针刺疗法联合丹红注射液对感染性休克患者治疗效果及对心肌保护作用分析
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摘要
目的:研究针刺疗法联合丹红注射液对感染性休克患者的治疗效果及对心肌保护作用。方法:选取我院2015年5月—2017年5月收治的50例感染性休克患者进行研究,将所有患者按照不同治疗方法分为实验组和对照组,每组各25例患者。对照组患者应用针刺疗法治疗,实验组则应用针刺疗法联合丹红注射液治疗。观察并比较两组患者临床疗效、生命体征、白细胞计数、PCT(血小板压积值)、IL-6(白细胞介素-6)、BNP(脑利钠肽)、hsCRP(超敏C-反应蛋白)、c Tn(心肌肌钙蛋白)、APACHEⅡ评分(急性生理与慢性健康评分)以及心功能指标情况。I结果:治疗后,实验组患者总有效率达到88%,而对照组仅为64%,两组比较差异显著(P<0.05)。两组患者治疗后体温、呼吸、心率和白细胞计数均较治疗前显著下降,且实验组患者相应指标改善情况均优于对照组患者(P<0.05)。两组患者PCT、IL-6以及BNP水平在治疗后均出现显著下降,且实验组相关水平下降程度与对照组比较更显著(P<0.05)。两组患者hs-CRP、c Tn I以及APACHEⅡ评分在治疗后均有明显下降,且实验组各指标水平下降较对照组更显著(P<0.05)。两组患者LVEDD(左心室舒张末期内径)、LVESD(左心室收缩末期内径)、LAD(左房内径)、LVPWH(左室后壁舒张期厚度)在治疗后均出现显著下降,LVEF(左心射血分数)水平则显著上升,且实验组相关水平改善程度与对照组比较更显著(P<0.05)。结论:针刺疗法联合丹红注射液对治疗感染性休克不仅可有效改善患者白细胞计数、生命体征以及心功能指标,还能有效降低患者PCT、IL-6、BNP、hs-CRP、c Tn I、APACHEⅡ评分,其临床疗效显著,可在临床推广。
Objective:To study effect of acupuncture combined with Danhong Injection on the treatment of septic shock and its myocardial protection. Methods:50 patients with septic shock from May 2015 to May 2017 were selected,all patients were divided into experiment group and control group according to the different treatment methods. Control group were treated by acupuncture,experiment group were using acupuncture combined with Danhong Injection. They were compared with the clinical efficacy,leukocyte count,vital signs,PCT,IL-6,BNP,hs-CRP,c Tn I,APACHEⅡ scores and heart function index the situation. Results:After treatment,the total effective rate of the experiment group was 88%,while the control group was only 64%,the difference between the two groups was significant(P<0.05). The body temperature,respiratory rate,heart rate and white blood cell count of the two groups were significantly lower than those before treatment,and the improvement of the corresponding indexes in the experimental group was better than that in the control group(P<0.05). The levels of PCT,IL-6 and BNP in the two groups were significantly decreased after treatment,and the level of correlation in the experimental group was more significant than that of the control group(P<0.05). The level of hs-CRP,c Tn I and APACHEⅡ scores in the two groups were significantly decreased after treatment,and the levels of the indexes in the experimental group were lower than those in the control group(P<0.05). Two patients in group LVEDD,LVESD,LAD,LVPWH were decreased significantly after treatment,LVEF level increased significantly,and the level of the degree of improvement of experimental group more significant compared with the control group(P<0.05). Conclusion:Acupuncture combined with Danhong Injection in the treatment of septic shock can not only effectively improve the white blood cell count,patients' vital signs and heart function index,can effectively reduce the patients with PCT,IL-6,BNP,hs-CRP,c Tn I,APACHEⅡ scores. Its clinical curative effect is remarkable,and can be popularized in clinic.
Objective:To study effect of acupuncture combined with Danhong Injection on the treatment of septic shock and its myocardial protection. Methods:50 patients with septic shock from May 2015 to May 2017 were selected,all patients were divided into experiment group and control group according to the different treatment methods. Control group were treated by acupuncture,experiment group were using acupuncture combined with Danhong Injection. They were compared with the clinical efficacy,leukocyte count,vital signs,PCT,IL-6,BNP,hs-CRP,c Tn I,APACHEⅡ scores and heart function index the situation. Results:After treatment,the total effective rate of the experiment group was 88%,while the control group was only 64%,the difference between the two groups was significant(P<0.05). The body temperature,respiratory rate,heart rate and white blood cell count of the two groups were significantly lower than those before treatment,and the improvement of the corresponding indexes in the experimental group was better than that in the control group(P<0.05). The levels of PCT,IL-6 and BNP in the two groups were significantly decreased after treatment,and the level of correlation in the experimental group was more significant than that of the control group(P<0.05). The level of hs-CRP,c Tn I and APACHEⅡ scores in the two groups were significantly decreased after treatment,and the levels of the indexes in the experimental group were lower than those in the control group(P<0.05). Two patients in group LVEDD,LVESD,LAD,LVPWH were decreased significantly after treatment,LVEF level increased significantly,and the level of the degree of improvement of experimental group more significant compared with the control group(P<0.05). Conclusion:Acupuncture combined with Danhong Injection in the treatment of septic shock can not only effectively improve the white blood cell count,patients' vital signs and heart function index,can effectively reduce the patients with PCT,IL-6,BNP,hs-CRP,c Tn I,APACHEⅡ scores. Its clinical curative effect is remarkable,and can be popularized in clinic.
