抗炎合剂在早期脓毒症患者中的治疗作用  

Curative effect of anti-inflammatory agent on prophase of sepsis

作　　者：卜建宏[1] 李越华[1] 何文姬[2] 

机构地区：[1]上海中医药大学附属上海市中医医院,上海200071 [2]上海市普陀区人民医院,上海200060

出　　处：《现代中西医结合杂志》2011年第32期4047-4049,4055,共4页Modern Journal of Integrated Traditional Chinese and Western Medicine

基　　金：上海市卫生局项目(2009177)

摘　　要：目的观察中药抗炎合剂治疗早期脓毒症患者的疗效。方法 61例早期脓毒症患者随机分为治疗组和对照组,对照组30例予常规治疗,治疗组31例在对照组基础上加用抗炎合剂。观察治疗前后APACHEⅡ评分,比较治疗前后不同时段血乳酸、肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)、血小板及D-二聚体的变化,随访28 d病死率。结果 2组治疗后APACHEⅡ评分均下降(P均<0.05),治疗组优于对照组(P<0.05)。治疗3 d后治疗组血乳酸水平下降(P<0.05),优于对照组(P<0.05);CRP治疗组下降明显(P<0.05);血小板对照组下降明显(P<0.05)。治疗7 d后,2组乳酸水平均恢复正常(P均<0.01),组间比较无显著性差异;TNF-α2组均下降(P均<0.05),治疗组下降更明显(P<0.05);CRP治疗组下降显著(P<0.01),优于对照组(P<0.05);对照组Plt下降持续,治疗组较对照组有一定程度恢复(P<0.05);D-二聚体对照组明显上升(P<0.05)。28 d病死率2组比较无显著性差异。结论抗炎合剂治疗早期脓毒症患者有效。Objective It is to observe the curative effect of anti-inflammatory agent on prophase of sepsis.Methods Sixty-one patients with prophase of sepsis were randomly divided into two groups.Thirty patients were in control group and treated with conventional treatment.Thirty-one patients were in treatment group and treated with anti-inflammatory agent based on the treatment of control group.The APACHE Ⅱ scores before and after treatment were observed.The changes of blood lactic acid,TNF-α,CRP,Plt and D-dimer before and after treatment in different time slots were compared.The 28 d fatality rate was followed up.Results The APACHE II scores in the two groups both lowered after treatment（both P0.05） and the treatment group was superior to the control group（P0.05）.The level of blood lactic acid in treatment group lowered after treatment for 3 d（P0.05） and the treatment group was superior to the control group（P0.05）.The level of CRP in treatment group lowered obviously（P0.05） and the level of Plt in control group lowered obviously（P0.05）.After treatment for 7 d,the level of blood lactic acid in the two groups both restored to normal（both P0.01） and the difference was no significance between the two groups.The level of TNF-α in the two groups both lowered（both P0.05） and that in treatment group lowered more obviously（P0.05）.The level of CRP in treatment group lowered significantly（P0.01） and was superior to the control group（P0.05）.The level of Plt in control group lowered continuously and that in treatment group restored to a certain level（P0.05）.The level of D-dimer in control group heightened obviously（P0.05）.The difference on the 28 d fatality rate was no significant between the two groups.Conclusion It is effective of anti-inflammatory agent on prophase of sepsis.

关 键 词：脓毒症 微循环障碍 炎症反应 凝血功能 抗炎合剂 

分 类 号：R631[医药卫生—外科学]