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中华肺部疾病杂志(电子版)

中华肺部疾病杂志(电子版) ›› 2026, Vol. 19 ›› Issue (02) : 247 -252. doi: 10.3877/cma.j.issn.1674-6902.2026.02.010

论著

大黄辅助治疗多发伤继发急性肺损伤的研究
殷琴1, 晏宇涵2, 姚伟2, 徐成文2, 戴小龙2, 杨豪2, 徐春伟3, 王栋3, 袁明4,†(), 刘振玉2,†()   
  1. 1330006　南昌，南昌大学第一附属医院门诊部
    2330006　南昌，南昌大学第一附属医院急诊科（创伤急救中心）
    3210002　南京，南京大学医学院附属金陵医院呼吸与危重症医学科
    4361003　厦门，厦门大学附属成功医院呼吸内科
  • 收稿日期:2025-09-29 出版日期:2026-04-25
  • 通信作者: 袁明, 刘振玉
  • 基金资助:
    江西省卫生健康委科技计划项目(20231058)

Research on the use of rhubarb as an adjuvant therapy for multiple injuries induced acute lung injury

Qin Yin1, Yuhan Yan2, Wei Yao2, ChengWen Xu2, Xiaolong Dai2, Hao Yang2, ChunWei Xu3, Dong Wang3, Ming Yuan4,†(), ZhenYu Liu2,†()   

  1. 1Outpatient Department, The First Affiliated Hospital of Nanchang University, Nanchang 330006, China
    2Emergency Department (Trauma Emergency Center), The First Affiliated Hospital of Nanchang University, Nanchang 330006, China
    3Department of Respiratory and Critical Care Medicine, Jinling Hospital, Nanjing University School of Medicine, Nanjing 210002, China
    4Department of Respiratory Medicine, The Chenggong Hospital Affiliated to Xiamen University, Xiamen 361003, China
  • Received:2025-09-29 Published:2026-04-25
  • Corresponding author: Ming Yuan, ZhenYu Liu
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引用本文：

殷琴, 晏宇涵, 姚伟, 徐成文, 戴小龙, 杨豪, 徐春伟, 王栋, 袁明, 刘振玉. 大黄辅助治疗多发伤继发急性肺损伤的研究[J/OL]. 中华肺部疾病杂志(电子版), 2026, 19(02): 247-252.

Qin Yin, Yuhan Yan, Wei Yao, ChengWen Xu, Xiaolong Dai, Hao Yang, ChunWei Xu, Dong Wang, Ming Yuan, ZhenYu Liu. Research on the use of rhubarb as an adjuvant therapy for multiple injuries induced acute lung injury[J/OL]. Chinese Journal of Lung Diseases(Electronic Edition), 2026, 19(02): 247-252.

目的

探讨大黄辅助治疗对多发伤继发急性肺损伤(acute lung injury, ALI)患者的临床疗效，及对炎症因子、氧化应激指标的影响。

方法

选择2022年6月至2024年6月我院收治的89例多发伤继发ALI患者，根据治疗方法分为观察组52例和对照组37例，对照组采用常规治疗，观察组在对照组基础上加用大黄煎剂。比较两组治疗前后呼吸功能指标动脉血氧分压(partial pressure of oxygen in arterial blood, PaO2)/吸氧浓度(fraction of inspired oxygen, FiO2)、最大中期呼气流量(maximal mid-expiratory flow, MMEF)、用力肺活量(forced vital capacity, FVC)、第一秒用力呼气容积(forced expiratory volume in 1 second, FEV1)、炎症因子肿瘤坏死因子α(tumor necrosis factor-α，TNF-α)、白细胞介素6(interleukin-6, IL-6)、氧化应激指标超氧化物歧化酶(superoxide dismutase, SOD)、一氧化氮(nitric oxide, NO)，入住ICU时间、总住院时间、生存情况。

