin time and thrombin time were shorter than before, fibrinogen level was inc-reased over the previous,but all of them in two groups were no significa-nt difference before and after treatment (P>0.05)10.The APACHEⅡscore and the Murray lung injury score before treatm-ent was significantly associated (P<0.01)11. The APACHEⅡscore and plasma protein C activity (P<0.01),antit-hrombinⅢactivity(P<0.05) were negatively correlated before treatment; the APACHEⅡscore and thrombin time (P<0.05), D-dimer levels (P<0.01) w ere positively correlated before treatment;12.The Murray lung injury score and plasma protein C activity, antit-hrombinⅢactivity were negatively correlated before treatment (P<0.01).Conclusion 1.Compared with the Western Medicine group, the group combining with the treatment of Modified Liangge San can significantly shorten the dura-tion of ventilation of ALI/ARDS patients, reduce the plateau pressure, imp-rove the level of the static lung compliance and Oxygenation index elast-icity. All of these indicate that Modified Liangge San can reduce lung in-jury and shorten the duration of ventilation for treating ALI/ARDS.2. Compared with the Western Medicine group, the group combining with the treatment of Modified Liangge San can significantly reduce the ALI/AR DS patients with APACHEⅡscore,to improve the acute physiological diso-rder, remission of disease.3. After treatment, the coagulation and fibrinolysis disorders of pati-ents were improved, and the plasma protein C activity and antithrombinⅢactivity of patients in the Integrative Medicine group after treatment w-ere increased more than the Western Medicine group largely, indicating th-at the Modified Liangge San take a supporting role in improving the in vivo anticoagulant activity of plasma protein C and antithrombinⅢ, thus improve the hypercoagulable state in vivo, to improve micro circulation on the one hand;on the other hand, it may be anti-inflammatory by increasing the body'sability to help the body inhibit the inflammatory response,the-reby reducing pulmonary damage, alleviate the condition.
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