引文
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[9]郑喜胜,史进,倪猛,等.血必净联合乌司他汀治疗感染性休克患者的临床疗效观察[J].中华医院感染学杂志,2016,14(4):769-771.
[10]林兵,吴伟,张伟清,等.针刺患者足三里、关元穴对感染性休克的治疗效果研究[J].中华医院感染学杂志,2017,27(4):766-769.
[11]王一凡,曾杰,付晶,等.生脉注射液对感染性休克患者氧代谢及血清细胞因子的影响研究[J].中华医院感染学杂志,2016,26(23):5421-5423.
[12]Zhang M,Zou L,Feng Y,et al.Toll-like receptor 4 is essential to preserving cardiac function and survival in low-grade polymicrobial sepsis[J].Anesthesiology,2014,121(6):1270-1280.
[13]Gon?alves RP,Guarido KL,Assreuy J,et al.Gender-specific differences in the in situ cardiac function of endotoxemic rats detected by pressure-volume catheter[J].Shock,2014,42(5):415-423.
[14]杨玲,尹春元,吕欣,等.早期脑钠肽、C反应蛋白、乳酸水平联合检查评估老年感染性休克患者预后的临床价值[J].中国老年学杂志,2016,21(4):940-941.
[15]方向明,易高,王志敏,等.乌司他丁联合阿托莫兰对感染性休克患者血清IL-6,TNF-α和PCT水平的影响[J].现代生物医学进展,2017,17(3):496-499.
[2]程山凤,严长苏,郑秀珍,等.ICU患者感染性休克死亡危险因素分析[J].中华医院感染学杂志,2015,15(3):595-596,602.
[3]De Geer L,Engvall J,Oscarsson A.Strain echocardiography in septic shock-a comparison with systolic and diastolic function parameters,cardiac biomarkers and outcome[J].Critical care,2015,19(1):857.
[4]Hsu JH,Yang RC,Lin SJ,et al.Exogenous heat shock cognate protein 70 pretreatment attenuates cardiac and hepatic dysfunction with associated anti-inflammatory responses in experimental septic shock[J].Shock,2014,42(6):540-547.
[5]刘婕,陶晔璇,蔡威,等.液体复苏对感染性休克儿童病死率影响的meta分析[J].临床儿科杂志,2014,32(1):70-75.
[6]赵映,刘苏,刘淑芳,等.脑钠肽水平对感染性休克患者心功能的评估研究[J].中华医院感染学杂志,2015,28(13):2891-2893.
[7]吕雪.重症监护室感染性休克患者预后死亡的危险因素分析[J].中国卫生统计,2015,32(5):803-804,807.
[8]Gelo?n A,Quintin L.Reverse Physiology,i.e.,Cellular Versus Integrative Versus Comparative Physiology?α-2 Agonists and Septic Shock[J].Critical care medicine,2016,44(4):e238-e239.
[9]郑喜胜,史进,倪猛,等.血必净联合乌司他汀治疗感染性休克患者的临床疗效观察[J].中华医院感染学杂志,2016,14(4):769-771.
[10]林兵,吴伟,张伟清,等.针刺患者足三里、关元穴对感染性休克的治疗效果研究[J].中华医院感染学杂志,2017,27(4):766-769.
[11]王一凡,曾杰,付晶,等.生脉注射液对感染性休克患者氧代谢及血清细胞因子的影响研究[J].中华医院感染学杂志,2016,26(23):5421-5423.
[12]Zhang M,Zou L,Feng Y,et al.Toll-like receptor 4 is essential to preserving cardiac function and survival in low-grade polymicrobial sepsis[J].Anesthesiology,2014,121(6):1270-1280.
[13]Gon?alves RP,Guarido KL,Assreuy J,et al.Gender-specific differences in the in situ cardiac function of endotoxemic rats detected by pressure-volume catheter[J].Shock,2014,42(5):415-423.
[14]杨玲,尹春元,吕欣,等.早期脑钠肽、C反应蛋白、乳酸水平联合检查评估老年感染性休克患者预后的临床价值[J].中国老年学杂志,2016,21(4):940-941.
[15]方向明,易高,王志敏,等.乌司他丁联合阿托莫兰对感染性休克患者血清IL-6,TNF-α和PCT水平的影响[J].现代生物医学进展,2017,17(3):496-499.