湖南中医杂志2025，Vol.41Issue(12)：12-17,6.DOI:10.16808/j.cnki.issn1003-7705.2025.12.003
基于支饮理论应用苓桂术甘汤治疗阳虚水泛型心源性撤机困难40例
Clinical effect of Linggui Zhugan decoction in treatment of cardiogenic difficult ventilator weaning with water overflowing due to Yang deficiency based on the theory of thoracic fluid retention:An analysis of 40 cases
摘要
Abstract
Objective:To investigate the clinical effect of Linggui Zhugan decoction in the treatment of cardiogen-ic difficult ventilator weaning with water overflowing due to Yang deficiency based on the theory of thoracic fluid retention.Methods:A total of 80 patients with cardiogenic difficult ventilator weaning with water overflowing due to Yang deficiency were randomly divided into treatment group and control group,with 40 patients in each group.The patients in the con-trol group were given conventional Western medicine treatment,while those in the treatment group were given Linggui Zhu-gan decoction in addition to the treatment in the control group;the course of treatment was 2 weeks for both groups.The two groups were compared in terms of traditional Chinese medicine(TCM)syndrome score,N-terminal pro-brain natri-uretic peptide(NT-proBNP),hemoglobin(Hb),central venous oxygen saturation(ScvO2),cardiopulmonary ultrasound parameters,Acute Physiology and Chronic Health Evaluation Ⅱ(APACHE Ⅱ)score,Sequential Organ Failure Assess-ment(SOFA)score,duration of mechanical ventilation after enrollment,success rate of ventilator weaning,28-day mortal-ity rate,and adverse drug reactions.Results:After treatment,both groups had an improvement in TCM syndrome score,a re-duction in NT-proBNP,and an increase in ScvO2,and the treatment group had significantly better improvements than the control group(P＜0.05).As for cardiopulmonary ultrasound parameters,both groups had significant changes in left ven-tricular end-diastolic diameter,left ventricular end-systolic diameter,lung ultrasound score,and left ventricular ejection frac-tion after treatment,and there were significant differences in these parameters between the two groups after treatment(P＜0.05).After treatment,both groups had significant reductions in APACHE Ⅱ score and SOFA score,and the treat-ment group had significantly better improvements than the control group(P＜0.05).Compared with the control group,the treatment group had a significantly shorter duration of mechanical ventilation after enrollment,a significantly higher success rate of ventilator weaning,and a significantly lower 28-day mortality rate(P＜0.05).No adverse drug reaction was observed in either group during treatment.Conclusion:Under the guidance of the theory of thoracic fluid retention,Linggui Zhugan de-coction combined with conventional Western medicine treatment can warm Yang and transform water,and it can also signifi-cantly improve cardiac function,alleviate pulmonary edema,increase the success rate of ventilator weaning,and reduce 28-day mortality rate in patients with cardiogenic difficult ventilator weaning,without obvious adverse reactions.Therefore,it holds promise for clinical application.关键词
心源性撤机困难/阳虚水泛型/苓桂术甘汤/支饮理论Key words
cardiogenic difficult ventilator weaning/edema syndrome due to Yang deficiency/Linggui Zhugan decoction/theory of thoracic fluid retention分类
医药卫生引用本文复制引用
许慧,何浩,张慧明..基于支饮理论应用苓桂术甘汤治疗阳虚水泛型心源性撤机困难40例[J].湖南中医杂志,2025,41(12):12-17,6.基金项目
全国中医药创新骨干人才项目(国中医药人教函[2019]128号) （国中医药人教函[2019]128号）
湖南省中医药科研计划项目(B2023066) （B2023066）
