中药复苏饮对严重脓毒症患者免疫功能的影响  

The Effect of Fusuyin Capsule on Immunologic Function of Patients with Severe Sepsis

作　　者：赵丽芸[1] 罗小星[2] 陈镜合[2] 陈宁[1] 

机构地区：[1]广东省第二中医院,广州510095 [2]广州中医药大学第一附属医院,广州510405

出　　处：《中国中医急症》2007年第7期768-771,共4页Journal of Emergency in Traditional Chinese Medicine

摘　　要：目的观察中药复苏饮对严重脓毒症患者机体免疫功能的影响。方法将40例患者随机分为复苏饮组(F组)和安慰剂组(A组),两组均西医常规监护、治疗,F组配合使用中药复苏饮,而A组则加用安慰剂;另选取15名健康者作为正常对照组(健康组)。所有患者入院后在治疗前、治疗第3日和第7日分别进行A- PACHEⅡ评分,同期采用ELISA法测定血清TNF-α、IL-6、IL-10浓度,流式细胞术检测外周血单核细胞HLA-DR表达率。结果两组治疗前各细胞因子均明显高于健康组,单核细胞HLA-DR表达明显低于健康组;治疗第3日F组TNF-α、IL-6明显下降,IL-10变化不明显,A组各细胞因子均无明显下降,两组HLA- DR表达均有恢复趋势,但变化不显著;治疗第7日F组抗炎因子IL-10和促炎因子TNF-α、IL-6均明显下降,与A组比较,各细胞因子差异有显著性;HLA-DR表达两组均明显回升,但F组HLA-DR表达率明显高于A组;同时F组第28日病死率明显低于A组,在治疗期间,两组APACHEⅡ评分的分值都呈下降趋势,治疗第3、7日F组分值较A组明显降低。结论复苏饮对促炎、抗炎性免疫反应具有相似的抑制作用。西医常规监护治疗结合中药复苏饮可有效调节严重脓毒症患者的免疫功能,缓解病情,降低死亡率,改善预后。Objective： To observe the effect of Fusuyin capsule on immunologic function in severe sepsis patients. Methods： 40 cases in this study were randomly divided into group F and group A. Patients in group F were treated with Fusuyin capsule and routine western therapy, while cases in group A were treated with placebo and routine western therapy. Another group of 15 healthy individuals were also included in the study as controls. On admission（before treatment）, on the 3th, 7th day after the treatment, Acute Physiology and Chronic Health Evaluation （APACHE Ⅱ）scores were also recorded, and the serum concentrations of TNF- α, IL- 6, IL- 10 were measured by means of ELISA, HLA - DR expression was assessed by means of flow cytometry. Results： On admission, all patients had significantly higher measured cytokines levels and lower HLA - DR expression than healthy individuals; On the 3th day, the levels of TNF- α, IL- 6 decreased significantly in group F, while HLA- DR expression increased slightly in the two groups, but there were not significant difference between them; On the 7th day, the levels of pro - inflammory and anti - inflammory cytokines in group F declined obviously than those in group A, whereas in group F HLA - DR expression were obviously higher. In adaddition, The 28 - day all - cause mortality was significant lowre in group F（30% ）than that in group A（55% ）. During the treatment, scores also showed a decrease in the two groups, especially on the 3th and the 7th day, scores declined significantly in group F. Conclusions： Fusuyin capsule had the similar effect on inhibiting pro - inflammatory and anti - inflammatory reaction. It could effectively regulate immune function, alleviate symptoms, decrease the mortality and improve the prognosis of patients by using Fusuyin capsule and the conventional western therapy.

关 键 词：脓毒症 细胞因子 HLA—DR 复苏饮 

分 类 号：R631.2[医药卫生—外科学]