芪参活血颗粒对肺炎合并脓毒症患儿血清炎症反应的影响  

Effects of Qishenhuoxue granule on serum inflammatory reaction in children with pneumonia complicated by sepsis

作　　者：张俊光[1] 黄东华[1] ZHANG Jun-guang;HUANG Dong-hua(Jizhong Energy Fengfeng Group Hospital, Handan 056201, China)

机构地区：[1]冀中能源峰峰集团总医院,河北邯郸056201

出　　处：《天津医药》2017年第5期510-513,共4页Tianjin Medical Journal

基　　金：邯郸市科技支撑计划项目(1623208095ZC)

摘　　要：目的探讨芪参活血颗粒对肺炎合并脓毒症患儿血清炎症反应的影响。方法选取2014年7月—2016年6月入住我院的138例肺炎合并脓毒症患儿作为研究对象。采用随机数字表法将患者分为观察组和对照组,每组69例。2组患者均给予常规西医对症支持治疗,观察组在此基础上联合芪参活血颗粒治疗。治疗结束后进行疗效评判;治疗前、治疗后7 d检测白细胞介素-6(IL-6)、白细胞介素-10(IL-10)、肿瘤坏死因子α(TNF-α)、血清降钙素原(PCT)、超敏C反应蛋白(hs-CRP)、CD4+CD25+调节性T淋巴细胞(Treg细胞)比例以及肌酸激酶同工酶(CK-MB)、肌酐(Scr)、天冬氨酸氨基转移酶(AST)、脑钠肽(BNP)水平;统计28 d病死率及治疗期住院时间;记录治疗期间不良反应事件。结果观察组疗效明显优于对照组(89.86%vs.71.01%,P<0.01)。治疗7 d后,2组IL-6、IL-10、TNF-α、PCT、hs-CRP水平及Treg细胞比例较治疗前均降低(P<0.05),且观察组L-6、IL-10、TNF-α、PCT、hs-CRP水平及Treg细胞比例低于对照组(P<0.05)。2组治疗7 d后,CK-MB、Scr、AST、BNP水平均较治疗前明显下降,且观察组CK-MB、Scr、AST、BNP水平明显低于对照组(P<0.05)。观察组28 d病死率及治疗期间住院时间均低于对照组(P<0.05)。观察组和对照组均未见不良反应发生。结论芪参活血颗粒有助于降低肺炎合并脓毒症患儿的炎症反应水平,提高治疗效果,且安全有效,值得临床推荐。Objective To study the effect of Qishenhuoxue granule on serum inflammatory response in children withpneumonia complicated with sepsis.Methods A total of138children with pneumonia complicated with sepsis who wereadmitted to our hospital from July2014to June2016were enrolled in this study.Children were randomly divided intoobservation group and control group.The patients in both groups were treated with conventional Western medicinesymptomatic support.The observation group was treated with Qishenhuoxue granule.The curative effect was determined aftertreatment.Interleukin-6(IL-6),interleukin-10(IL-10),tumour necrosis factor-α(TNF-α),serum procalcitonin(PCT),hypersensitive C-reactive protein(hs-CRP),CD4+CD25+regulatory T cell(Treg cells)ratio value,creatine kinase-MB(CKMB),creatinine(Scr),aspartic transaminase(AST)and brain natriuretic peptide(BNP)were measured before and7days afterthe treatment.Data of mortality and duration of pediatric intensive care unit(PICU)stay during treatment and adverse eventswere recorded during treatment.Results The total effective rate was89.86%in the observation group,which wassignificantly higher than that of control group(71.01%,P<0.01).The levels of IL-6,IL-10,TNF-α,PCT,hs-CRP and Tregcell ratio were significantly lower after7-day treatment in two groups than those before treatment(P<0.05),and levels of IL-6,IL-10,TNF-α,PCT,hs-CRP and Treg cell ratio were significantly lower in observation group than those in control group(P<0.05).The CK-MB,Scr,AST and BNP were reduced after7-day treatment in two groups,and those data were significantlylower in observation group than those of the control group(P<0.05).The28-day mortality and the number of PICU days weresignificantly lower in observation group than those in control group(P<0.05).No adverse reactions were found in the both groups.Conclusion Qishenhuoxue granule can decrease the inflammatory response in children with pneumoniacomplicated with sepsis and improve the therapeutic effect.It is safe and effective and worthy of clinical

关 键 词：肺炎 脓毒症 儿童 住院 药物疗法 联合 中药疗法 炎症 芪参活血颗粒 

分 类 号：R725.6[医药卫生—儿科] R969.4[医药卫生—临床医学]