化纖膠囊1號方對瘀毒內(nèi)阻型膿毒癥患者T細(xì)胞亞群的影響
發(fā)布時間：2019-06-05 11:15
【摘要】：目的:探討化纖膠囊1號方對瘀毒內(nèi)阻型膿毒癥(sepsis)免疫抑制患者臨床療效及T細(xì)胞亞群的影響,為中醫(yī)益氣活血解毒法治療瘀毒內(nèi)阻型膿毒癥免疫抑制奠定臨床研究基礎(chǔ)。方法:本研究采取的研究方式為隨機(jī)對照臨床研究,納入符合標(biāo)準(zhǔn)的瘀毒內(nèi)阻型膿毒癥患者80例,病例來自于黑龍江中醫(yī)藥大學(xué)附屬第一醫(yī)院ICU病房,將患者隨機(jī)分為治療組和對照組各40例。對照組患者參照《2012年版膿毒癥國際指南》予以治療,治療組患者在西醫(yī)治療的基礎(chǔ)上予以化纖膠囊1號方水煎劑治療,療程為7日。觀察用藥前后APACHE-‖評分、SOFA評分、中醫(yī)證候積分、炎癥指標(biāo)、T細(xì)胞亞群等治療指標(biāo),并記錄治療過程中不良反應(yīng)及不良事件,評價化纖膠囊1號方對瘀毒內(nèi)阻型膿毒癥患者的臨床療效及對T細(xì)胞亞群的影響。結(jié)果:1.治療前一般基線資料比較:兩組患者之間的性別、年齡、APACHE-‖評分、SOFA評分、中醫(yī)證候積分、WBC、CRP、PCT、T細(xì)胞亞群之間的差異無統(tǒng)計學(xué)意義(P0.05)。2.治療前后組間比較:兩組患者之間APACHE-‖評分、SOFA評分、CRP、PCT之間的差異有統(tǒng)計學(xué)意義(P0.05),CD4+T細(xì)胞、中醫(yī)證候積分之間的差異具有顯著統(tǒng)計學(xué)意義(P0.01),兩組患者之間WBC、CD8+T細(xì)胞、CD4+/CD8 +的差異無統(tǒng)計學(xué)意義(P0.05)。3.治療前后組內(nèi)比較:治療后第7天治療組APACHE-‖評分、SOFA 評分、WBC、CRP、PCT、CD4+T、CD4+/CD8 +與治療前變化均有顯著統(tǒng)計學(xué)意義(P0.01)。治療后第7天治療組CD8+T細(xì)胞的變化與治療前變化有顯著統(tǒng)計學(xué)意義(P0.01),而對照組中CD8+T細(xì)胞的變化雖有統(tǒng)計學(xué)意義但統(tǒng)計學(xué)意義不顯著(P0.05)。4.中醫(yī)瘀毒內(nèi)阻癥狀療效評價:治療后第7天兩組患者瘀毒內(nèi)阻癥狀均得到改善,但治療組患者的改善程度優(yōu)于對照組。5.安全性觀察:兩組患者均未出現(xiàn)不良反應(yīng)。結(jié)論化纖膠囊1號方能夠改善瘀毒內(nèi)阻型膿毒癥患者APACHE-‖評分、SOFA評分,減少中醫(yī)證候積分,降低炎癥指標(biāo),改善免疫功能,起到益氣扶正、活血解毒作用,恢復(fù)瘀毒內(nèi)阻型膿毒癥患者CD4+T細(xì)胞數(shù)目,改善免疫抑制。
[Abstract]:Objective: to investigate the effect of Huaxian capsule No. 1 on (sepsis) immunosuppression and T cell subsets in patients with sepsis caused by blood stasis and internal obstruction, and to lay a foundation for clinical research on immunosuppression of sepsis treated with Yiqi Huoxue jiedu method. Methods: a randomized controlled clinical study was conducted in this study. 80 patients with sepsis of stasis toxin were included in this study. The cases were from ICU ward, the first affiliated Hospital of Heilongjiang University of traditional Chinese Medicine. The patients were randomly divided into treatment group (n = 40) and control group (n = 40). The patients in the control group were treated with reference to the 2012 edition of the International guidelines for sepsis, and the patients in the treatment group were treated with Huaxian capsule No. 1 decoction on the basis of western medicine. The course of treatment was 7 days. The APACHE- score, SOFA score, TCM syndrome score, inflammation index and T cell subgroup were observed before and after treatment, and the adverse reactions and adverse events were recorded. To evaluate the clinical effect of Huaxian capsule No. 1 on patients with sepsis with internal obstruction of blood stasis and its effect on T cell subsets. Result: 1. Comparison of general baseline data before treatment: there was no significant difference in sex, age, APACHE- score, SOFA score, TCM syndrome score and WBC,CRP,PCT,T cell subsets between the two groups (P 0.05). Comparison between the two groups before and after treatment: there were significant differences in APACHE- score, SOFA score and CRP,PCT between the two groups (P 0.05), and there were significant differences in CD4 T cells and TCM syndrome scores between the two groups (P 0.01). There was no significant difference in WBC,CD8 T cells and CD4 / CD8 between the two groups (P 0.05). Comparison before and after treatment: on the 7th day after treatment, there were significant changes in APACHE- score, SOFA score, WBC,CRP,PCT,CD4 T, CD 4 / CD8 and pre-treatment (P 0.01). On the 7th day after treatment, the changes of CD8 T cells in the treatment group were significantly different from those before treatment (P 0.01), while the changes in CD8 T cells in the control group were statistically significant but not statistically significant (P 0.05). Evaluation of the curative effect of internal obstruction of blood stasis in traditional Chinese medicine: on the 7th day after treatment, the symptoms of internal obstruction of blood stasis in both groups were improved, but the improvement degree of the patients in the treatment group was better than that in the control group. 5. Safety observation: there were no adverse reactions in both groups. Conclusion Huaxian capsule No. 1 can improve the APACHE- score and SOFA score, reduce the score of TCM syndromes, reduce the inflammatory index, improve the immune function, and play the role of invigorating qi and promoting blood circulation and detoxification. The number of CD4 T cells in patients with sepsis was restored and immunosuppression was improved.
