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中国医药导报  2023, Vol. 20 Issue (29): 157-160,165    DOI: 10.20047/j.issn1673-7210.2023.29.34
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茯苓四逆汤辅助治疗对重症脓毒症连续性血液净化治疗患者器官功能及炎症反应的影响
朱颖茜  顾娴  秦兵
江苏省太仓市中医医院重症医学科,江苏太仓 215400
Effect of adjuvant therapy with Fuling Sini Decoction on organ function and inflammation response in patients with severe sepsis after continuous blood purification treatment
ZHU Yingxi GU Xian QIN Bing
Department of Critical Care Medicine, Taicang Traditional Chinese Medicine Hospital, Jiangsu Province, Taicang 215400, China
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摘要 目的 研究茯苓四逆汤辅助治疗对重症脓毒症连续性血液净化治疗患者器官功能及炎症反应的影响。方法 选取2017年12月至2021年12月江苏省太仓市中医医院重症医学科重症脓毒症患者88例,将其按照随机数字表法分为对照组、观察组,各44例。对照组采用连续性血液净化治疗,观察组在对照组基础上采用茯苓四逆汤。比较两组疗效,并比较治疗前、治疗3 d后中医证候积分、器官功能[谷丙转氨酶(GPT)、谷草转氨酶(GOT)、总胆红素(TB)、血肌酐(SCr)、血尿素氮(BUN)、尿酸(UA)、左室射血分数(LVEF)、左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)]、炎症反应[白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、白细胞计数(WBC)、C反应蛋白(CRP)],并统计机械通气时间与住院时间。 结果 治疗3 d后,两组中医证候积分均降低,且观察组低于对照组(P<0.05);观察组疗效优于对照组(P<0.05);治疗3 d后,两组GPT、GOT、TB、LVEDD、LVESD、SCr、BUN、UA低于治疗前,LVEF高于治疗前,且观察组GPT、GOT、TB、LVEDD、LVESD、SCr、BUN、UA低于对照组,LVEF高于对照组(P<0.05);治疗3 d后,两组血清IL-6、TNF-α、WBC、CRP水平均降低,且观察组低于对照组(P<0.05);观察组机械通气时间、住院时间短于对照组(P<0.05)。 结论 茯苓四逆汤辅助连续性血液净化治疗重症脓毒症患者效果显著,能降低中医证候积分,改善器官功能,减轻炎症反应,缩短机械通气时间与住院时间。
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朱颖茜  顾娴  秦兵
关键词 重症脓毒症连续性血液净化治疗茯苓四逆汤    
Abstract:Objective To study the effect of adjuvant therapy with Fuling Sini Decoction on organ function and inflammation response in patients with severe sepsis after continuous blood purification treatment. Methods A total of 88 patients with severe sepsis in the Department of Critical Care Medicine, Taicang Traditional Chinese Medicine Hospital, Jiangsu Province from December 2017 to December 2021 were selected and they were divided into control group and observation group according to random number table method, with 44 patients in each group. The control group was treated with continuous blood purification, and the observation group was treated with Fuling Sini Decoction on the basis of the control group. The efficacy of the two groups was compared, and the traditional Chinese medicine syndrome score, organ function (glutamic-pyruvic transaminase [GPT], glutamic-oxaloacetic transaminase [GOT], total bilirubin [TB], serum creatinine [SCr], blood urea nitrogen [BUN], uric acid [UA], left ventricular ejection fraction [LVEF], left ventricular end diastolic diameter [LVEDD], left ventricular end systolic diameter [LVESD]), inflammatory response (interleukin-6 [IL-6], tumor necrosis factor-α [TNF-α], white blood cell count [WBC], C-reactive protein [CRP]) before and after three days of treatment were compared and mechanical ventilation time and hospital stay were counted. Results After three days of treatment, traditional Chinese medicine syndrome scores of both groups were decreased, and those of observation group was lower than those of control group (P<0.05). The curative effect of observation group was better than that of control group (P<0.05). After three days of treatment, GPT, GOT, TB, LVEDD, LVESD, SCr, BUN, and UA in both groups were lower than before treatment, and LVEF was higher than before treatment, and GPT, GOT, TB, LVEDD, LVESD, SCr, BUN, and UA in observation group were lower than control group, and LVEF was higher than control group (P<0.05). After three days of treatment, serum levels of IL-6, TNF-α, WBC, and CRP in both groups were decreased, and those in observation group was lower than those in control group (P<0.05). Mechanical ventilation time and hospital stay in observation group were shorter than those in control group (P<0.05). Conclusion Fuling Sini Decoction with continuous blood purification is effective in the treatment of severe sepsis. It can reduce traditional Chinese medicine syndrome score, improve organ function, reduce inflammation response, shorten mechanical ventilation time and hospital stay.
Key wordsSevere sepsis    Continuous blood purification treatment    Fuling Sini Decoction
    
基金资助:江苏省自然科学基金资助项目(2019Z831)。
引用本文:   
朱颖茜  顾娴  秦兵. 茯苓四逆汤辅助治疗对重症脓毒症连续性血液净化治疗患者器官功能及炎症反应的影响[J]. 中国医药导报, 2023, 20(29): 157-160,165.
ZHU Yingxi GU Xian QIN Bing. Effect of adjuvant therapy with Fuling Sini Decoction on organ function and inflammation response in patients with severe sepsis after continuous blood purification treatment. 中国医药导报, 2023, 20(29): 157-160,165.
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https://www.yiyaodaobao.com.cn/CN/10.20047/j.issn1673-7210.2023.29.34     或     https://www.yiyaodaobao.com.cn/CN/Y2023/V20/I29/157

 

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