摘要
目的:探讨益气凉血化瘀法治疗脓毒症心功能障碍及对血浆炎症因子及心功能的影响。方法:65例脓毒症心功能障碍患者随机分为治疗组35例和对照组30例。两组均参照指南进行治疗,同时予适当的强心利尿。治疗组在此基础上加用参芎地黄汤口服,每日2次。两组疗程均为7天。两组分别于治疗第1及第7天,抽血检测可溶性晚期糖基化终末产物受体(Soluble Receptor for Advanced Glycation End Products,sRAGE)、白细胞介素-6(Interleukin-6,IL-6)、氨基末端脑钠肽前体(N-terminal pro-B Natriuretic Peptide,NT-proBNP)、心肌肌钙蛋白(Cardiac Troponin,cTnT)浓度。心脏彩超测定心率(Heart Rate,HR)、左室舒张末内径(Left Ventricular End Diastolic Diameter,LVEDd)、每搏输出量(Stroke Volume,SV)、左室射血分数(Left Ventricular Ejection Fraction,LVEF)和中医证候积分。结果:两组患者治疗后血sRAGE、IL-6、NT-proBNP、cTnT浓度和中医证候总积分均较治疗前有明显下降,治疗组比对照组下降更加明显,差异均有显著统计学意义(P<0.05)。两组患者治疗后心率HR、LVEDd较治疗前明显下降,SV、LVEF较治疗前明显升高,治疗组LVEDd更低,SV、LVEF更高,差异均有显著统计学意义(P<0.05)。结论:与单纯西药治疗相比较,合用益气凉血化瘀中药治疗可以更好地抑制脓毒症心功能障碍患者炎症反应,减轻心肌损伤,改善心脏舒缩功能。
Objective:To explore the effect of the Yiqi Liangxue Huayu method(益气凉血化瘀法)on sepsis cardiac dysfunction patients and plasma inflammatory factors and cardiac function.Methods:65 patients with sepsis cardiac dysfunction were randomly divided into the treatment group of 35 cases and control group of 30 cases.Both groups were treated with reference to the guidelines,and given appropriate cardiotonic and diuretic drugs.The treatment group was treated with the shenxiong dihuang decoction(参芎地黄汤).The course of treatment in both groups was 7 days.The concentrations of sRAGE,IL-6,NT-proBNP,cTnT and total score of TCM syndrome were measured on the first and seventh day of treatment.HR,LVEDd,SV,LVEF were measured by color Doppler echocardiography.Results:After treatment,the concentrations of sRAGE,IL-6,NT-proBNP cTnT and total score of TCM syndrome in the two groups were significantly lower than those before treatment,the decrease in the treatment group was more significant than that in the control group,the difference was statistically significant(P<0.05).After treatment,HR and LVEDd in the two groups were significantly lower than before treatment,SV and LVEF were significantly higher than before treatment.Compared with the control group,LVEDd in the treatment group was lower,SV and LVEF were higher,the differences were statistically significant(P<0.05).Conclusion:Compared with western medicine alone,the combination of Yiqi Liangxue Huayu therapy method can better inhibit the inflammatory response of sepsis patients with cardiac dysfunction,reduce myocardial damage,and improve the function of heart relaxation and contraction.
出处
《中医临床研究》
2021年第7期82-86,共5页
Clinical Journal Of Chinese Medicine
基金
广州市卫生和计划生育科技项目,编号:20182A011027。
