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丹芪精颗粒对急进高原人员的防护作用:高原野外现场队列研究

李敏 陆柏辰 齐小荣 王鹏 秦丽

李敏, 陆柏辰, 齐小荣, 王鹏, 秦丽. 丹芪精颗粒对急进高原人员的防护作用:高原野外现场队列研究[J]. 解放军医学院学报.
引用本文: 李敏, 陆柏辰, 齐小荣, 王鹏, 秦丽. 丹芪精颗粒对急进高原人员的防护作用:高原野外现场队列研究[J]. 解放军医学院学报.
LI Min, LU Baichen, QI Xiaorong, WANG Peng, QIN Li. Protective effect of Danqijing granules on acute high altitude exposure: A field cohort study on plateau[J]. ACADEMIC JOURNAL OF CHINESE PLA MEDICAL SCHOOL.
Citation: LI Min, LU Baichen, QI Xiaorong, WANG Peng, QIN Li. Protective effect of Danqijing granules on acute high altitude exposure: A field cohort study on plateau[J]. ACADEMIC JOURNAL OF CHINESE PLA MEDICAL SCHOOL.

丹芪精颗粒对急进高原人员的防护作用:高原野外现场队列研究

基金项目: 军委后勤保障部中医药服务能力培育与提升专项计划(2021ZY047)
详细信息
    作者简介:

    李敏,女,博士研究生,副主任医师、副教授,研究方向:中西医结合防治肺损伤的临床与基础研究。Email:kittenlee1115@126.com

  • 中图分类号: R286

Protective effect of Danqijing granules on acute high altitude exposure: A field cohort study on plateau

  • 摘要:   背景  急进高原作训如果减少阶梯习服或低氧预适应训练,会增加急性高原病(AMS)的发生风险。AMS是因急性缺氧而引起的潜在致命性疾病,可直接导致作训减员。因此,积极进行药物研发,预防AMS的发生具有十分重要的意义。 目的  观察口服丹芪精颗粒对快速进入高原地区人员发生急性高原反应的防护作用。  方法  以2022年6月某部参加高原训练分队的男性官兵为研究对象,采用前瞻性、随机、对照临床试验设计,共纳入80例(18 ~ 35岁官兵),随机分为治疗组和对照组,每组40例。治疗组口服丹芪精颗粒(主要由黄芪、丹参、黄精等药物组成),对照组口服红景天胶囊(主要成分为红景天),于进驻高原前7天开始口服,共给予14天。比较两组在进驻高原后第1天(T1)、第3天(T2)、第7天(T3)时一般情况、中医证候分级量化表和AMS量表评分、血清肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、白细胞介素-8(IL-8)水平及药物安全性指标。  结果  两组受试者的收缩压(mm/Hg),舒张压(mm/Hg),心率(次/分),SpO2(%)在各个时间点比较无统计学意义(P>0.05)。两组进驻高原后第7天中医证候积分与本组进驻高原后第1天比较均下降显著(P<0.05),且治疗组较对照组下降显著(P<0.01)。与进驻第1天比较,在进驻第3天、7天时两组TNF-α、IL-6水平均降低(P<0.01),且治疗组优于对照组(P<0.05)。IL-8水平及AMS发生率组间差异无统计学意义(P>0.05)。肝、肾等指标均未见异常。  结论  丹芪精颗粒可减少中医证候分级量化表评分,改善急进高原人员临床症状;可能通过降低血清TNF-α、IL-6水平,对急性高原暴露人员发生AMS起到防护作用。

     

  • 表  1  两组基线资料比较

    Table  1.   Comparison of baseline data between the two groups

    指标治疗组(n=40)对照组(n=40)tP
    年 龄/岁24.20 ± 3.3325.60 ± 3.911.7250.089
    身 高/cm173.48 ± 5.12173.40 ± 5.770.0620.951
    体 重/kg66.32 ± 8.4569.46 ± 8.371.6690.099
    心 率/(次/分)75.13 ± 8.8273.18 ± 11.180.8660.389
    收缩压/(mmHg)117.88 ± 8.13116.00 ± 8.960.9800.330
    舒张压/(mmHg)71.70 ± 9.2768.58 ± 7.271.6770.097
    SpO2/%96.23 ± 4.3396.50 ± 2.050.3630.718
    下载: 导出CSV

