加味小承气汤合五味消毒饮联合乌司他丁治疗脓毒症的临床研究  

Clinical study on the treatment of sepsis with the combination of Xiaochengqi decoction,Wuweixiaodu decoction and ustodin

作　　者：杭敏[1] 李艳秋[1] 许磊[1] 郭东风[1] 施琴[1] 罗前程[1] 奚志华 陈果 

机构地区：[1]上海市浦东新区公利医院,上海200135

出　　处：《现代中西医结合杂志》2017年第31期3444-3447,共4页Modern Journal of Integrated Traditional Chinese and Western Medicine

摘　　要：目的观察加味小承气汤合五味消毒饮联合乌司他丁治疗脓毒症的临床疗效。方法将72例脓毒症患者随机分为观察组和对照组。对照组给予乌司他丁治疗,观察组在此基础上给予加味小承气汤合五味消毒饮治疗,2组均以7 d为1个疗程,治疗1个疗程。观察2组治疗前后临床症状、APACHEⅡ评分、血清炎性物质含量、体液免疫指标及细胞免疫指标的变化。结果观察组治疗后总有效率显著高于对照组(P<0.05);2组治疗后APACHEⅡ评分及肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)含量均显著降低(P均<0.05),而IL-10含量均显著升高(P均<0.05),且观察组改善情况均优于对照组(P均<0.05);治疗后,观察组体液免疫指标水平均明显升高(P均<0.05),对照组免疫五项指标均无显著变化(P均>0.05);治疗后,2组CD4+、CD4+/CD8+细胞均显著升高(P均<0.05),而CD8+显著降低(P<0.05),且观察组治疗后细胞免疫指标改善情况均显著优于对照组(P均<0.05)。结论加味小承气汤合五味消毒饮联合乌司他丁可有效调节脓毒症患者机体免疫功能,减轻体内炎症反应,从而有效改善患者临床症状及预后。Objective It is to observe the clinical effect of the combination of Xiaochengqi decoction, Wuweixiaodu decoction and ustodin on sepsis. Methods 72 patients with sepsis were randomly divided into observation group and control group. The control group was treated with ustantidine, and the observation group was treated with combination of Xiaochengqi decoction, Wuweixiaodu decoction and ustodin. Both groups were treated for 7 days. The changes of clinical symptoms, APACHE Ⅱ score, serum contents of inflammatory substances, humoral immunity and cellular immunity indicators before and after treatment were observed in both groups. Results The total effective rate after treatment was significantly higher in the observation group than that in the control group （P 〈 0.05）. After treatment, APACHE Ⅱ scores and the contents of TNF-α, IL-6 were significantly decreased（ P 〈 0. 05 ） , the content of IL-10 was significantly increased in both groups （P 〈 0. 05 ）, and the improvements in the observation group were better than that in the control group （ P 〈 0. 05 ）. After treatment, the levels of humoral immunity indexes were significantly increased in the observation group （ P 〈 0.05 ）, but no significant change was found in the control group （P 〉 0.05 ）. After treatment, the levels of CD4^＋ , CD4^＋/CD8^＋ were significantly increased （P 〈 0.05 ）, while CD8^＋ was decreased significantly in both groups（P 〈 0.05 ）, and the improvements of these cellular immunity indexes in the observation group were significantly better than that in the control group （ P 〈 0.05 ）. Conclusion The combination of Xiaochengqi decoction, Wuweixiaodu decoction and ustodin can effectively regulate the body＇ s immune function, relieve inflammation reaction, so as to effectively improve the clinical symptoms and prognosis in the patients with sepsis.

关 键 词：脓毒症 小承气汤 五味消毒饮 乌司他丁 免疫功能 

分 类 号：R631.2[医药卫生—外科学]