【學(xué)位授予單位】：黑龍江中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R278
[Abstract]:Objective: to investigate the effect of Huaxian capsule No. 1 on (sepsis) immunosuppression and T cell subsets in patients with sepsis caused by blood stasis and internal obstruction, and to lay a foundation for clinical research on immunosuppression of sepsis treated with Yiqi Huoxue jiedu method. Methods: a randomized controlled clinical study was conducted in this study. 80 patients with sepsis of stasis toxin were included in this study. The cases were from ICU ward, the first affiliated Hospital of Heilongjiang University of traditional Chinese Medicine. The patients were randomly divided into treatment group (n = 40) and control group (n = 40). The patients in the control group were treated with reference to the 2012 edition of the International guidelines for sepsis, and the patients in the treatment group were treated with Huaxian capsule No. 1 decoction on the basis of western medicine. The course of treatment was 7 days. The APACHE- score, SOFA score, TCM syndrome score, inflammation index and T cell subgroup were observed before and after treatment, and the adverse reactions and adverse events were recorded. To evaluate the clinical effect of Huaxian capsule No. 1 on patients with sepsis with internal obstruction of blood stasis and its effect on T cell subsets. Result: 1. Comparison of general baseline data before treatment: there was no significant difference in sex, age, APACHE- score, SOFA score, TCM syndrome score and WBC,CRP,PCT,T cell subsets between the two groups (P 0.05). Comparison between the two groups before and after treatment: there were significant differences in APACHE- score, SOFA score and CRP,PCT between the two groups (P 0.05), and there were significant differences in CD4 T cells and TCM syndrome scores between the two groups (P 0.01). There was no significant difference in WBC,CD8 T cells and CD4 / CD8 between the two groups (P 0.05). Comparison before and after treatment: on the 7th day after treatment, there were significant changes in APACHE- score, SOFA score, WBC,CRP,PCT,CD4 T, CD 4 / CD8 and pre-treatment (P 0.01). On the 7th day after treatment, the changes of CD8 T cells in the treatment group were significantly different from those before treatment (P 0.01), while the changes in CD8 T cells in the control group were statistically significant but not statistically significant (P 0.05). Evaluation of the curative effect of internal obstruction of blood stasis in traditional Chinese medicine: on the 7th day after treatment, the symptoms of internal obstruction of blood stasis in both groups were improved, but the improvement degree of the patients in the treatment group was better than that in the control group. 5. Safety observation: there were no adverse reactions in both groups. Conclusion Huaxian capsule No. 1 can improve the APACHE- score and SOFA score, reduce the score of TCM syndromes, reduce the inflammatory index, improve the immune function, and play the role of invigorating qi and promoting blood circulation and detoxification. The number of CD4 T cells in patients with sepsis was restored and immunosuppression was improved.
【學(xué)位授予單位】：黑龍江中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R278
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