升降散治疗脓毒症心肌损伤患者的临床疗效评价  

Clinical Efficacy Evaluation of “Shengjiang Powder” on Myocardial Injury in Patients with Sepsis

作　　者：赵雷[1] 钱风华[1] 沈梦雯[1] 巫亚颖[1] 王进[1] 郭健[1] 

机构地区：[1]上海中医药大学附属岳阳中西医结合医院急诊科,上海200437

出　　处：《上海中医药大学学报》2016年第6期19-24,共6页Academic Journal of Shanghai University of Traditional Chinese Medicine

基　　金：国家自然科学基金青年基金资助项目(81303101);上海市卫计委科研基金资助项目(201440399)

摘　　要：目的:评价升降散结合西医常规疗法治疗脓毒症心肌损伤患者的临床疗效。方法:纳入脓毒症心肌损伤(毒热内盛证)患者62例,随机分为西医对照组(简称"对照组")31例和中西医结合治疗组(简称"治疗组")31例。对照组给予西医常规治疗,治疗组在西医常规治疗基础上加用升降散治疗,两组疗程均为7 d。于治疗前后观察并比较两组患者的急性生理学与慢性健康状况评分(APACHEⅡ),检测患者的血清肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)、C反应蛋白(CRP)水平,评价两组患者的中医证候积分及中医证候疗效。结果:治疗后,两组患者的中医证候积分较治疗前均明显降低(P<0.01),且治疗组患者的中医证候积分改善情况优于对照组(P<0.01);对照组的中医证候总有效率为71.0%,治疗组为93.1%,治疗组疗效优于对照组(P<0.05)。治疗后,两组患者的血清TNF-α、IL-6、CRP水平较治疗前均显著降低(P<0.01),且治疗组患者的血清TNF-α、IL-6、CRP水平降低程度优于对照组(P<0.01,P<0.05);两组患者的APACHEⅡ评分较治疗前均显著降低(P<0.01),且治疗组患者的APACHEⅡ评分降低程度优于对照组(P<0.05)。结论:升降散结合西医常规疗法能有效改善脓毒症心肌损伤(毒热内盛证)患者的中医证候,减轻患者的心肌炎症反应。Objective： To evaluate the clinical curative effect of＂Shengjiang Powder＂combined with conventional western medicine on the myocardial injury in the patients with sepsis. Methods： Sixty-two patients with myocardial injury of sepsis（ toxic heat flourishing syndrome） were selected and randomly divided into the western medicine control group（ abbreviated to＂control group＂） and integrated Chinese and western medicine treatment group（ abbreviated to＂treatment group＂）,with 31 cases in each group. The patients in the control group were treated with conventional western medicine and the patients in the treatment group were treated with conventional western medicine combined with＂Shengjiang Powder＂,with a course of 7 days.The scores of Acute Physiology and Chronic Health Evaluation Ⅱ（ APACHE Ⅱ） were observed and compared before and after treatment,the levels of serum tumor necrosis factor-α（ TNF-α）,interleukin-6（ IL-6） and C-reactive protein（ CRP） were detected,and the scores and effects of Chinese medical syndrome were evaluated. Results： After treatment,the scores of Chinese medical syndrome of both groups were significantly decreased（ P〈0. 01）,and the score improvement of the treatment group was superior to that of the control group（ P〈0. 01）; the total effective rates of the control group and the treatment group on Chinese medical syndrome were 71. 0% and 93. 1% respectively,and the effect of the treatment group was better than that of the control group（ P〈0. 05）. After treatment,the levels of serum TNF-α,IL-6 and CRP were obviously decreased in both groups（ P〈0. 01）,and the reduction degree of the levels of serum TNF-α,IL-6 and CRP in the treatment group was superior to those in the control group（ P〈0. 01,P〈0. 05）. After treatment,the scores of APACHEⅡwere significantly decreased in both groups（ P〈0. 01）,and the reduction degree of the APACHE Ⅱ scores in the treatment group was superior to that in the control group（

关 键 词：脓毒症 心肌损伤 升降散 炎症因子 

分 类 号：R459.7[医药卫生—急诊医学]