山莨菪碱治疗感染性休克的临床应用进展  

Review on Clinical Application of Anisodamine in Treatment of Septic Shock

作　　者：郭思宇 张景媛 吴嘉瑞[1] 周唯[1] 肖浩[2] 杨军[3] 管来顺[4] 王琦 成云芳 贾珊珊 GUO Siyu;ZHANG Jingyuan;WU Jiarui;ZHOU Wei;XIAO Hao;YANG Jun;GUAN Laishun;WANG Qi;CHENG Yunfang;JIA Shanshan(School of Chinese Materia Medica, Beijing University of Chinese Medicine, Beijing 102488, China;Dept.of Emergency, the Second Hospital of Hebei Medical University,Hebei Shijiazhuang 050000, China;Dept.of Emergency, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China;Dept.of Emergency, Shaanxi Provincial People s Hospital,Shaanxi Xi’an 710068, China;Dept.of Emergency, Tangdu Hospital Affiliated to Air Force Military Medical University,Shaanxi Xi’an 710038, China;Dept.of Medical Affairs, Chengdu the First Pharmaceutical Co., Ltd.,Sichuan Chengdu 611930, China)

机构地区：[1]北京中医药大学中药学院,北京102488 [2]河北医科大学第二医院急诊科,河北石家庄050000 [3]首都医科大学附属北京朝阳医院急诊科,北京100020 [4]陕西省人民医院急诊科,陕西西安710068 [5]空军军医大学唐都医院急诊科,陕西西安710038 [6]成都第一制药有限公司医学事务部,四川成都611930

出　　处：《中国医院用药评价与分析》2019年第4期389-392,共4页Evaluation and Analysis of Drug-use in Hospitals of China

基　　金：国家自然科学基金项目(No.81673829);北京中医药大学与成都第一制药有限公司合作课题

摘　　要：感染性休克是急诊科常见的急危重症,是指严重感染导致的低血压持续存在,经充分的液体复苏难以纠正的急性循环衰竭,可迅速导致严重组织器官功能损伤,主要死亡原因为多器官功能衰竭,病死率高。我国茄科植物山莨菪中提取得到的抗胆碱药山莨菪碱具有扩张血管、改善微循环、改善心血管功能、保护细胞和降低血乳酸浓度等作用,能降低感染性休克的病死率,是感染性休克治疗的一个重要辅助手段,值得在临床推广应用。本研究通过检索中国知网、万方数据库和维普数据库等数据库,系统收集山莨菪碱治疗感染性休克的相关文献并进行综述。研究结果显示,山莨菪碱用于感染性休克治疗的疗效较好,其抗休克的主要机制包括能够解除血管痉挛、改善微循环、抑制血小板聚集、阻断M胆碱受体、兴奋机体的呼吸中枢、调节迷走神经和抑制腺体分泌等。希望本综述能够对山莨菪碱治疗感染性休克的临床应用提供参考。Septic shock is a common acute and critical disease in the emergency department. It refers to the persistent hypotension caused by severe infection, and the acute circulatory failure that is difficult to correct after adequate fluid resuscitation, which can quickly lead to severe damage of tissues and organs. The main cause of death is multi-organ failure, with a higher fatality rate. Anisodamine, an anticholinergic drug extracted from Chinese Solanaceae, can dilate the blood vessels, improve the microcirculation, improve the cardiovascular function, protect cells and reduce the blood lactic acid concentration, and decrease the mortality of septic shock. It is an important auxiliary means for the treatment of septic shock and is worthy of clinical application. This study systematically collected and reviewed the related literature on the treatment of septic shock with anisodamine by searching the databases of CNKI, Wanfang database and VIP database. The results showed that anisodamine was effective in the treatment of septic shock, and its main anti-shock mechanisms included relieving vasospasm, improving microcirculation, inhibiting platelet aggregation, blocking M-cholinergic receptor, stimulating the respiratory center of the body, regulating the vagus nerve and inhibiting the gland secretion. It is hoped that this review can provide a reference for the clinical application of anisodamine in the treatment of septic shock.

关 键 词：山莨菪碱 感染性休克 临床应用 综述 

分 类 号：R932[医药卫生—生药学]