參附注射液對(duì)膿毒癥合并MODS患者的炎癥反應(yīng)的影響研究
發(fā)布時(shí)間:2018-03-26 19:09
本文選題:參附注射液 切入點(diǎn):膿毒癥并發(fā)MODS 出處:《山東中醫(yī)藥大學(xué)》2014年碩士論文
【摘要】:目的:觀察參附注射液(Shenfu Injection,SF)在膿毒癥并發(fā)MODS患者中的治療作用。 方法:選擇山東省千佛山醫(yī)院41例嚴(yán)重膿毒癥并發(fā)MODS患者,隨機(jī)分為參附組和對(duì)照組。對(duì)照組采用西醫(yī)綜合治療(包括積極控制感染、呼吸功能支持、維持血流動(dòng)力學(xué)穩(wěn)定、改善微循環(huán)、營養(yǎng)支持及其他支持治療等),參附組在對(duì)照組治療基礎(chǔ)上加用益氣扶正參附注射液50ml靜脈推注,每次10-15分鐘,每天2次,連用7天。計(jì)算并比較治療前、治療后兩組患者APACHE Ⅱ評(píng)分、中醫(yī)證侯積分和28天病死率。同時(shí)檢測(cè)并比較所有入選病例治療前、治療后7天的靜脈血降鈣素原(procalcitonin,,PCT)、白細(xì)胞(WBC)、腫瘤壞死因子α(TNF-α)、炎性介質(zhì)白介素6(IL-6)、血清高遷移率族蛋白B1(high mobility group protein,HMGB1)水平。 結(jié)果:治療前兩組PCT、WBC、TNF-α、IL-6、HMGB1無明顯差異(p0.05);治療7天后,兩組患者APACHE Ⅱ評(píng)分、中醫(yī)證侯積分、PCT、WBC、TNF-α、IL-6、HMGB1均呈下降趨勢(shì),與治療前比較差異具有統(tǒng)計(jì)學(xué)意義(p0.05);治療后參附組中醫(yī)癥候積分、WBC、TNF-α、IL-6、HMGB1與對(duì)照組比較顯著下降(p0.05);但APACHE Ⅱ評(píng)分、28天病死率、PCT與對(duì)照組比較差異無統(tǒng)計(jì)學(xué)意義(p0.05)。 結(jié)論:在常規(guī)治療基礎(chǔ)上應(yīng)用SF治療嚴(yán)重膿毒癥并發(fā)MODS有助于減輕患者炎癥反應(yīng),其機(jī)制可能與調(diào)節(jié)炎癥因子有關(guān)。
[Abstract]:Aim: to observe the therapeutic effect of Shenfu injection SF in patients with sepsis complicated with MODS. Methods: 41 patients with severe sepsis complicated with MODS in Qianfushan Hospital of Shandong Province were randomly divided into Shenfu group and control group. The control group was treated with western medicine comprehensive therapy (including active control of infection, respiratory function support, maintenance of hemodynamic stability). To improve microcirculation, nutritional support and other supportive therapy, the Shenfu group was treated with 50ml injection of Yiqi Fuzhenfu injection for 10-15 minutes, twice a day for 7 days, on the basis of treatment in the control group, and calculated and compared before treatment. After treatment, APACHE 鈪
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