加味参附颗粒对严重脓毒症患者血流动力学和氧代谢的影响  

Effects of Modified Shenfu Granule on Hemodynamic and Oxygen Metabolism in Patients with Severe Sepsis

作　　者：方统念[1] 王清海[1] 赵丽芸[1] 刘秋江[1] 王同汉[1] FANG Tongnian WANG Qinghai ZHAO Liyun LIU Qiujiang WANG Tonghan(Guangdong Second Traditional Chinese Medicine Hospital, Guangzhou 510095, China)

机构地区：[1]广东省第二中医院,广东广州510095

出　　处：《山东中医药大学学报》2016年第5期455-457,共3页Journal of Shandong University of Traditional Chinese Medicine

摘　　要：目的:探讨加味参附颗粒对严重脓毒症患者血流动力学和氧代谢的影响。方法:87例患者分为治疗组和对照组,对照组西药常规治疗,治疗组西药常规治疗基础上加用加味参附颗粒,连续5 d,应用脉波轮廓温度稀释连续心排量测量技术(Pi CCO)监测心脏指数(CI)、每搏量指数(SVI)、心率(HR)、平均动脉压(MAP)、中心静脉压(CVP)、氧输送(DO2)、氧消耗(VO2)、中心静脉血氧饱和度(Sa VO2)、血乳酸不同时点的结果变化。结果:治疗组与对照组比较,治疗后12 h,MAP比较差异有统计学意义(P<0.05);治疗后第2天、第3天、第5天,两组CI、SVI、HR、MAP比较差异有统计学意义(P<0.01,P<0.05),治疗后第2天,两组DO2、Sa VO2比较差异有统计学意义(P<0.05),治疗后第3天、第5天,两组DO2、VO2、Sa VO2、血乳酸比较,均差异有统计学意义(P<0.01,P<0.05)。结论:加味参附颗粒能明显改善严重脓毒症患者的血流动力学,提高氧输送,改善组织灌注,改善氧供与氧需平衡。Objective：To investigate the effects of modified Shenfu granule on the hemodynamic and oxygen metabolism in patients with severe sepsis. Methods：Total 87 patients were divided into treatment group and control group. The control group was accepted conventional western medicine treatment while the treatment group was treated with modified Shenfu granule based on conventional treatment for five days. All patients were needed to monitor various indicators such as cardiac index（CI）,stroke volume index（SVI）,heart rate（HR）,mean arterial pressure（MAP）,central venous pressure（CVP）,oxygen delivery（DO2）,oxygen consumption（VO2）,oxyhemoglobin saturation（Sa VO2）,lactic acid by Pi CCO. The changes were observed at different times. Results：MAP was statistically significant compared between the two groups（P 〈0.05） after treating for 12 h.CI,SVI,HR and MAP were statistically significant compared between the two groups（P 〈0.01,P 〈0.05） after treating for 2 days,3 days,5 days. DO2,Sa VO2 were statistically sig nificant compared between the two groups（P 〈0.05） after treating for 2 days. DO2,VO2,Sa VO2,lactic acid were statistically significant compared between the two groups（P〈0.01,P〈0.05） after treating for 3 days and 5 days. Conclusion：Modified Shenfu granule can significantly improve the hemodynamics of patients with severe sepsis,increase oxygen,improve tissue perfusion and improve the balance of oxygen supply and oxygen demand.

关 键 词：加味参附颗粒 严重脓毒症 血流动力学 氧代谢 临床研究 

分 类 号：R261.31[医药卫生—中医外科学]