摘要
目的观察清源养心汤对重症骨创伤所致脓毒症患者的心脏保护作用。方法将78例重症骨创伤所致脓毒症患者随机分为2组。对照组39例予常规西医治疗;治疗组39例在对照组治疗基础上加清源养心汤治疗。2组均治疗7 d。比较2组治疗前后凝血功能指标血浆凝血酶原时间(PT)、纤维蛋白原(FIB)、部分活化凝血活酶时间(APTT)及血清D-二聚体(D-D)水平,心肌生化指标[血浆肌酸激酶同工酶(CK-MB)、高敏心肌肌钙蛋白T(hs-cTnT)、N末端脑利钠肽前体(NT-ProBNP)]及血清C反应蛋白(CRP)水平,心功能指标左室射血分数(LVEF)、舒张早期心室充盈速度最大值E峰/舒张晚期心室充盈速度最大值A峰(E/A)比值、左室舒张末期容积指数(LVEDVI)及左室收缩末期容积指数(LVESVI)变化情况。结果 2组治疗后PT、APTT均较本组治疗前缩短(P<0.05),FIB水平升高(P<0.05),D-D水平降低(P<0.05),且治疗组与对照组比较差异有统计学意义(P<0.05)。2组治疗后血浆CK-MB、hs-cTnT、NTProBNP及血清C-反应蛋白水平均较本组治疗前下降(P<0.05),且治疗组低于对照组(P<0.05)。治疗后治疗组LVEF、E/A比值均较本组治疗前升高(P<0.05),LVEDVI及LVESVI降低(P<0.05),且与对照组治疗后比较差异均有统计学意义(P<0.05);对照组治疗后E/A比值、LVEDVI及LVESVI均较本组治疗前明显改善(P<0.05)。结论清源养心汤对重症骨创伤所致脓毒症患者具有心脏保护作用。
Objective To observe the clinical effects of Qingyuan-Yangxin decoction on cardiac protection of severe bone trauma-induced sepsis. Methods 78 patients with severe bone trauma-induced sepsis were randomly divided into two groups. 39 cases in control groupwere treated by conventionalwesternmedicine. 39 cases in treatment groupwere treated by Qingyuan-Yangxin decoction on the basis of control group. After treatment for 7 days,blood coagulation function [ plasma prothrombin time（ PT）,fibrinogen（ FIB）,partial activated thromboplastin time（ APTT） ] and serum DD dimer,cardiac biochemical index [plasma creatine kinase isoenzyme（ CK-MB）,high-sensitivity cardiac troponin T（ hs-c Tn T）,N-terminal brain natriuretic peptide precursor（ NT-Pro BNP） ]and C-reactive protein,cardiac function index [ left ventricular ejection fraction（ LVEF）,maximum value of ventricular filling velocity at early diastolic velocity E peak/A peak（ E/A） ratio,left ventricular end diastolic volume index（ LVEDVI） and left ventricular end systolic volume index（ LVESVI） ]were compared before and after treatment in two groups. Results After treatment,PT and APTT were lower in the two groups than before treatment（ P〈0. 05）,and FIB and D-dimer levels were decreased（ P〈0. 05）,and there was a significant difference between the treatment group and the control group after treatment（ P〈0. 05）. After treatment,the Plasma levels of CK-MB,hs-c Tn T,NT-Pro BNP and serum CRP in the two groups were lower than before treatment（ P〈0. 05）,and the treatment group was lower than the control group（ P〈0. 05）. After treatment,the LVEF and E/A ratios in the treatment group were higher than those before treatment（ P〈0. 05）,and LVEDVI and LVESVI were decreased（ P〈0. 05）,and there was a significant difference between the treatment group and the control group after treatment（ P〈0. 05）. After treatment,the E/A ratio,LVEDVI,and LVESVI in control group were significantly improved compared with tho
作者
宋延斌
陈明月
王军
杜俊凯
SONG Yanbin;CHEN Mingyue;PANG Jun;et al.(Department of Emergency, The First Affiliated Hospital of Xi＇an Jiaotong University, Shaanxi, Xi＇an 710061)
出处
《河北中医》
2018年第5期681-685,共5页
Hebei Journal of Traditional Chinese Medicine
关键词
创伤和损伤
脓毒症
中药疗法
Trauma and injury
Sepsis
Chinese medicine therapy
