Sepsis3.0诊断标准下ICU脓毒症患者中医虚实证素对预后评估的探讨  

Analysis of Traditional Chinese Medicine(TCM) Excess and Deficiency Syndrome Element for Prognosis of the Patients with Sepsis According to the New Diagnostic Criteria(Sepsis-3) in the Intensive Care Unit

作　　者：宋麦芬[1] 杨思雯[1] 郭玉红[1] 夏非[1] 吴彦青[1] 石筝筝[1] 史清泉[1] 陈腾飞[1] 刘清泉[1,2] 

机构地区：[1]首都医科大学附属北京中医医院,北京100010 [2]中医感染性疾病基础研究北京市重点实验室,北京100010

出　　处：《中国中医急症》2016年第12期2238-2240,2264,共4页Journal of Emergency in Traditional Chinese Medicine

基　　金：北京市医院管理局重点医学专业发展计划中医急诊重点医学专业(ZYLX201611)

摘　　要：目的探索脓毒症患者的中医虚实证素特点,分析其对疾病的预后趋势。方法采用回顾观察性研究方法,将首都医科大学附属北京中医医院2014年7月至2016年6月期间ICU住院患者545例,根据sepsis3.0诊断标准入组病例189例,按虚实辨证分组,其中虚证组78例,实证组111例,比较虚证组与实证组患者入院时一般情况、实验室指标、评分、病死率之间的差异。结果 1)本研究189例患者中虚证组占41.27%,实证组占58.73%。2)虚证组与实证组比较,虚证组脓毒症患者WBC、NEUT显著升高[WBC(10×9/L):(12.39±5.33)比(11.14±5.48),NEUT(%):(83.89±12.39)比(80.56±12.70),均P<0.05];3)虚证组与实证组比较,两组间SOFA、q SOFA、APACHEⅡ及格拉斯哥评分无显著差异;4)虚证组脓毒症的病死率显著高于实证组[38.76%(30/78)比20.72%(23/111),P<0.05]。结论虚证脓毒症患者具有较高病死率,应将"扶正"思想全程贯彻于脓毒症的治疗中。Objective： To investigate TCM excess and deficiency syndrome element characteristics of patients with sepsis and analysis the trend of prognosis of disease. Methods： A retrospective study was conducted to collect clinical data on the septic patients who were admitted to the intensive care unit （ICU） of Beijing Hospital of Traditional Chinese Medicine Affiliated to Capital University of Medical Sciences from July 2014 to June 2016. 189 septic patients who met the diagnostic criterion of Sepsis-3 were divided into excessive syndrome group and deficiency syndrome group. There were 78 patients in the deficiency group while the 111 patients stayed in the excessive group. The basic information,laboratory index,scale and mortality were enrolled. Results： 1 ）The morbidity of patients in deficiency group was 41.27%,while that of patients in excessive group was 58.73%. 2）There was a significant difference between two groups about the quantity of WBC and the average of NEUT [WBC （109/ L）：（12.39±5.33） with （11.14±5.48）,NEUT （%）： （83.89±12.39） with （80.56±12.70）]（all P〈0.05）. 3）There was no statistical difference between two groups on the SOFA points, qSOFA points ,APACHE Ⅱ and GCS. 4）The deficiency syndrome group showed a higher mortality than the excessive syndrome group [38.76% （30/78） with 20.72% （23/111 ） ] （P 〈 0.05）. Conclusion： The deficiency group predicates a higher mortality. We should pay more attention to strengthening the body resistance in the treatment of sepsis.

关 键 词：Sepsis3.0 脓毒症 虚实 

分 类 号：R278[医药卫生—中医学]