The Clinical Explore Of Dachengqi Decoction’s Effect For Patients With Acute Respiratory Distress Syndrome

Obiective: The purpose of this study is to use the anti-inflammatory properties of dachengqi decoction to enema,and then through rigorous prospective randomized controlled experiments to explore the effect of dachengqi decoction enema for patients with acute respiratory distress syndrome.Methods: Select 40 cases of patients with acute respiratory distress syndrome accompanied by constipation during the period of March 2014 to March 2015 in emergency department of The First Affiliated Hospital of Dalian Medical University. According to the principle of randomization, patients were randomly divided into experimental group and control group. The experimental group of 20 cases were treated with basic treatment plus dachengqi decoction enema. And the control group of 20 cases were treated with basic treatment plus placebo enema(warm water). Patients in both groups were treated for 5 days. Specimens from the femoral artery blood were obtained from 1 t, 3t, 5t and 7t after the diagnosis of ARDS. Use the bedside blood gas analyzer to analysis arterial blood gas, then record patients’ oxygen concentration(FiO2) and arterial partial pressure of oxygen(PaO2). For all of the patients, take its acute physiology score, age, and chronic health evaluation within 24 h and the fifth day for APACHE Ⅱ score.Besides, record extravascular lung water index(ELWI) and pulmonary vascular permeability index(PVPI)from PiCCO. Using statistical methods to compare the differences of the relevant indicators in each group, and judging the effect of dachengqi decoction enema for patients with acute respiratory distress syndrome respiratory function. Compared the two sample mean with t test, with P < 0.05 said the difference was statistically significant.Results : 1、Before treatment,the ELWI value of each groups were higher than normal,it is suggests the presence of pulmonary edema, the ELWI value between two groups have no significant difference(P > 0.05). The first days, third days, fifth days after treatment,ELWI value of the experimental group decreased gradually until close to the normal level. While the ELWI value of the control group in the first 1-3 days reached the peak,and then decreased gradually. The ELWIvalues of first days, third days, fifth days were confirmed having a statistical significance between the two groups(P < 0.05). This suggests that Dachengqi Decoction can shorten the peak period of pulmonary edema or skip the peak period of pulmonary edema.and then reduce the degree of pulmonary edema.2、Before treatment,the PVPI value of each groups were both higher,it suggests that the pulmonary vascular permeability were higher. the PVPI value between two groups have no significant difference(P > 0.05). The first days, third days, fifth days after treatment,PVPI value of each group were decreased gradually.The PVPI value between two groups at first day have no significant difference(P > 0.05).While the PVPI value between two groups at third days and fifth days have significant difference(P > 0.05).It suggests that Dachengqi Decoction can improve the permeability of pulmonary vessels in patients with ARDS.3、Before treatment,the oxygenation index of each groups were lower than 200, then a few days later,the oxygenation index change values of two groups were increased gradually.While the oxygenation index change values of experimental group rises much more than the control group. The oxygenation index change values in the first day between two groups have no significant difference(P > 0.05). But the oxygenation index change values of the third day and the fifth day between two groups were confirmed having a statistical significance(P<0.05). This suggests that Dachengqi Decoction can improve the oxygenation index and the respiratory functionin in patients with ARDS.4、Before treatment,the acute physiological and chronic health evaluation of each groups were higher than normal. The scores between two groups have no significant difference(P > 0.05). While the scores at the fifth day between two groups have no significant difference(P > 0.05). But the APACHEII at the fifth day between two groups were both decreased, and the difference was statistically significant(P < 0.05).This suggests that Dachengqi decoction has no obvious effect on improving the prognosis of patients with ARDS.Conclusions : Dachengqi Decoction enema intervention can promote oxygenation in patients with ARDS,then improve the respiratory function of ARDS patients, alleviate the degree of pulmonary edema. the effect of Dachengqi Decoction enema is good,and valuable for clinical application.