摘要
目的 :探讨内毒素血症与病情严重程度、药物疗效间的关系。方法 :按照随机对照的原则将15 3例急性感染患者分为单纯抗生素治疗组 (简称单纯治疗组 )及抗生素与中药联合治疗组 (简称联合治疗组 ) ,每组患者据APACHE Ⅲ评分又分为 3型 ,即A型 (APACHE Ⅲ评分≤ 2 0分 )、B型 (APACHE Ⅲ评分2 1～ 4 0分 )、C型 (APACHE Ⅲ评分 >4 0分 )。其中单纯治疗组 77例 ,男性 4 0例 ,女性 37例 ;年龄 18～ 76岁 ,平均 (46 5± 2 7 5 )岁 ;A型 4 1例 ,B型 2 8例 ,C型 8例 ;疗程 10～ 14天 ,平均 (11 5± 2 5 )天。联合治疗组 76例 ,男性 39例 ,女性 37例 ;年龄 18～ 70岁 ,平均 (44 5± 2 5 5 )岁 ;A型 37例 ,B型 30例 ,C型 9例 ;疗程 10～ 14天 ,平均 (10 5± 2 5 )天。采用鲎试剂法测定患者外周血内毒素含量 ,并进一步分析内毒素血症与APACHE Ⅲ评分的相关关系。结果 :急性重症感染患者APACHE Ⅲ评分 >2 0分者出现内毒素血症 (P <0 0 5 ) ,并与APACHE Ⅲ评分呈正相关 (r=0 718,P <0 0 5 ) ;中药加抗生素较单纯抗生素治疗能明显减轻内毒素血症 (P <0 0 5 ) ,改善预后。结论 :内毒素血症可作为预测病情严重度的一项参考指标 。
Objective: To explore the relationship between endotoxemia and the severity of disease condition and therapeutic effect. Methods: According to randomized controlled principle, the 153 acute infectious patients were divided into simple antibiotics treated group and antibiotics plus Chinese drugs combined treated group, and patients in each group were subdivided into 3 types according to acute physiology and chronic health evaluation (APACHE Ⅲ) scoring: type A (APACHE Ⅲ scoring ≤20 points), type B (APACHE Ⅲ scoring 21-40 points) and type C (APACHE Ⅲ scoring >40 points). The 77 cases in the simple treated group were 40 males and 37 females, aging 18-76 years, mean 46.5±27.5 years, 41 cases of type A, 28 of type B and 8 of type C, treatment course 10-14 days, mean 11.5±2.5 days. The 76 cases in the combined treated group were 39 males and 37 females, aging 18-70 years, mean 44.5±25.5 years, 37 of type A, 30 of type B and 9 of type C, treatment course 10-14 days, mean 10.5±2.5 days. Limulus test was used to determine the endotoxin content in peripheral blood of patients, and further analysis on the relationship between endotoxemia and APACHE Ⅲ scoring was conducted. Results: Acute severe infectious patients whose APACHE Ⅲ scoring >20 points occurred endotoxemia (P<0 05), and the condition of disease was positively related to the APACHE Ⅲ scoring (r=0 718,P<0 05). Chinese drugs plus antibiotics can obviously alleviate endotoxemia (P<0 05) and improve the prognosis of patients. Conclusion: Endotoxemia can serve as a referential parameter for predicting the severity of disease. Integrated therapy of Chinese and western medicine in treating bacterial infection revealed better results than that of antibiotics solely
出处
《中国中西医结合杂志》
CAS
CSCD
北大核心
2001年第12期906-908,共3页
Chinese Journal of Integrated Traditional and Western Medicine