结果

治疗后观察组PaO2/FiO2(375.78±84.59)mmHg、MMEF(2.32±0.57)L/s、FVC(3.69±0.42)L、FEV1(76.23±8.33)%高于对照组PaO2/FiO2(323.45±73.45)mmHg、MMEF(1.85±0.42)L/s、FVC(3.16±0.38)L、FEV1(70.48±9.47)%(P<0.05)。观察组治疗后血清TNF-α(21.36±6.91)ng/L、IL-6(39.52±9.36)ng/L、NO(22.01±6.08)μmol/L低于对照组TNF-α(34.66±8.06)ng/L、IL-6(60.60±10.03)ng/L、NO(30.12±8.12)μmol/L(P<0.05)；观察组SOD(142.33±36.06)mU/L高于对照组(125.02±33.23)mU/L(P<0.05)。观察组入住ICU时间(9.02±3.26)d、总住院时间(17.02±6.14)d短于对照组入住ICU时间(11.21±4.36)d、总住院时间(20.16±8.33)d(P<0.05)。住院期间经治疗观察组生存折43例(82.69%)，死亡9例(17.31%)；对照组生存者26例(70.27%)，死亡11例(29.73%)(P>0.05)。

结论

大黄辅助治疗可改善多发伤继发ALI患者的肺通气及氧合功能，降低炎症因子水平，提高抗氧化能力，缩短住院时间。

关键词: 多发伤, 急性肺损伤, 大黄, 炎症因子, 氧化应激
Objective

To investigate the clinical efficacy of adjuvant therapy with rhubarb in patients with secondary acute lung injury (ALI) after multiple trauma, and its effects on inflammatory factors and oxidative stress indicators.

Methods

A total of 89 patients with secondary ALI after multiple trauma admitted to our hospital from June 2022 to June 2024 were enrolled and divided into a control group 37 cases and an observation group 52 cases. The control group received conventional treatment, while the observation group received rhubarb decoction in addition to conventional treatment. Respiratory function indicators [partial pressure of oxygen in arterial blood (PaO2)/ fraction of inspired oxygen (FiO2), maximal mid-expiratory flow (MMEF), forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1)], inflammatory factors [tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6)], oxidative stress indicators [superoxide dismutase (SOD), nitric oxide (NO)], as well as ICU stay, total hospital stay, and survival status were compared between the two groups before and after treatment.

Results

After treatment, the observation group showed significantly higher values of PaO2/FiO2 (375.78±84.59 mmHg), MMEF (2.32±0.57 L/s), FVC (3.69±0.42 L), and FEV1 (76.23±8.33%) than the control group [PaO2/FiO2 (323.45±73.45 mmHg), MMEF (1.85±0.42 L/s), FVC (3.16±0.38 L), FEV1 (70.48±9.47%)] (all P<0.05). After treatment, serum levels of TNF-α (21.36±6.91 ng/L), IL-6 (39.52±9.36 ng/L), and NO (22.01±6.08 μmol/L) in the observation group were significantly lower than those in the control group [TNF-α(34.66±8.06 ng/L), IL-6 (60.60±10.03 ng/L), NO (30.12±8.12 μmol/L)] (all P<0.05); the SOD level in the observation group (142.33±36.06 mU/L) was higher than that in the control group (125.02±33.23 mU/L) (P<0.05). The observation group had shorter ICU stay (9.02±3.26 d) and total hospital stay (17.02±6.14 d) than the control group (11.21±4.36 d and 20.16±8.33 d, respectively) (both P<0.05). During hospitalization, 43 patients (82.69%) survived and 9 (17.31%) died in the observation group, compared with 26 survivors (70.27%) and 11 deaths (29.73%) in the control group (P>0.05).

Conclusion

Adjuvant therapy with rhubarb can improve pulmonary ventilation and oxygenation function, reduce inflammatory factor levels, enhance antioxidant capacity, and shorten hospital stay in patients with secondary ALI after multiple trauma.

