摘要
目的 探讨扶正解毒汤灌肠联合西医综合治疗对脓毒症病人急性生理学和慢性健康状况评价Ⅱ(APACHE Ⅱ)评分及血清降钙素原水平的影响。方法 前瞻性选择2019年3月至2021年5月海南省中医院收治的94例脓毒症病人,并按随机数字表法划分入西医组(n=47)、中西医结合组(n=47)两组内。其中西医组实施常规西医综合治疗,包括早期液体复苏、使用血管活性药、抗感染、辅助通气、纠正水电解质失衡、血液净化等;中西医结合组在西医组基础上加用扶正解毒汤灌肠治疗。治疗1周后判定两组疗效,并比较两组治疗前、治疗1周后中医证候积分、APACHE Ⅱ评分、血清炎症指标(降钙素原、白介素6)及血流动力学指标[平均动脉压(MAP)、心排血指数(CI)、血管外肺水指数(EVLWI)]。结果 中西医结合组治疗总有效率明显较西医组高(P<0.05);治疗后两组中医证候积分、APACHE Ⅱ评分[西医组:(14.47±2.16)分比(19.91±3.86)分,中西医结合组:(10.50±1.78)分比(20.38±4.21)分]、血清降钙素原[西医组:(7.12±1.45)μg/L比(16.25±3.39)μg/L,中西医结合组:(3.21±1.04)μg/L比(16.79±3.65)μg/L]、白介素6水平及EVLWI和同组治疗前相比均明显降低(均P<0.05),且中西医结合组治疗后均明显较西医组低(均P<0.05);治疗后两组MAP、CI和同组治疗前相比均明显增高(均P<0.05),且中西医结合组治疗后均明显较西医组高(均P<0.05)。结论 与常规西医综合治疗相比,对脓毒症病人联合扶正解毒汤灌肠治疗的效果较佳,可有效下调病人血清降钙素原、白介素6等炎性因子水平,明显改善病人中医症状及血流动力学,显著降低APACHE Ⅱ评分。
Objective To investigate the influences of Fuzheng Jiedu decoction enema combined with comprehensive Western medicine treatment on acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ) score and serum procalcitonin level of patients with sepsis.Methods Ninety-four patients with sepsis admitted to Hainan Hospital of Traditional Chinese Medicine from March 2019 to May 2021 were prospectively selected and assigned into Western medicine group(n=47) and integrated Chinese and Western medicine group(n=47) according to random number table. The Western medicine group implemented routine Western medicine comprehensive treatment, including early fluid resuscitation, use of vasoactive drugs, anti-infection, auxiliary ventilation, correction of water electrolyte imbalance, blood purification, etc;and Fuzheng Jiedu decoction enema treatment was adopted in the integrated Chinese and Western medicine group in addition to Western medicine treatment. After 1 week of treatment, the efficacies of the two groups were determined,and the scores of TCM syndromes, APACHE Ⅱ score, serum inflammation indexes [procalcitonin, interleukin-6] and hemodynamic indicators [mean arterial pressure(MAP), cardiac output index(CI), extravascular lung water index(EVLWI)] were compared between the two groups before treatment and 1 week after treatment.Results The total effective rate of treatment in the integrated Chinese and Western medicine group was significantly higher than that in the Western medicine group(P<0.05). After treatment, the scores of TCM syndromes, APACHE Ⅱ scores [Western medicine group:(14.47±2.16) points vs.(19.91±3.86) points, integrated Chinese and Western medicine group:(10.50±1.78) points vs.(20.38±4.21) points], serum procalcitonin [Western medicine group:(7.12±1.45) μg/L vs.(16.25±3.39) μg/L, integrated Chinese and Western medicine group:(3.21±1.04) μg/L vs.(16.79±3.65) μg/L], interleukin-6 levels and EVLWI of the two groups were significantly lower than those of the same group before treatment(all P<
作者
欧哲耀
林文燕
邓小彦
OU Zheyao;LIN Wenyan;DENG Xiaoyan(Second Department of Brain,Hainan Hospital of Traditional Chinese Medicine,Haikou,Hainan 570203,China;Emergency Department of The First Affiliated Hospital of Hainan Medical College,Haikou,Hainan 570102,China)
出处
《安徽医药》
CAS
2023年第3期601-605,共5页
Anhui Medical and Pharmaceutical Journal
