参附注射液治疗升压药依赖性感染性休克患者临床疗效观察
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摘要
目的观察参附注射液对升压药依赖性感染性休克的临床疗效。方法将81例升压药依赖性感染性休克患者随机分为对照组(41例)和治疗组(40例),对照组给予常规治疗,治疗组在常规治疗的基础上联用参附注射液100 mL/d。至患者病情稳定,升压药停用为治疗结束。记录两组升压药减量时间和使用时间,比较两组急性生理与慢性健康状况评分Ⅱ评分(APACHE-Ⅱ评分)、序贯性器官功能衰竭评分(SOFA评分)以及中医临床疗效。结果与本组治疗前比较,治疗后两组APACHE-Ⅱ评分和SOFA评分下降(P<0.01)。与对照组比较,治疗组治疗后APACHE-Ⅱ评分以及升压药平均减量时间、升压药用药总时间降低(P<0.05,P<0.01),中医疗效提高(P<0.05)。结论参附注射液能够改善感染性休克患者对升压药的依赖性,并提高中医疗效。
Objective To observe the clinical effect of Shenfu Injection on septic shock with vasopressor dependence. Methods Totally 81 cases of vasopressor dependent septic shock patients were randomly assigned to the control group(41 cases) and the treatment group(40 cases). The control group was treated with routine treatment. The treatment group was treated with Shenfu Injection 100 mL/day combined with routine treatment. Treatment was completed when the patients were in stable condition and the vasopressor was withdraw. The vasopressor reduction time and using time were recorded. Acute physiology and chronic health evaluation scoring system Ⅱ(APACHE-Ⅱ) score,sequential organ failure assessement(SOFA) score and the Chinese medicine curative effect were compared. Results The APACHE-Ⅱ score and SOFA score in two groups decreased after treatment(P<0.01). Compared with the control group, average reduction time and totally using time of vasopressor, APACHE-Ⅱ score in the treatment group decreased(P<0.05, P<0.01), while Chinese medicine curative effect improved(P<0.05). Conclusion Shenfu Injection can improve the dependence of vasopressor in septic shock patients and improve the Chinese medicine curative effect.
Objective To observe the clinical effect of Shenfu Injection on septic shock with vasopressor dependence. Methods Totally 81 cases of vasopressor dependent septic shock patients were randomly assigned to the control group(41 cases) and the treatment group(40 cases). The control group was treated with routine treatment. The treatment group was treated with Shenfu Injection 100 mL/day combined with routine treatment. Treatment was completed when the patients were in stable condition and the vasopressor was withdraw. The vasopressor reduction time and using time were recorded. Acute physiology and chronic health evaluation scoring system Ⅱ(APACHE-Ⅱ) score,sequential organ failure assessement(SOFA) score and the Chinese medicine curative effect were compared. Results The APACHE-Ⅱ score and SOFA score in two groups decreased after treatment(P<0.01). Compared with the control group, average reduction time and totally using time of vasopressor, APACHE-Ⅱ score in the treatment group decreased(P<0.05, P<0.01), while Chinese medicine curative effect improved(P<0.05). Conclusion Shenfu Injection can improve the dependence of vasopressor in septic shock patients and improve the Chinese medicine curative effect.
引文
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[12] Guo Z,Li C.Therapeutic effects of shenfu injection on post-cardiac arrest syndrome[J].Chin J Integr Med,2013,19(9):716-720.
[13] Xiao P,Wang F,Feng G,et al.A pharmacophylogenetic study of Aconitum L.(Ranunculaceae) from China[J].Acta Phytotaxonomica Sinica,2006,44(1):1-46.
[14] Yue H,Pi Z,Song F,et al.Studies on the aconitine-type alkaloids in the roots of Aconitum Carmichaeli Debx.by HPLC/ESIMS/MS(n) [J].Talanta,2009,77(5):1800-1807.
[15] 殷文朋,李春盛.参附注射液对心源性休克犬血流动力学及氧代谢的影响[J].中国中西医结合急救杂志,2008,15(1):20-23.
[16] 陈鹏,郭瑞敏,孙燕妮.参附注射液对感染性休克患者的血流动力学影响的研究进展[J].中国中医急症,2018,27(5):911-914.
