摘要
目的观察芪归银颗粒治疗脓毒症急性肾损伤的临床疗效,评价芪归银颗粒对脓毒症急性肾损伤(AKI)患者的肾脏保护作用。方法纳入脓毒症急性肾损伤患者60例,随机分为治疗组与对照组各30例,对照组按照指南常规治疗,治疗组在对照组基础上予芪归银颗粒口服(或胃管注入)。记录两组患者治疗前后血尿素氮(BUN)、血清肌酐(SCr)、28 d死亡率、ICU平均住院天数、24 h尿量、肾损伤恢复率。结果经治疗,两组患者SCr、BUN均呈下降趋势,治疗组SCr在治疗后第3天下降较对照组明显(P <0.05);两组非连续性肾脏替代治疗(CRRT)患者治疗第3天24 h尿量均呈明显上升(P <0.05),且治疗组提升的尿量高于对照组;两组中需要CRRT的患者尿量没有明显差异(P> 0.05),但治疗组平均进行血滤天数明显低于对照组(P <0.05);治疗7 d后,治疗组较对照组肾损伤恢复率更高(P <0.05)。两组患者ICU住院时间及28 d死亡率均无明显差异(P>0.05)。治疗组在治疗第3天虚实夹杂证患者SCr均明显低于实证和虚证(P <0.05)。结论芪归银颗粒能够降低脓毒症AKI患者的SCr水平,提高肾损伤恢复率,对于需要行CRRT的脓毒症患者,芪归银颗粒能够明显降低其CRRT的时间,较早脱离血液过滤;对于不需要CRRT的脓毒症AKI患者,芪归银颗粒能够较早提高其24 h尿量。但对ICU住院时间及28 d致死率没有影响,无法改善患者的预后。芪归银颗粒治疗不同证型的脓毒症AKI患者存在疗效差异,对降低虚实夹杂证患者的SCr效果最为显著。
Objective:To observe the clinical efficacy of Qiguiyin Granules in treating sepsis acute kidney injury(AKI),and to evaluate the renal protective effect of Qiguiyin Granules on patients with sepsis and acute kidney injury.Methods:60 patients with sepsis AKI were randomly divided into a treatment group and a control group,30 cases in each group.The control group was treated according to the guidelines,and the treatment group was given Qiguiyin Granules orally(or gastric tube injection)on the basis of the control group.The blood urea nitrogen(BUN),serum creatinine(SCr),28 d mortality,ICU average hospital stay,24 hour urine output,and recovery rate of renal injury were recorded before and after treatment in the two groups.Results:After treatment,SCr and BUN of the two groups showed a downward trend.The SCr of the treatment group decreased significantly on the 3rd day after treatment(P<0.05);on the 3rd day of the continuous renal replacement therapy(CRRT),the 24 h urine volume of the two groups increased significantly,and the treatment group increased more significantly than the control group(P<0.05);there was no significant difference in the urine volume of patients requiring CRRT between the two groups(P>0.05),but the average number of days of hemofiltration in the treatment group was significantly lower than the control group(P<0.05);after 7 days of treatment,the treatment group had a higher recovery rate of renal injury than the control group(P<0.05).There was no significant difference in ICU hospitalization time and 28 day mortality between the two groups(P>0.05).On the 3rd day of treatment,the SCr in the treatment group was significantly lower than that of the excess syndrome group and the deficiency syndrome group(P<0.05).Conclusion:Qiguiyin Granules can reduce the level of SCr in patients with sepsis AKI and improve the recovery rate of renal injury in patients with sepsis AKI.For sepsis patients who need CRRT,Qiguiyin Granules can significantly reduce the time for CRRT and help them get rid of the blood filtr
作者
狄浩然
王晓鹏
梁立新
卢幼然
郭玉红
段美丽
刘清泉
无
Di Haoran;Wang Xiaopeng;Liang Lixin;Lu Youran;Guo Yuhong;Duan Meili;Luu Qingquan(Shunyi Hospital,Beijing Hospital of Traditional Chinese Medicine,Beijing 101300,China)
出处
《中国中医急症》
2021年第9期1583-1585,1606,共4页
Journal of Emergency in Traditional Chinese Medicine
基金
首都卫生发展科研专项项目(首发2018-1-1161)
北京市属医院科研培育计划项目(PZ2019009)。
关键词
脓毒症
急性肾损伤
芪归银颗粒
中西医结合
Sepsis
Acute kidney injury
Qiguiyin Granules
Integrative Chinese and western medicine