    表  2  两组干预后基础指标比较

    Table  2.   Comparison of general conditions before and after treatment between the two groups

    指标 时间点 治疗组(n=40) 对照组(n=40) 球形检验(Huynh-Feldt ε)组间(F,P)时间(F,P)交互(F,P)
    收缩压/(mmHg)T1127.42 ± 10.70123.98 ± 11.610.9820.847,0.3631.261,0.2950.447,0.643
    T2126.05 ± 8.21123.63 ± 10.38
    T3125.78 ± 8.90124.28 ± 7.11
    舒张压/(mmHg)T181.25 ± 9.1979.00 ± 8.940.9351.536,0.2232.681,0.0810.134,0.875
    T278.65 ± 8.4477.28 ± 8.91
    T380.30 ± 9.2878.18 ± 7.97
    心率/(次/分)T182.85 ± 12.4582.53 ± 10.160.9760.071,0.9310.038,0.8461.116,0.338
    T282.08 ± 9.4084.33 ± 11.07
    T383.53 ± 10.4282.73 ± 8.87
    SpO2/%T185.45 ± 5.4486.53 ± 4.901.0000.436,0.5130.429,0.6541.573,0.221
    T286.55 ± 4.8684.93 ± 7.28
    T386.82 ± 4.3485.93 ± 4.00
    下载: 导出CSV

    表  3  进驻高原后两组AMS发生率比较[例(%)]

    Table  3.   Comparison of AMS severity in two groups at different time points after rushing to plateau (n [%])

    指标时间点治疗组(n=40)对照组(n=40)χ2P
    T1无症状39(97.50)35(87.50)8.0000.238
    轻度1(2.50)2(5.00)
    中度0(0)0(0)
    重度0(0)3(7.50)
    T2无症状37(92.50)36(90.00)12.0000.213
    轻度2(5.00)1(2.50)
    中度1(2.50)3(7.50)
    重度0(0)0(0)
    T3无症状40(100.00)37(92.50)4.0000.135
    轻度0(0)3(7.50)
    中度0(0)0(0)
    重度0(0)0(0)
    下载: 导出CSV

    表  4  两组干预后中医证候分级量化表评分比较[Md(IQR), 分]

    Table  4.   Comparison of TCM syndrome grading scale scores before and after treatment between the two groups (Md[IQR],score)

    组 别中医证候分级量化表评分tP
    治疗组(n=40)对照组(n=40)
    T11.80 ± 1.991.70 ± 2.110.2180.828
    T70.38 ± 0.630.88 ± 1.382.085
    0.0400
    t4.3202.066
    P<0.0010.042
    下载: 导出CSV

    表  5  两组干预后血清炎症因子相关指标比较(pg/mL)

    Table  5.   Comparison of serum inflammatory cytokines before and after treatment between the two groups (pg/mL)

    指标 时间点 治疗组(n=40) 对照组(n=40) 球形检验(Huynh-Feldt ε)组间(F, P)时间(F, P)交互(F, P)
    IL-6T132.25 ± 11.9333.60 ± 16.680.995732.53,
    <0.001
    143.93,
    <0.001
    4.990,
    0.009
    T238.58 ± 10.9137.72 ± 11.41
    T314.77 ± 7.3921.45 ± 12.40a
    IL-8T1414.03 ± 164.00418.22 ± 358.050.8301.085,
    0.301
    13.217,
    <0.001
    2.487,
    0.086
    T2502.93 ± 218.18668.75 ± 882.85
    T3349.21 ± 210.41481.14 ± 572.68a
    TNF-aT137.03 ± 11.8344.85 ± 23.060.9735.064,
    0.026
    97.039,
    <0.001
    3.339,
    0.041
    T243.97 ± 13.2748.78 ± 26.06
    T319.93 ± 8.9632.53 ± 22.40
    aP<0.05, vs 治疗组
    下载: 导出CSV
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  • 收稿日期:  2023-02-22
  • 网络出版日期:  2023-04-10

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