扶正解毒化瘀颗粒治疗脓毒性心肌病的临床研究  

Clinical study of Fuzhengjiedu Huayu granule on the treatment of septic cardiomyopathy

作　　者：朱海云[1,2] 阚建英[2] 曹书华[3] 

机构地区：[1]天津中医药大学,天津300193 [2]天津市中医药研究院附属医院,天津300120 [3]天津市一中心医院,天津300192

出　　处：《中国中西医结合急救杂志》2016年第3期245-247,共3页Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care

基　　金：天津市中医药管理局中西医结合科研课题（13004）

摘　　要：目的探讨扶正解毒化瘀颗粒对脓毒性心肌病（SC）患者的影响。方法将80例SC患者按随机数字表法分为对照组和观察组，每组38例。两组均给予西医常规治疗，观察组加用扶正解毒化瘀颗粒（每袋23．125g），每日2次，连用10d。观察治疗后中医证候积分、急性生理学与慢性健康状况评分系统Ⅱ（APACHEⅡ）评分及心功能指标B型钠尿肽（BNP）、左室射血分数（LVEF）、心肌肌钙蛋白I（cTnI）及感染指标降钙素原（PCT）、C-反应蛋白（CRP）水平的变化。结果观察组治疗后中医证候积分（分：11．84±2．38比16．53±2．88）和APACHEⅡ评分（分：9．87±3．37比12．24±3．17）均较对照组明显降低（P〈0．05）。观察组BNP于治疗后3d起、cTNI和PCT于治疗后7d起均较对照组明显下降[治疗后3dBNP（μg，L）：2．070±1．930比3．335±2．686，治疗后7dcTNI（ng／L）：0．094±0．161比0．221±0．267，PCT（ng／L）：1．53±0．97比1．98±0．75，均P〈0．05J，LVEF于治疗后3d起较对照组明显升高（0．43±0．07比0．40±0．06），持续到治疗后10d；观察组治疗后10dCRP较对照组显著下降（ng／L：70．1±43．6比99．3±52．6，P〈0．01）。结论中药扶正解毒化瘀颗粒能较好地减轻炎症反应和心肌损伤，改善心功能。Objective To discusse the influences of the fuzhengjiedu huayu granule on septic cardiomyopathy （SC） patients. Methods Eighty patients with SC patients were divided into control group and observation group by random number table, 38 cases in each group. Both groups were given conventional western medicine treatment, the patients in observation group were given fuzhengjiedu huayu granule （each hag 23.125 g）, 2 times a day, once every 10 days. The changes of traditional Chinese medicine （TCM） syndrome scores and acute physiology and chronic health evaluation Ⅱ （APACHE Ⅱ） score and cardiac function of B-type natriuretic peptide （BNP）, left ventricular ejection fraction （LVEF）, cardiac troponin I （cTnI）, infection indication of procalcitonin （PCT）, C-reactive protein （CRP） were observed after treatment. Results TCM syndrome scores （11.84 ±2.38 vs. 16.53±2.88） and APACHE Ⅱ scores （9.87 ±3.37 vs. 12.24 ±3.17） in observation group were significantly lower than those in control group （all P 〈 0.05）. The observation group after treatment 3 days BNP onwards, after treatment cTNI and PCT 7 days compared with the control group were significantly decreased [3 days after treatment BNP （txg/L）： 2.070 ±1.930 vs. 3.335 ±2.686, 7 days after treatment cTNI （ng/L）： 0.094 ±0.161 vs. 0.221 ±0.267, PCT （ng/L）： 1.53 ±0.97 vs. 1.98 ± 0.75, all P 〈 0.05], at 3 days after treatment LVEF was significantly higher than the control group （0.43 ± 0.07 vs. 0.40 ±0.06）, until after treatment 10 days; After 10 days CRP in observation group was decreased significantly than that in the control group （ng/L： 70.1 ± 43.6 vs. 99.3 ± 52.6, P 〈 0.01）. Conclusions Fuzhengjiedu huayu granule can better reduce inflammation, improve heart function and reduce myocardial injury.

关 键 词：扶正解毒化瘀颗粒 脓毒性心肌病 中西医结合疗法 

分 类 号：R259.872[医药卫生—中西医结合]