Key words: Multiple trauma, Acute lung injury, Rhubarb, Inflammatory factors, Oxidative stress
图1 多发伤继发ALI患者纳入排除流程图
表1 两组创伤继发性ALI患者呼吸功能指标结果( ±s)
组　别 例数 PaO2/FiO2(mmHg) MMEF(L/s) FVC(L) FEV1(%)
治疗前 治疗后 治疗前 治疗后 治疗前 治疗后 治疗前 治疗后
观察组 52 218.77±72.45 375.78±84.59 0.66±0.16 2.32±0.57 2.29±0.35 3.69±0.42 62.49±8.89 76.23±8.33
对照组 37 225.45±64.37 323.45±73.45 0.63±0.18 1.85±0.42 2.31±0.33 3.16±0.38 63.35±9.77 70.48±9.47
t值   0.448 3.034 0.827 4.247 0.272 6.101 0.431 3.031
P值   0.654 0.003 0.410 0.000 0.786 0.000 0.667 0.003
表2 两组创伤继发性ALI患者炎症因子及氧化应激指标结果( ±s)
组　别 例数 TNF-α(ng/L) IL-6(ng/L) SOD(mU/L) NO(μmol/L)
治疗前 治疗后 治疗前 治疗后 治疗前 治疗后 治疗前 治疗后
观察组 52 52.03±17.71 21.36±6.91 88.03±24.91 39.52±9.36 99.72±24.11 142.33±36.06 44.04±8.18 22.01±6.08
对照组 37 55.55±15.48 34.66±8.06 86.36±20.88 60.60±10.03 95.36±22.62 125.02±33.23 42.36±9.33 30.12±8.12
t值   0.973 8.348 0.333 10.159 0.862 2.304 1.093 5.389
P值   0.333 0.000 0.740 0.000 0.391 0.024 0.277 0.000
图2 创伤继发性ALI典型患者胸部CT图。图A为治疗前可见左上肺少许半片状高密度影；图B为治疗后可见左上肺及两肺下叶见斑片、条索状密度影，提示治疗效果相对温和；图C为治疗前可见两肺斑片状密度增高影；图D为治疗后可见两肺斑片状密度增高影较前明显减少，说明治疗效果良好
1
张鹏，史慢慢，马辉，等. 急性呼吸窘迫综合征患者机械通气动脉血二氧化碳分压变异率与预后风险相关性[J/OL]. 中华肺部疾病杂志(电子版), 2025, 18(2): 226-230.
2
王辰，詹庆元. 急性肺损伤与急性呼吸窘迫综合征的临床管理进展[J]. 中华医学杂志，2024, 104(12): 889-895.
3
Li Y, Zhang H, Wang L, et al. Emodin inhibits NLRP3 inflammasome activation to alleviate lipopolysaccharide-induced acute lung injury in mice[J]. Int Immunopharmacol, 2023, 118: 110245.
4
Zhao X, Liu J, Chen M, et al. Rhubarb extract protects against sepsis-induced acute lung injury by regulating NF-κB signaling pathway[J]. J Ethnopharmacol, 2022, 298: 115689.
5
刘振玉，徐成文，姚伟. 大黄煎剂对急性肺损伤大鼠肺组织SOD活性及MDA含量的影响[J]. 中国中医急症，2022, 31(5): 821-823.
6
陈明，李娟，张伟. 大黄素对创伤后急性肺损伤患者炎症因子及预后的影响[J]. 中国中西医结合急救杂志，2023, 30(2): 165-168.
7
Ranieri VM, Rubenfeld GD, Thompson BT, et al. Acute respiratory distress syndrome: the berlin definition[J]. JAMA, 2012, 307(23): 2526-2533.
8
中华医学会创伤学分会. 多发伤救治指南(2024版)[J]. 中华创伤杂志，2024, 40(4): 241-248.
9
Wang H, Zhang Y, Li J, et al. Role of oxidative stress in acute lung injury and potential antioxidant therapies[J]. Oxid Med Cell Longev, 2023, 2023: 5689021.
10
Zhang C, Wang X, Zhao Y, et al. Tumor necrosis factor-α induces alveolar epithelial cell apoptosis via the mitochondrial pathway in acute lung injury[J]. Mol Med Rep, 2022, 26 (4): 168.
11
李萌，王磊，赵越. IL-6在创伤后急性肺损伤中的作用及靶向治疗进展[J]. 中华创伤急救杂志，2023, 39(7): 665-669.
12
Dinarello CA. Interleukin-6: from basic biology to selective inhibition[J]. Eur J Immunol, 2022, 52 (1): 3-18.
13
