【摘要】：目的:在時間醫(yī)學(xué)因時治療的理論指導(dǎo)下,擇時運(yùn)用參附注射液治療膿毒性休克(陽氣暴脫型)并觀察其臨床效果。方法:選取來自于哈爾濱醫(yī)科大學(xué)附屬第二醫(yī)院ICU病房并確診為膿毒性休克(陽氣暴脫型)的患者89例,按隨機(jī)數(shù)字表隨機(jī)分為四組,分別為對照組、午時組、子時組、辰時組。對照組23例,參附治療組每組22例。午時組在常規(guī)治療的基礎(chǔ)上(11:00-13:00)聯(lián)合參附注射液治療;子時組在常規(guī)治療的基礎(chǔ)上(23:00-1:00)聯(lián)合參附注射液治療;辰時組在常規(guī)治療的基礎(chǔ)上(7:00-9:00)聯(lián)合參附注射液治療。連續(xù)治療7天后,觀察每組患者第 7d 的 SOFA評分(Sequential organ failure assessment score)、降鈣素原(Procalcitonin,PCT)、采用全自動生化儀測量的心肌肌鈣蛋白I(Cardiac troponin I,cTnI)及血中 B 型尿鈉肽(Type B natriuretic petide,BNP)、平均動脈壓(Mean artery pressure,MAP)及動脈血乳酸值(Lactic acid,LAC)。四組之間,分別通過兩兩比較第7d的所觀察指標(biāo)的變化,進(jìn)行療效判定。結(jié)果:本次研究共有89例患者,在觀察過程中脫落9例,期間5例放棄治療轉(zhuǎn)院;4例因嚴(yán)重感染、多臟器功能衰竭死亡。1.四組患者在基本資料中年齡、體重、APACHEⅡ評分經(jīng)統(tǒng)計學(xué)比較無統(tǒng)計學(xué)意義(P0.05);2.SOFA評分的結(jié)果顯示:與對照組比較,其余三組SOFA評分均增高;午時組高于子時組、辰時組,辰時組高于子時組,差異具有統(tǒng)計學(xué)意義(P0.05);3.PCT的結(jié)果顯示:與對照組比較,其余三組PCT均增高;午時組高于子時組、辰時組,辰時組高于子時組,差異具有統(tǒng)計學(xué)意義(P0.05);4.cTnⅠ的結(jié)果顯示:與對照組比較,其余三組cTnI均增高;午時組高于子時組、辰時組,辰時組高于子時組,差異具有統(tǒng)計學(xué)意義(P0.05);5.BNP的結(jié)果顯示:與對照組比較,其余三組BNP均增高;午時組高于子時組、辰時組,辰時組高于子時組,差異具有統(tǒng)計學(xué)意義(P0.05);6.MAP的結(jié)果顯示:與對照組比較,其余三組MAP均增高;午時組高于子時組、辰時組,辰時組高于子時組,差異具有統(tǒng)計學(xué)意義(P0.05);7.LAC的結(jié)果顯示:與對照組比較,其余三組LAC均增高;午時組高于子時組、辰時組,辰時組高于子時組,差異具有統(tǒng)計學(xué)意義(P0.05);結(jié)論:1.基于時間醫(yī)學(xué)擇時應(yīng)用參附注射液聯(lián)合常規(guī)治療的方法與單純的常規(guī)治療方法對膿毒性休克(陽氣暴脫型)患者都有療效,但因"時"治療效果更佳。2.午時組(11:00-13:00)用藥,療效最佳,這可能與機(jī)體正盛邪虛有關(guān)。
[Abstract]:Objective: to observe the clinical effect of Shenfu injection in the treatment of septic shock. Methods: Eighty-nine patients from ICU ward of the second affiliated Hospital of Harbin Medical University who were diagnosed as septic shock were randomly divided into four groups: control group, midday group and sub-time group. Chen Shi group. 23 cases in control group and 22 cases in each group in Shenfu treatment group. The midday group was treated on the basis of routine treatment (11: 00-13: 00) combined with Shenfu injection, Zishi group (2300-1: 00) combined with Shenfu injection on the basis of routine treatment, and Chenshi group was treated with Shenfu injection on the basis of routine treatment (7: 00-9: 00). After seven consecutive days of treatment, The SOFA scores of (Sequential organ failure assessment score), procalcitonin (Procalcitonin,PCT) were measured on the 7th day of each group. Cardiac troponin (I (Cardiac troponin I), type B urinary natriuretic peptide (Type B natriuretic petide,BNP), mean arterial pressure (Mean artery pressure,MAP) and arterial blood lactic acid (Lactic acid,LAC) were measured by automatic biochemical instrument. Among the four groups, the curative effect was evaluated by comparing the changes of the observed indexes on the 7th day. Results: there were 89 patients in this study, 9 cases dropped out during the observation, 5 cases gave up treatment and transferred to hospital, 4 cases died of multiple organ failure due to severe infection. 1. The age, weight and APACHE 鈪，

本文編號：2270815