红玉赔赈颗粒对脓毒症患者凝血指标的影响
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摘要
目的探讨红玉赔赈颗粒对脓毒症患者凝血功能的影响。方法将61例脓毒症患者随机分为2组。中西医治疗组在西医常规治疗基础上加用红玉赔赈颗粒,对照组予以西医常规治疗。比较2组患者中医证候积分疗效及凝血指标变化。结果治疗后,2组患者的急性生理和慢性健康状况评分系统(APACHEⅡ)评分均显著降低(P<0.05);2组患者治疗后中医证候积分疗效有显著差异(P<0.05)。治疗7 d后,与对照组比较,中西医治疗组纤维蛋白原降解产物(FDP)、D-二聚体(D-D)、凝血酶时间(TT)、凝血酶原时间(PT)显著下降,活化部分凝血活酶时间(APTT)显著延长,血小板计数(PLT)显著升高(P<0.05)。结论红玉赔赈颗粒能够升高脓毒症患者PLT计数,降低FDP、D-D水平和APACHEⅡ评分,改善脓毒症患者预后。
Objective To observe clinical efficacy of hongyu peizhen granules on coagulation indexes of patients with sepsis. Methods A total of 64 patients with sepsis were randomly divided into two groups,traditional Chinese and western medicine group applied hongyu peizhen granules based on conventional western medicine,while the control group was given routine treatment of western medicine. The changes of blood coagulation index,and efficacy of TCM syndrome scores were observed. Results After treatment,the scores of acute physical and chronic health status scoring system( APACHEⅡ) in both groups were significantly lower( P < 0. 05); the efficacy of TCM syndrome scores in the two groups after treatment showed a significant difference( P < 0. 05). After 7 days of treatment,traditional Chinese and western medicine group had significantly decreased fibrinogen degradation products( FDP),D-dimer( DD),thrombin time( TT),and prothrombin time( PT),significantly prolonged partial thromboplastin time( APTT) and increased platelet count( PLT) compared with the control group( P < 0. 05). Conclusion Hongyu peizhen particles can increase PLT count for patients with sepsis,reduce FDP,D-D level and APACHE Ⅱscore,and improve prognosis of sepsis.
Objective To observe clinical efficacy of hongyu peizhen granules on coagulation indexes of patients with sepsis. Methods A total of 64 patients with sepsis were randomly divided into two groups,traditional Chinese and western medicine group applied hongyu peizhen granules based on conventional western medicine,while the control group was given routine treatment of western medicine. The changes of blood coagulation index,and efficacy of TCM syndrome scores were observed. Results After treatment,the scores of acute physical and chronic health status scoring system( APACHEⅡ) in both groups were significantly lower( P < 0. 05); the efficacy of TCM syndrome scores in the two groups after treatment showed a significant difference( P < 0. 05). After 7 days of treatment,traditional Chinese and western medicine group had significantly decreased fibrinogen degradation products( FDP),D-dimer( DD),thrombin time( TT),and prothrombin time( PT),significantly prolonged partial thromboplastin time( APTT) and increased platelet count( PLT) compared with the control group( P < 0. 05). Conclusion Hongyu peizhen particles can increase PLT count for patients with sepsis,reduce FDP,D-D level and APACHE Ⅱscore,and improve prognosis of sepsis.
引文
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[2]叶文,王锦权,陶晓根.脓毒症与凝血功能紊乱[J].医学综述,2006,12(5):296-298.
[3]马晓春.加强对获得性凝血病的认识[J].中国实用外科杂志,2012,3(11):885-886.
[4]Levy M M,Fink M P,Marshall JC,et al.2001SCCM/ESICM/ACCP/ATS/SIS international sepsis definitions conference[J].Crit Care Med,2003,31(4):1250-1256.
[5]中国中西医结合学会急救医学专业委员会.脓毒症中西医结合诊治专家共识[J].中华危重病急救医学,2013,25(4):194-197.
[6]Singer M,Deutschman C S,Seymour C W,et al.The third international consensus definitions for sepsis and septic Shock[J].IAMA,2016,315(8):801-810.
[7]郑筱萸.《中药新药临床研究指导原则(试行)》[M].北京:中国医药科技出版社,2002:185-187.
[8]陈德昌,景炳文,李红江,等.大黄对危重症患者系统炎症反应治疗作用的临床研究[J].中国危重病急救医学,2000,12(10):584-585.
[9]吴同辰,徐建如.制大黄治疗脓毒症临床研究[J].浙江中西医结合杂志,2009,10(19):621-622.
[10]钱风华,朱亮.升降散治疗脓毒症性脑病临床疗效观察[J].上海中医药杂志,2010,44(6):48-50.
[11]顼志兵,马金苗,朱杰,等.清毒调血方对脓毒症凝血功能紊乱干预的临床观察[J].中国中医急症,2017,26(9):1551-1553.
[12]刘景超,袁惠芳,等.杨栗山“升降散”临床应用研究进展[J].江西中医药,2006,11(37):287-289.