解毒祛瘀法干预脓毒症热毒炽盛证的疗效及对人高迁移率族蛋白1影响的研究  

Effect of Jiedu Quyu Therapy on fire-toxin syndrome of sepsis and on human high mobility group1 protein

作　　者：陈莉云[1] 李淑芳[1] CHEN Liyun LI Shufang(Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 200021)

机构地区：[1]上海中医药大学附属曙光医院,上海200021

出　　处：《现代中医临床》2017年第5期29-33,共5页Modern Chinese Clinical Medicine

基　　金：上海市科学技术委员会资助项目(No.13401904500)

摘　　要：目的观察解毒祛瘀法干预脓毒症热毒炽盛证的疗效以及对人高迁移率族蛋白1(HMGB1)的影响。方法将90例脓毒症热毒炽盛证患者随机分为治疗组45例、对照组45例。治疗组在西医综合治疗的基础上加用解毒祛瘀中药,对照组在西医综合治疗的基础上加用中药安慰剂。比较2组临床疗效,发热、呼吸道症状及消化道症状积分,血清HMGB1值。结果治疗组45例中,临床控制11例(24.4%),显效12例(26.7%),有效18例(40.0%),无效4例(8.9%),总有效率为91.1%;对照组45例中,临床控制4例(8.9%),显效12例(26.7%),有效20例(44.4%),无效9例(20.0%),总有效率80.0%。经秩和检验,Z=-2.232,P=0.026,P<0.05,说明治疗组疗效优于对照组。2组治疗前后症状积分重复测量方差分析结果显示,便秘的组别和观察时间的交互作用有统计学意义(P<0.05),其余症状的交互作用均没有统计学意义(P>0.05)。2组组间比较显示:治疗组咳嗽、喘息、腹胀、便秘积分均较对照组下降,差异有统计学意义。血清HMGB1治疗后治疗组较本组治疗前下降,差异有统计学意义(P<0.05)。结论解毒祛瘀法可以提高脓毒症热毒炽盛证患者的疗效,改善发热、咳嗽、喘息、腹胀和便秘等症状,其机制可能与解毒祛瘀法降低脓毒症患者血清HMGB1水平有关。Objective To observe the effect of Jiedu Quyu Therapy on fire-toxin syndrome of sepsis and the effect on human high mobility group-1 protein（ HMGB1）. Methods Ninety patients with fire-toxin syndrome of sepsis were divided into control group（ n = 45） and treatment group（ n = 45）. Control group was treated with comprehensive treatment of western medicine combined with placebo,and treatment group was given the comprehensive treatment of western medicine plus the traditional Chinese medicine Jiedu Quyu therapy. Daily observation of TCM Syndrome： such as fever,cough,wheezing,abdominal distension,constipation. As well as tongue,pulse and other general symptoms and signs,and the TCM syndrome score. HMGB1 in serum was measured by enzyme-linked immunosorbent assay（ ELISA）before and after ten days＇ treatment respectively. Results In treatment group,there were 11 cases（ 24.4%） were clinically controlled,and 12 cases（ 26. 7%） with obvious effects,18 cases（ 40. 0%） with effects,4（ 8. 9%） without effects,and the total effective rate was 91. 1%. In control group,there were4 cases（ 8. 9%） were clinically controlled,12 cases（ 26. 7%） with obvious effects,20 with（ 20. 4%）effects,9（ 20. 0%） without effects,and the total effective rate was 80. 0%. Z =-2. 232,P = 0. 026,P 〈0. 05 after rank sum test. 2 groups before and after treatment of symptomatic points repeated measurement analysis of variance analysis showed that： As for the constipation symptom,the interaction between groups and observation time was statistically significant（ P 〈0. 05）,however,as for other symptoms the interaction between groups and observation time was not statistically significant（ P 〈0. 05）. Compared with the control group,the scores of cough,wheezing,abdominal distension and constipation in the treatment group were lower than those in the control group. The difference was statistically significant. After treatment,serum HMGB1 levels in the treatment group were lower than before treatment,th

关 键 词：解毒祛瘀法 脓毒症 人高迁移率族蛋白1 

分 类 号：R285.6[医药卫生—中药学]