1.Clinical study of two different doses of pulmonary surfactant of early treatment for late preterm children with respiratory distress syndrome
Chinese Journal of Primary Medicine and Pharmacy 2015;(11):1707-1711,1712
Objective To investigate the clinical,safety and cost effect of porcine pulmonary surfactant (import)and bovine pulmonary surfactant(domestic)with full dose and low dosage of early treatment for late preterm children with respiratory distress syndrome,for the clinical selection treatment programs provide a reference.Methods Late preterm children with respiratory distress syndrome were divided into full dose group A of 24 cases,low dose group A of 25 cases,full dose group B of 26 cases,low dose group B of 24 cases.The first dose of full dose group A was 200mg/kg,the first dose of low dosage group A was 100mg/kg,again administered doses was 100mg/kg,the first dose of full dose group B was 70mg/kg,the first dose of low dosage group B was 50mg/kg,again administered dose was 50mg/kg.Results The differences of PaO2 ,PaCO2 ,FiO2 ,OI between two low dosage groups and full dose group A were significantly different.Treated 6h,the differences of PaCO2 ,FiO2 between low dosage group B and full dose group A were significantly different(q =3.273,3.236,all P <0.05).A group of low volume with a sufficient amount PaO2 6 h B group differences were statistically significant(q =3.823,P <0.05),12h of PaO2 ,PaCO2 ,FiO2 ,OI with enough B group difference was statistically significant(q =3.293,3.923,3.423,3.434,all P <0.05),24h of FiO2 , OI group was significantly lower than the full amount of B(q =3.234,3.356,all P <0.05).Low dose group B 6h, 12h,24h of PaO2 was significantly lower than enough group B,6h,12h of PaCO2 were significantly higher than enough group B(q =3.892,3.922,3.583,all P <0.05),12h,24h of FiO2 ,OI group were significantly higher than a suffi cient amount B(12h of q =3.892,3.762,24h of q =3.819,3.678,P <0.05),24h of OI was significantly higher than the low amount of a group(q =3.784,P <0.05).Chest evaluation 12h,24h grade difference between groups was sta-tistically significant(Z =3.982,5.323,all P <0.05).Two low -volume set of ventilator -associated pneumonia rates were 16.00%,16.67%,significantly higher than the amount of the two -legged group(low dose group A χ2 =4.988, 5.023,low dose group B χ2 =5.102,5.234,all P <0.05).Conclusion Porcine pulmonary surfactant(import)and bovine pulmonary surfactant(domestic)full dose early treatment of late preterm children with respiratory distress syn-drome could significantly relieve pulmonary symptoms and signs,effects are better than low dosage,and has high secu-rity,low dosage treatment does not reduce the cost of treatment,bovine pulmonary surfactant therapy administered in an amount sufficient lower cost,select the appropriate treatment plan based on your specific needs.
2.Effects of rhubarb and ephedra prescription on pulmonary function and blood pressure circadian rhythm in patients with acute exacerbation of chronic obstructive pulmonary disease
Lijie YU ; Fengdan LI ; Bingmao LI ; Hemei XIAO ; Xinfeng LEI ; Weihong HAN ; Xinxia HE ; Li TONG
Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care 2017;24(4):380-384
Objective To investigate the effect of rhubarb and ephedra prescription on the pulmonary function and blood pressure circadian rhythm in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD).Methods One hundred and enghty six patients with AECOPD admitted to Department of Integrated Medicine of Harrison International Peace Hospital from December 2013 to Auguest 2016 were enrolled, and they were divided into a control group 90 cases and an experimental group 96 cases by random number talbe method. The patients in control group were treated with conventional therapy, while those in the experimental group were treated with the conventional therapy and additionally rhubarb and ephedra prescription (including rhubarb 6 g, ephedra 5 g, agrimony 15 g, licorice 15 g), taken orally 2 times a day, the therapeutic course in the two groups being 2 weeks. The diference of blood gas analysis, pulmonary function indexes, dyspnea score (mMRC) and ambulatory blood pressure monitoring were compared before and after treatment in the two groups.Results Compared with before treatment, the pH value, arterial partial pressure of oxygen (PaO2), forced vital capacity (FVC), one second forced expiratory volume (FEV1), FEV1/FVC of the two groups were significantly increased after treatment, while the arterial partial pressure of carbon dioxide (PaCO2) and mMRC score were significantly lowered, and the changes in the experimental group were more significant than those in the control group [pH: 7.40±0.04 vs. 7.37±0.03, PaO2 (mmHg, 1 mmHg = 0.133 kPa): 81.09±12.54 vs. 76.27±12.20, PaCO2 (mmHg): 48.01±8.27 vs. 51.91±8.37, FVC (L): 2.37±0.39 vs. 2.13±0.45, FEV1 (L): 2.08±0.38 vs. 1.87±0.41, FEV1/FVC: (69.01±12.04)% vs. (64.02±11.81)%, mMRC: 2.02±0.76 vs. 2.40±0.87, allP < 0.05 orP < 0.01]. Based on the percentage of blood pressure circadian value difference, the blood pressure circadian rhythm was divided into dipper type, non dipper type, super dipper type and anti dipper type, 24.2% patients were of dipper type and 75.8% patients were of non dipper, super dipper and anti dipper types. There was no significant difference in daytime systolic blood pressure (dSBP) between patients with super dipper and dipper types (P > 0.05),and the dSBP (mmHg) in patients with non dipper type was significantly higher than that in patients with dipper, super dipper and anti dipper types (131.55±5.08 vs. 117.78±4.47, 118.26±4.24, 113.37±3.97, allP < 0.05); the daytime diastolic blood pressure [dDBP (mmHg)] of anti dipper, non dipper type, dipper type, super dipper type increased in turn (respectively, 63.27±2.80, 70.24±3.82, 73.98±2.61, 82.96±4.52, allP < 0.05); the night SBP (nSBP) of anti dipper type was the highest (127.38±4.98) mmHg, and the nSBP of super dipper type was the lowest (89.07±3.81) mmHg; the night DBP (nDBP) of dipper type was lower than that of non dipper, anti dipper and super dipper types (mmHg: 63.57±1.37 vs. 68.86±2.12, 67.15±1.56, 67.89±2.04, allP < 0.05). After treatment, the proportion of patients with dipper type [66.7% (64/96) vs. 54.4% (49/90)], no dipper type [11.5% (11/96) vs. 8.9% (8/90)], and super dipper type [5.2% (5/96) vs. 2.2% (2/90)] in experimental group was significantly higher than that in the control group, the proportion of patients with anti dipper type [16.7% (16/96) vs. 34.4% (31/90)] in experimental group were significantly lower than those in the control group (allP< 0.05).Conclusion The Rhubarb and ephedra prescription can obviously improve the blood gas analysis indexes, pulmonary function and blood pressure rhythm in patients with AECOPD.
