清毒调血方对脓毒症凝血功能紊乱干预的临床观察  

Clinical Observation of the Intervention of Qingdu Tiaoxue Decoction on Coagulation Disorders of Sepsis

作　　者：顼志兵[1] 马金苗 朱杰 宋丽[1] 吴永伟[1] 张丽葳 

机构地区：[1]上海中医药大学附属第七人民医院,上海200137

出　　处：《中国中医急症》2017年第9期1551-1553,共3页Journal of Emergency in Traditional Chinese Medicine

基　　金：上海市浦东新区中医领军型人才培养项目资助(PDZYXK-4-2014007)

摘　　要：目的观察清毒调血方对脓毒症凝血功能紊乱的临床疗效并探讨其机制。方法选取脓毒症患者60例。研究采用随机、单盲、对照的临床试验设计,分为中西医结合组和对照组,各30例。两组均按指南予以西医规范治疗,中西医结合组在西医常规治疗的基础上,加以清毒调血方治疗,比较两组患者治疗7 d后的临床疗效。结果入院时两组患者的急性生理和慢性健康(APACHEⅡ)评分和序贯性器官衰竭(SOFA)评分无显著性差异,治疗后两组患者均显著降低(P<0.05),组间差异有统计学意义(P<0.05);两组患者治疗后中医证候积分差异有统计学意义(P<0.05),中西医结合组患者治疗显著高于对照组(P<0.05)。治疗7 d后,与对照组比较,中西医结合组APACHEⅡ、SOFA评分显著降低(P<0.05)。与对照组比较,中西医结合组治疗后凝血酶原时间、激活部分凝血酶原时间降低,纤维蛋白原升高,差异无统计学意义(P>0.05);血小板,ATⅢ升高,差异有统计学意义(P<0.05),TT治疗前后无明显变化,组间比较无明显差异。结论清毒调血方升高PLT、ATⅢ,降低APACHEⅡ评分和SOFA评分,改善脓毒症预后。Objective： To observe the clinical curative effect of Qingduu Tiaoxue Decoction on coagulation disorders of sepsis,and to explore its mechanism. Methods： 60 patients with sepsis were selected. The randomized,single blind and controlled clinical trial design was used to divide the cases into 30 cases in the integrative medicine group and 30 cases in the control group. The two groups were treated by Western standard treatment according to the guidelines,and the integrative medicine group was treated with Qingdu Tiaoxue Decoction,based on the routine treatment of Western medicine. The clinical efficacy of the two groups was Compared 7d after treatment. Results： There was no significant difference in APACHEⅡ and SOFA between the two groups before treatment. APACHEⅡ and SOFA in both groups decreased significantly after treatment（P 0.05）. There was significant statistic difference（P 0.05）. The scores of TCM syndromes in the two groups after treatment were statistically significant（P 0.05）. The integrative medicine group was significantly higher than the control group（P 0.05）.Seven days after treatment,Compared with the control group,in the integrative medicine group,APACHE Ⅱ and SOFA decreased significantly（P 0.05）;PT and APTT decreased;FIB increased;the difference was not statistically significant（P 0.05）;PLT and ATⅢ rose;the difference was statistically significant（P 0.05）. No significant changes in TT were observed before and after treatment,and there was no statistical difference between the two groups. Conclusion： Qingdu Tiaoxue Decoction can elevate levels of blood platelets（PLT） and ATⅢ,reduce the APACHEⅡ score and SOFA score,and improve the prognosis of sepsis.

关 键 词：清毒调血方 脓毒血症 凝血功能 中医证候 

分 类 号：R631[医药卫生—外科学]