Wu D, Chen L, Li Y, et al. Nitric oxide-mediated endothelial dysfunction in acute lung injury[J]. Front Physiol, 2023, 14: 1068907.
14
谭宜，许新才，万秋风，等. 麦冬皂苷D对急性肺损伤和肠黏膜屏障损伤的保护作用[J/OL]. 中华肺部疾病杂志(电子版), 2025, 18(4): 527-533.
15
Vallance P, Leiper J. Nitric oxide and the vascular endothelium[J]. Philos Trans R Soc Lond B Biol Sci, 2020, 375(1803): 20190297.
16
Nossaman BD, Kadowitz PJ. Stimulators of soluble guanylyl cyclase: future clinical indications[J]. Ochsner J, 2013, 13(1): 147-56.
17
Allbritton-King JD, García-Cardeña G. Endothelial cell dysfunction in cardiac disease: driver or consequence？[J]. Front Cell Dev Biol, 2023, 11: 1278166.
18
Nejmanová I, Vitverová B, Eissazadeh S, et al. High soluble endoglin levels affect aortic vascular function during mice aging[J]. J Cardiovasc Dev Dis, 2021, 8(12): 173.
19
Aryal B, Suárez Y. Non-coding RNA regulation of endothelial and macrophage functions during atherosclerosis[J]. Vascul Pharmacol, 2019, 114: 64-75.
20
Chen Z, Haus JM, Chen L, et al. CCL28-induced CCR10/eNOS interaction in angiogenesis and skin wound healing[J]. FASEB J, 2020, 34(4): 5838-5850.
21
Halliwell B. Oxidative stress and its implications for health[J]. J R Soc Interface, 2021, 18(183): 20210372.
22
王艳，李娜，张超. 超氧化物歧化酶在急性肺损伤中的保护作用及调控机制[J]. 中国病理生理杂志，2023, 39(5): 951-956.
23
Averill-Bates Diana. Reactive oxygen species in cell signaling[J]. Biochim Biophys Acta Mol Cell Res, 2024, 1871(2): 119573.
24
Zhou J, Li XY, Liu YJ, et al. Full-coverage regulations of autophagy by ROS: from induction to maturation[J]. Autophagy, 2022, 18(6): 1240-1255.
25
Sugimoto M, Ko R, Goshima H, et al. Formononetin attenuates H2O2-induced cell death through decreasing ROS level by PI3K/Akt-Nrf2-activated antioxidant gene expression and suppressing MAPK-regulated apoptosis in neuronal SH-SY5Y cells[J]. Neurotoxicology, 2021, 85: 186-200.
26
Lin YJ, Li XN, Chen XM, et al. γ-aminobutyric acid effectively modulate growth performance, physiological response of largemouth bass (Micropterus Salmoides) under combined stress of flow velocity and density[J]. Aquac Nutr, 2024, 2024: 9180554.
27
Lewis L, Valvi D, Gedaly R, et al. Mitochondrial unfolded protein response in regulatory T cell function: a protective mechanism in immune aging[J]. Front Immunol, 2025, 16: 1621759.
28
Dörschmann P, Prinz M, Schmitkall G, et al. Specific assay protocols for porcine single-eye retinal pigment epithelium concerning oxidative stress and inflammation[J]. Int J Mol Sci, 2025, 26(17): 8434.
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