芪参活血颗粒辅助治疗危重症患者急性肾损伤的疗效观察  

Effect of Qishen Huoxue Granule for Auxiliary Treatment of Critical Cases of Acute Kidney Injury

作　　者：虞燕波[1] 庄海舟[1] 刘冲[1] 段美丽[1] 张淑文[1] 李昂[1] 

机构地区：[1]首都医科大学附属北京友谊医院重症医学科,北京100050

出　　处：《中国中西医结合杂志》2010年第8期819-822,共4页Chinese Journal of Integrated Traditional and Western Medicine

摘　　要：目的探讨应用中药芪参活血颗粒辅助治疗危重症患者急性肾损伤(AKI)的临床疗效。方法选择北京友谊医院重症医学科AKI患者52例,随机分为A组(25例)给予芪参活血颗粒(成分包括黄芪、丹参、赤芍、川芎、红花、当归等;10g/袋,每次10g,胃管注入,每天3次,疗程共14天)加血液滤过;B组(27例)给予血液滤过治疗。A、B两组中再根据是否应用机械通气分为A1亚组及B1亚组,是否应用血管活性药物分为A2亚组及B2亚组。分析比较A、B两组患者肾功能恢复时间、住重症监护病房(ICU)时间、28天病死率及血清中半胱氨酸蛋白酶抑制剂C(CystatinC)值的变化。同时比较A1亚组与B1亚组使用呼吸机时间的变化,以及A2亚组与B2亚组使用血管活性药物时间的变化。结果与B组比较,A组患者肾功能恢复时间早,血清CystatinC水平由第10天开始降低(P<0.05);A1亚组患者较B1亚组使用呼吸机时间短(P<0.05)。A2亚组患者较B2亚组使用血管活性药物时间短(P<0.05);住ICU时间及28天病死率两组比较,差异无统计学意义(P>0.05)。结论芪参活血颗粒可缩短肾功能恢复时间,缩短机械通气时间及血管活性药物使用时间,在治疗危重患者急性肾损伤方面显示了较好的治疗前景。Objective To explore the efficacy of Qishen Huoxue Granules（QHG） for auxiliary treatment of critical patients with acute kidney injury（AKI） .Methods Fifty-two AKI patients came from critical care medical department of Beijing Friendship Hospital were randomly assigned to two groups：Group A（25 patients） was treated with QHG（consisted of Radix Astragali,Radix Salviae miltiorrhizae,Radix Paeoniae rubra,Flos Carthami,and Radix Angelicae sinensis,etc.,10 g/bag,administered via gastric perfusion,3 times per day,10 g in each time） and continuous renal replacement therapy（CRRT）;Group B（27 cases） was treated only by CRRT,all for 14 days.Besides,mechanical ventilation and vasoactive drugs were applied in case of necessary.The time of renal function recovery,days in ICU,28-day mortality,changes of serum Cystatin C concentration as well as the time of mechanical ventilation（T-V） and vasoactive drugs application（T-D） in patients,who received corresponding treatment were observed.Results The renal function recovery time in Group A was markedly earlier than that in Group B（P 0.05）,with concentration of serum Cystatin C began to decrease from day 10.T-V and T-D in Group A were markedly shorter than those in Group B,respectively（P 0.05） .No significantly statistical difference between the two groups for days in ICU and 28-day mortality was found（P 0.05） .Conclusion QHG shows favorable prospect in treating critical AKI patients,it can significantly accelerate the renal function recovery time,shorten the duration of mechanical ventilation and vasoactive drugs application.

关 键 词：芪参活血颗粒 急性肾损伤 机械通气 血管活性药物 

分 类 号：R277.5[医药卫生—中医学]