大承气汤对行机械通气严重脓毒症患者炎症反应和免疫调节功能的影响  

EFFECTS OF DACHENGQI DECOCTION ON INFLAMMATORY RESPONSES AND IMMUNOLOGIC FUNCTION OF SEVERE SEPSIS PATIENTS WITH VENTILATION

作　　者：余丹凤[1] 翁银燕[1] 徐建[1] 胡马洪[1] 金东[1] 张庚[1] 

机构地区：[1]浙江省立同德医院急诊内科,杭州310012

出　　处：《中国中医药科技》2011年第3期181-182,175-176,共2页Chinese Journal of Traditional Medical Science and Technology

基　　金：浙江省中医药科技计划项目No.2006C150

摘　　要：目的:观察大承气汤对行机械通气严重脓毒症患者炎症反应及免疫调节功能的影响。方法:将75例行机械通气的严重脓毒症患者,随机分为对照组和观察组,对照组采用西药常规治疗,观察组在西医常规治疗基础上加中药大承气汤鼻饲;观察比较两组患者炎症相关性指标炎性介质中的肿瘤坏死因子(TNF)、白介素-2(IL-2)、白介素-6(IL-6),急性时相蛋白(APPs)中的C反应蛋白(CRP)、al酸性糖蛋白(AAG)、铜蓝蛋白(CER)、结合珠蛋白(HP)及免疫相关性指标淋巴细胞亚群中的CD3+、CD4+、CD8+、CD4+/CD8+各值在治疗前及治疗后第3、7、14、28天的变化情况。结果:两组治疗前各值比较均无差异;观察组治疗后第3、7、14天炎症介质中的TNF、IL-2、IL-6各值较对照组下降明显(P<0·05);治疗后第3、7、14天两组的CPR、AAG,第3、7天的HP有差异(P<0·01);CER治疗前后均无差异(P>0·05)。所有患者淋巴细胞亚群中的CD3+、CD4+在1周达最低值,2周后开始回升,28天后均恢复正常,两组治疗后的第3、7、14天各指标比较有差异(P<0·05)。结论:大承气汤能减少炎症介质的产生、抑制炎症反应并具有免疫调节功能。Objective:To observe the effect of dachengqi decoction on inflammatory responses and immunologic function of severe sepsis patients with ventilation.Methods:75 Cases severe sepsis patients with ventilation were randomly divided into control group and observed group,control group was given normal western medicine,observed group was given dachengqi decoction on the basis of normal western medicine to nasal feeding.The changes of inflammatory responses related indexes such as TNF-α,IL-2,IL-6,CRP,AAG,CER,HP and immune-related indexes such as CD+3,CD+4 and CD+8 were determined before treated and after treated 3,7,and 14days.Results:There were no differences between the two groups before treated on the inflammatory responses related indexes and immune-related indexes,the levels of TNF-α,IL-2 and IL-6 were obviously decreased in observed group after treated for 3,7,14 days,there were differences between the two groups;the levels of CRP and AAG in observed group after treated for 3,7,14 days were obviously lower than those in the control group,HP content was significantly lower on the third and the seventh day after treated.The CD+3,CD+4 and CD+8 levels were reduce to the lowest value,they began increasing in the second week and recovered to the normal level after treated for 28 days,there was difference between the two groups on the third,seventh and fourteenth day.Conclusion:Dachengqi decoction could reduce the inflammatory factors of severe sepsis patients with ventilation and inhibit the inflammatory responses,regulate their immune function.

关 键 词：脓毒症/中医药疗法 大承气汤/治疗应用 人类 

分 类 号：R278[医药卫生—中医学]