3.Effects of Chinese rhubarb and ephedra prescription on pulmonary function and blood pressure rhythm in patients with chronic obstructive pulmonary disease in remission stage
Lijie YU ; Fengdan LI ; Hemei XIAO ; Xinfeng LEI ; Bingmao LI
Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care 2018;25(1):28-32
Objective To investigate the effect of Chinese rhubarb and ephedra prescription on the pulmonary function and blood pressure rhythm in patients with chronic obstructive pulmonary disease (COPD) in remission stage. Methods One hundred and fifty-two patients with COPD were admitted to Harrison International Peace Hospital from March 2014 to December 2016, and they were divided into a western medicine control group (72 cases) and a rhubarb and ephedra prescription group (80 cases) by random number table method, the conventional therapy was given to both groups, and in the rhubarb and ephedra group, additionally Chinese rhubarb and ephedra prescription (rhubarb 6 g, ephedra 5 g, agrimony 15 g, licorice 15 g) was applied, one dose orally taken daily, once 1/2 dose, 2 times a day, the therapeutic course being 3 months. The blood gas analysis, pulmonary function, 6-minute walking distance (6MWD) were detected, and modify medical research committee (mMRC) questionnaire for dyspnea score, the change of ambulatory blood pressure level monitoring and clinical effect were observed before and after treatment for 1, 2, 3 months. Results Compared with those before treatment, the blood gas indexes, the arterial partial pressure of oxygen (PaO2), arterial blood oxygen saturation (SaO2), and pulmonary function indexes, the percentage of one second forced expiratory volume (FEV1) in predictive value (FEV1%), the ratio of FEV1/forced vital capacity (FEV1/FVC) and 6MWD levels in both groups were continuously increased after treatment, while the arterial partial pressure of carbon dioxide (PaCO2) and mMRC score were persistently decreased after treatment in the two groups. After treatment for 2 months, compared with before treatment, the statistical differences appeared in the western medicine control group, while in the rhubarb and ephedra group, the statistical differences turned up after 1 month of treatment. After 3 months of treatment,the PaO2, SaO2, FEV1%, FEV1/FVC and 6MWD in the rhubarb and ephedra group were significantly higher than those in the western medicine control group [PaO2(mmHg, 1 mmHg = 0.133 kPa): 95.42±14.88 vs. 88.28±13.38, SaO2:0.97±0.02 vs. 0.96±0.02, FEV1%: 77.35±11.57 vs. 72.63±10.66, FEV1/FVC (%): 71.01±9.47 vs. 69.28±10.04, 6MWD (m): 318.0±40.1 vs. 306.6±35.7], PaCO2and mMRC were obviously lower in the rhubarb and ephedra group than those in the western medicine control group [PaCO2(mmHg): 40.35±7.58 vs. 43.57±7.85, mMRC score: 1.09±0.65 vs. 1.23±0.69], the differences of the two groups were statistically significant (all P < 0.05). After 3 months of treatment, in the western medicine control group, the percentage of patients with abnormal blood pressure rhythm was reduced to 44.4% (32/72), while in the rhubarb and ephedra group, was decreased to 32.5% (26/72), and the decrease amplitude of the rhubarb and ephedra group was greater than that of the western medicine control group (P > 0.05). The ratio of blood pressure morning peak in the rhubarb and ephedra group was significantly lower than that in the western medicine control group [23.8% (19/80) vs. 31.9% (23/72), P < 0.05], and the total effective rate in rhubarb and ephedra group was significantly higher than that in the western medicine control group [92.5% (74/80) vs. 73.6% (53/72), P < 0.05]. Conclusion Chinese rhubarb and ephedra prescription can improve indexes of blood gas analysis, pulmonary function and blood pressure rhythm in COPD patients in remission phase, and its clinical efficacy is significant.