[17] 岳胜,朱平,岳磊,等.参附注射液在感染性休克的疗效分析[J].北方药学,2017,14(1):100-101.
[18] Mou Z,Lv Z,Li Y,et al.Clinical effect of Shenfu injection in patients with septic shock:a meta-analysis and systematic review[J].Evid Based Complement Alternat Med,2015,2015:863149.
[19] 卓道勤,吕国焰,闵磊,等.参附注射液对感染性休克早期血流动力学紊乱干预性研究[J].中国中医急症,2011,20(12):2005.
[2] 宗学奎,林丽华.参附注射液拮抗升压药依赖临床观察[J].山东中医杂志,2000,19(4):204-205.
[3] Rhodes A,Evans LE,Alhazzani W,et al.Surviving sepsis campaign:international guidelines for management of sepsis and septic shock:2016[J].Crit Care Med,2017,43(3):486-552.
[4] 中华人民共和国卫生部药政局.中药治疗厥脱证的临床研究指导原则[J].中国医药学报,1989,4(1):71-73.
[5] 中国中西医结合学会急救医学专业委员会.重修“95庐山会议”多器官功能障碍综合征病情分期诊断及严重程度评分标准(2015)[J].中华危重病急救医学,2016(2):99-101.
[6] Patel GP,Grahe JS,Sperry M,et al.Efficacy and safety of dopamine versus norepinephrine in the management of septic shock[J].Shock,2010,33(4):375-380.
[7] Du Y,Wang L,Shi H,et al.Comparison of clinical effect of dopamine and norepinephrine in the treatment of septic shock[J].Pak J Pharm Sci,2015,28(4 Suppl):1461.
[8] Knaus WA,Draper EA,Wagner DP,et al.APACHE Ⅱ:a severity of disease classification system[J].Crit Care Med,1985,13(10):818-829.
[9] Vincent JL,Moreno R,Takala J,et al.The SOFA (Sepsis-related Organ Failure Assessment) score to describe organ dysfunction/failure.On behalf of the Working Group on Sepsis-Related Problems of the European Society of Intensive Care Medicine[J].Intensive Care Med,1996,22(7):707-710.
[10] Thwaites CL,Lundeg G,Dondorp AM.Recommendations for infection management in patients with sepsis and septic shock in resource-limited settings[J].Intensive Care Med,2016,42(12):2040-2042.
[11] 田鲜美,王玫,任传云,等.参附注射液治疗脓毒症休克(阳脱证)的临床疗效观察[J].北京中医药,2017,36(1):88-91.
[12] Guo Z,Li C.Therapeutic effects of shenfu injection on post-cardiac arrest syndrome[J].Chin J Integr Med,2013,19(9):716-720.
[13] Xiao P,Wang F,Feng G,et al.A pharmacophylogenetic study of Aconitum L.(Ranunculaceae) from China[J].Acta Phytotaxonomica Sinica,2006,44(1):1-46.
[14] Yue H,Pi Z,Song F,et al.Studies on the aconitine-type alkaloids in the roots of Aconitum Carmichaeli Debx.by HPLC/ESIMS/MS(n) [J].Talanta,2009,77(5):1800-1807.
[15] 殷文朋,李春盛.参附注射液对心源性休克犬血流动力学及氧代谢的影响[J].中国中西医结合急救杂志,2008,15(1):20-23.
[16] 陈鹏,郭瑞敏,孙燕妮.参附注射液对感染性休克患者的血流动力学影响的研究进展[J].中国中医急症,2018,27(5):911-914.
[17] 岳胜,朱平,岳磊,等.参附注射液在感染性休克的疗效分析[J].北方药学,2017,14(1):100-101.
[18] Mou Z,Lv Z,Li Y,et al.Clinical effect of Shenfu injection in patients with septic shock:a meta-analysis and systematic review[J].Evid Based Complement Alternat Med,2015,2015:863149.
[19] 卓道勤,吕国焰,闵磊,等.参附注射液对感染性休克早期血流动力学紊乱干预性研究[J].中国中医急症,2011,20(12):2005.