本文選題：血必凈注射液　切入點：膿毒癥　出處：《廣州中醫(yī)藥大學(xué)》2017年碩士論文

【摘要】：目的:本研究的主要目的在于觀察中醫(yī)證型為毒熱內(nèi)盛或瘀毒內(nèi)阻證的膿毒癥(Sepsis)患者在膿毒癥早期集束化治療中應(yīng)用清熱解毒、活血化瘀代表方藥血必凈注射液的治療效果。通過對比治療前后患者的序貫器官衰竭評分(SOFA評分)及降鈣素原(PCT)的變化評價其治療效果,以期進一步探討中藥復(fù)方制劑的臨床療效。方法:本研究為前瞻性隨機對照研究,以2016年6月至2017年2月間廣州中醫(yī)藥大學(xué)第一附屬醫(yī)院重癥醫(yī)學(xué)科收治的60例膿毒癥患者為研究對象,按照隨機數(shù)表法,將患者分為治療組和對照組,每組各30例。兩組患者均按照"2012年嚴重膿毒癥和膿毒癥休克治療指南"治療,治療組在西醫(yī)常規(guī)集束化治療基礎(chǔ)上加用血必凈注射液50ml(0.9%氯化鈉溶液配置至100ml),在患者收入ICU、確診為膿毒癥時即刻滴注一次,隨后Q12H滴注一次,治療時間為5天。對照組僅用西醫(yī)常規(guī)集束化治療。記錄各患者治療前、治療后6h、24h及5天的SOFA評分及PCT數(shù)值。成果:1.治療前兩組患者的基本資料對比(性別、年齡、APACHE Ⅱ評分、SOFA評分、PCT數(shù)值),差異無統(tǒng)計學(xué)意義(P0.05),說明兩組患者的數(shù)據(jù)具有可比性;2.治療前后兩組的組內(nèi)對比,兩組患者的SOFA評分、PCT數(shù)值均較治療前有下降;治療后6h、治療后24h、治療后5天與治療前相比,差異存在顯著統(tǒng)計學(xué)意義(P0.05)。說明在6h早期集束化治療中和24h早期集束化治療中,兩種治療方案能明顯改善膿毒癥患者炎癥反應(yīng)及器官功能衰竭的病情。3.治療后兩組的組間對比,治療后6h、治療后24h及治療后5天,治療組的SOFA評分和PCT數(shù)值均低于對照組,差異有統(tǒng)計學(xué)意義(P0.05),說明治療組的療效優(yōu)于對照組。4.治療前后兩組的相關(guān)性分析,治療前、治療后6h、治療后24h及治療后5天,治療組患者的SOFA評分與PCT數(shù)值具有顯著相關(guān)性(P0.01);對照組患者的SOFA評分與PCT數(shù)值具有顯著相關(guān)性(P0.01),說明SOFA評分與PCT數(shù)值評估疾病與藥物療效的效價相當。結(jié)論:無論是西醫(yī)常規(guī)集束化治療,還是集束化聯(lián)合血必凈注射液治療,兩種治療方案均能夠改善膿毒癥患者的病情。與西醫(yī)常規(guī)集束化治療相比,在膿毒癥早期集束化治療中使用血必凈注射液治療,能更大程度的減輕機體炎性反應(yīng),減少多臟器衰竭風(fēng)險,在一定程度上降低患者死亡率,改善疾病預(yù)后。在評估疾病嚴重程度方面,SOFA評分與PCT數(shù)值具有良好相關(guān)性,說明兩者均屬能準確評估血必凈注射液療效及膿毒癥的病情變化,屬于有效評估指標,值得在臨床上進一步推廣使用。
[Abstract]:Objective: the main purpose of this study was to observe the therapeutic effect of Sepsis of sepsis in the early stage of sepsis treated by clearing heat and detoxifying, activating blood circulation and removing blood stasis.The therapeutic effect was evaluated by comparing the changes of sequential organ failure score (sofa) and procalcitonin (PCT) before and after treatment in order to further explore the clinical efficacy of traditional Chinese medicine compound preparation.Methods: a prospective randomized controlled study was conducted in 60 sepsis patients admitted from the Department of intensive Medicine, the first affiliated Hospital of Guangzhou University of traditional Chinese Medicine, from June 2016 to February 2017.The patients were divided into treatment group and control group with 30 cases in each group.Both groups were treated in accordance with the 2012 guidelines for the treatment of severe sepsis and septic shock,The control group was only treated with conventional western medicine cluster therapy.SOFA scores and PCT values were recorded at 24 h and 5 days before and 6 hours after treatment.Result: 1.Before treatment, the basic data of the two groups were compared (sex, age, Apache 鈪，

本文編號：1701486