锦红汤加味配合西医常规治疗对重症脓毒症患者血清内毒素、降钙素原水平的影响分析
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摘要
目的:观察锦红汤配合西医常规治疗对重症脓毒症患者血清血清降钙素原(PCT)、内毒素(LPS)水平的影响。方法:随机将84例重症脓毒症患者分为对照组和观察组,对照组给予常规西医对症治疗,观察组在对照组治疗基础上给予锦红汤治疗,观察两组患者临川疗效及对患者血清内毒素、降钙素原水平的影响。结果:两组患者治疗后的症状积分较治疗前有明显下降(P<0.05),观察组改善效果优于对照组(P<0.05);观察组和对照组的临床总有效率分别为90.476%和73.81%(P<0.05);与治疗前对比,两组患者治疗后的血清PCT、LPS、脑钠肽(BNP)、肿瘤坏死因子α(TNF-α)、白细胞介素-6(IL-6)水平有显著下降(P<0.05),观察组上述生化指标改善效果明显优于对照组(P<0.05);两组患者治疗后的APACHEⅡ评分及Marshall器官功能障碍评分较治疗前显著降低(P<0.05),观察组下降幅度较对照组更明显(P<0.05)。结论:锦红汤加味用于重症脓毒症治疗中效果显著,可行通融泻浊、扶正补托、通腑攻下、败毒祛瘀之效,可促进患者机体内炎症反应改善,降低器官衰竭等风险,利于患者病情恢复。
Objective: To investigate the effect of Jinhong Decoction combined with routine western medicine treatment on serum levels of procalcitonin procalcitonin(PCT) and endotoxin(LPS) in patients with severe sepsis. Methods: 84 patients with severe sepsis were randomly divided into controlled group and observation group. The controlled group was treated with routine western medicine,the observation group was treated with Jinhong Decoction on the basis of the controlled group,the curative effect of Linchuan and the serum endotoxin of the two groups were observed. Results: The symptom score of the two groups was significantly lower than that before treatment(P<0.05),and the improvement effect of the observation group was better than that of the controlled group(P<0.05). The total effective rates of the observation group and the controlled group were 90.476% and 73.81%,respectively(P<0.05). After treatment,the levels of serum PCT LPS,brain natriuretic peptide,TNF-α,interleukin-6(IL-6) were significantly decreased in both groups(P<0.05). The improvement effect of the above biochemical indexes in the observation group was significantly better than that in the controlled group(P<0.05),the APACHE Ⅱ score of the two groups after treatment was significantly higher than that in the control group(P<0.05). The score of Marshall organ dysfunction was significantly lower than that before treatment(P<0.05). Conclusion: The effect of Jinghong Decoction on treating severe sepsis is more obvious than that of the controlled group(P<0.05). Reduce the risk of organ failure,conducive to the recovery of the patient's condition.
Objective: To investigate the effect of Jinhong Decoction combined with routine western medicine treatment on serum levels of procalcitonin procalcitonin(PCT) and endotoxin(LPS) in patients with severe sepsis. Methods: 84 patients with severe sepsis were randomly divided into controlled group and observation group. The controlled group was treated with routine western medicine,the observation group was treated with Jinhong Decoction on the basis of the controlled group,the curative effect of Linchuan and the serum endotoxin of the two groups were observed. Results: The symptom score of the two groups was significantly lower than that before treatment(P<0.05),and the improvement effect of the observation group was better than that of the controlled group(P<0.05). The total effective rates of the observation group and the controlled group were 90.476% and 73.81%,respectively(P<0.05). After treatment,the levels of serum PCT LPS,brain natriuretic peptide,TNF-α,interleukin-6(IL-6) were significantly decreased in both groups(P<0.05). The improvement effect of the above biochemical indexes in the observation group was significantly better than that in the controlled group(P<0.05),the APACHE Ⅱ score of the two groups after treatment was significantly higher than that in the control group(P<0.05). The score of Marshall organ dysfunction was significantly lower than that before treatment(P<0.05). Conclusion: The effect of Jinghong Decoction on treating severe sepsis is more obvious than that of the controlled group(P<0.05). Reduce the risk of organ failure,conducive to the recovery of the patient's condition.
引文
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[4] 中华医学会重症医学分会.中国严重脓毒症/脓毒性休克治疗指南(2014)[J].中华内科杂志,2015,54(6):401～426
[5] 中华医学会急诊医学分会危重病专家委员会.脓毒症的定义、诊断标准、中医证候诊断要点及说明(草案)[J].中华急诊医学杂志,2007,16(8):797～798
[6] 中华医学会重症医学分会.中国严重脓毒症/脓毒性休克治疗指南(2014)[J].全科医学临床与教育,2015,54(4):401～426
[7] 王今达.脓毒症的诊断标准及中西医结合治疗指南的研究(讨论稿)[M].天津:天津科技翻译出版公司,2005:406～409
[8] 徐顺娟,芮庆林,奚肇庆.脓毒症中医辨证分型的研究进展[J].中国中医急症,2016,25(2):286～288
[9] 王宜艳,陈伟.从“毒”“瘀”“虚”谈脓毒症的中医治疗进展[J].中国中医急症,2017,26(9):1609～1612
[10] 陈明祺,鲁俊,吕海,等.犀角地黄汤对脓毒症凝血功能障碍患者凝血指标及预后的影响[J].中国中西医结合急救杂志,2016,23(6):568～572
[11] 刘佳丽,常毓颖.大承气汤治疗严重脓毒症有效性的临床观察[J].中医药信息,2015,32(1):99～100