摘要
目的探讨茯苓四逆汤对脓毒性心肌病(SIC)患者心功能的影响。方法选择2021年1月至2022年12月北京中医药大学深圳医院(龙岗)重症监护病房(ICU)收治的60例SIC患者作为研究对象,按随机数字表法将患者分为对照组和治疗组,每组30例。两组均给予常规治疗,治疗组在常规治疗基础上加用茯苓四逆汤(组成:茯苓30 g,干姜12 g,人参10 g,制附子12 g,炙甘草15 g),每剂煎煮成200 mL,每日1剂,分3次服用;两组疗程均为8 d。记录两组血管活性药物使用时间、ICU和总住院时间、28 d病死率;观察两组中医症状积分、序贯器官衰竭评分(SOFA)、急性生理学与慢性健康状况评分Ⅱ(APACHEⅡ)、降钙素原(PCT)、动脉血氧合指数(PaO_(2)/FiO_(2))、血乳酸(Lac)、心型脂肪酸结合蛋白(H-FABP)、心肌肌钙蛋白I(cTnI)、N末端脑钠肽前体(NT-proBNP)、左室射血分数(LVEF)、左室收缩期末内径(LVESD)、左室舒张期末内径(LVEDD)、二尖瓣口舒张早期血流速度峰值(E)、二尖瓣口舒张晚期血流速度峰值(A)、E/A比值及三尖瓣瓣环收缩期位移(TAPSE)变化。结果治疗组血管活性药物使用时间、ICU停留时间、总住院时间均较对照组明显缩短〔血管活性药物使用时间(d):4.47±2.16比6.32±3.23,ICU停留时间(d):9.18±3.32比12.25±4.39,总住院时间(d):13.58±5.14比17.13±6.65,均P<0.05〕;治疗组和对照组28 d病死率比较差异无统计学意义〔20.00%(6/30)比43.33%(13/30),P>0.05〕。两组治疗后APACHEⅡ评分、SOFA评分均较治疗前明显下降,治疗组下降更明显,且以治疗8 d两组对比最为显著〔APACHEⅡ评分(分):13.71±3.37比16.21±3.82,SOFA评分(分):3.24±0.85比4.13±1.56,均P<0.05〕;两组治疗后中医症状积分亦均较治疗前明显下降,以治疗组下降更明显(分:治疗3 d为26.25±6.64比29.43±6.83,治疗5 d为21.42±4.22比24.81±4.65,治疗8 d为14.43±3.45比17.58±4.56,均P<0.05);两组治疗后PCT、Lac、H-FABP均较治疗前下降
Objective To explore the effect of Fuling Sini decoction on cardiac function in patients with sepsis-induced cardiomyopathy(SIC).Methods Sixty SIC patients admitted to the department of intensive care unit(ICU)of Shenzhen Hospital(Longgang)of Beijing University of Traditional Chinese Medicine(TCM)from January 2021 to December 2022 were divided into a control group and a treatment group using a random number table method,with 30 patients in each group.Both groups received routine treatment,and the treatment group received Fuling Sini decoction(consisting of Poria cocos 30 g,Dry ginger 12 g,Ginseng 10 g,Prepared aconite 12 g,and Roasted licorice 15 g)based on routine treatment.Each dose was decocted into 200 mL,1 dose per day,divided into 3 times.Both groups of treatments lasted for 8 days.The use time of vasoactive drugs,ICU stay time and total hospital stay time,the 28-day mortality of two groups were recorded.TCM symptom score,sequential organ failure assessment(SOFA),acute physiology and chronic health evaluationⅡ(APACHEⅡ),procalcitonin(PCT),arterial oxygenation index(PaO_(2)/FiO_(2)),blood lactic acid(Lac),cardiac troponin I(cTnI),N-terminal pro-brain natriuretic peptide(NT-proBNP),heart type-fatty acid binding protein(H-FABP),left ventricular ejection fraction(LVEF),left ventricular end-systolic diameter(LVESD),left ventricular end-diastolic diameter(LVEDD),mitral orifice early diastolic blood flow velocity(E),mitral orifice late diastolic blood flow velocity(A),and E/A ratio and tricuspid annular plane systolic excursion(TAPSE)were observed.Results The use time of vasoactive drugs,ICU stay time,and total hospital stay time in the treatment group were significantly shorter than those in the control group[use time of vasoactive drugs(days):4.47±2.16 vs.6.32±3.23,ICU stay time(days):9.18±3.32 vs.12.25±4.39,total hospital stay time(days):13.58±5.14 vs.17.13±6.65,all P<0.05].There was no statistically significant difference in the 28-day mortality between the treatment group and control group[20.00%(6/3
作者
王评
黄壑霏
彭晓洪
黄亚秀
黄永莲
Wang Ping;Huang Hefei;Peng Xiaohong;Huang Yaxiu;Huang Yonglian(Department of Critical Care Medicine,Shenzhen Hospital(Longgang)of Beijing University of Traditional Chinese Medicine,Shenzhen 518172,Guangdong,China)
出处
《中国中西医结合急救杂志》
CAS
CSCD
2024年第3期277-282,共6页
Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care
基金
广东省中医药局科研项目(20211349)。
关键词
脓毒性心肌病
心功能
茯苓四逆汤
Sepsis-induced cardiomyopathy
Cardiac function
Fuling Sini decoction
