抗炎合剂治疗脓毒症疗效及对血管内皮细胞的影响研究  

Efficacy of Kangyan Heji (抗炎合剂) on Sepsis and Its Influence on Vascular Endothelial Cells

作　　者：刘征 卜建宏[1] 钱春美[1] 周琳[1] LIU Zheng;BO Jianhong;QIAN Chunmei;ZHOU Lin(Shanghai Municipal Hospital of Traditional Chinese Medicine,Shanghai University of Traditional Chinese Medicine,Shanghai 200071,China)

机构地区：[1]上海中医药大学附属市中医医院,上海200071

出　　处：《山东中医杂志》2020年第5期472-476,共5页Shandong Journal of Traditional Chinese Medicine

基　　金：上海市卫生和计划生育委员会青年课题项目(编号:20154Y0078)。

摘　　要：目的:观察抗炎合剂治疗脓毒症疗效,并从凝血功能方面探讨抗炎合剂对脓毒症患者血管内皮细胞的影响。方法:选取脓毒症患者76例,随机分成对照组和观察组,每组38例。对照组根据药敏试验选择敏感抗生素,同时给予西医基础治疗,观察组在对照组基础上给予抗炎合剂,两组疗程均为7 d。比较两组治疗前后外周静脉血中组织因子途径抑制物(TFPI)、抗凝血酶-Ⅲ(AT-Ⅲ)、组织型纤溶酶原激活物(t-PA)、纤溶酶原激活物抑制物-1(PAI-1)的变化及临床总有效率。结果:治疗7 d后,两组外周血中TFPI、AT-Ⅲ、t-PA均较治疗前上升,且观察组较对照组上升更为显著(P<0.05);两组PAI-1均较治疗前下降,且观察组较对照组下降更为显著(P<0.05);观察组总有效率89.47%,优于对照组的73.68%(P<0.05)。结论:抗炎合剂能改善脓毒症患者的血管内皮细胞功能,促进内皮细胞分泌内源性TFPI,合成AT-Ⅲ及t-PA,抑制PAI-1的合成,对改善微循环、保护脏器功能有积极影响。Objective:To investigate the efficacy of Kangyan Heji(抗炎合剂) on sepsis and its influence on vascular endothelial cells from coagulation function. Methods:Seventy six patients with sepsis were randomly divided into control group and observation group,38 patients in each group. In the control group,sensitive antibiotics were administered according to drug sensitivity test with routine treatment of western medicine.The observation group was further treated with Kangyan Heji besides the treatment of control group. The treatment lasted for 7 days. The changes of tissue factor pathway inhibitor (TFPI), antithrombase Ⅲ(AT-Ⅲ),tissue-type plasminogen activator(t-PA),and plasminogen activator inhibitor-1( PAI-1) in peripheral venous blood before and after treatment were compared between the two groups. Results:After 7 days of treatment,TFPI,AT-Ⅲ,t-PA in peripheral blood of the two groups were increased,and in the observation group the increase was more significant than that in the control group(P<0.05);PAI-1 in both groups was lower than before treatment,and in the observation group was more significant than that in the control group(P<0.05). The total efficacy in the observation group(89.47%) was better than that in the control group(73.68%)(P<0.05). Conclusion:Kangyan Heji can improve the function of vascular endothelial cells in patients with sepsis,promote endogenous TFPI secretion,production of AT-Ⅲ and t-PA,inhibit the production of PAI-1. It is good at improve the microcirculation and protect the function of organs.

关 键 词：抗炎合剂 脓毒症 凝血功能 血管内皮细胞 组织因子途径抑制物 抗凝血酶-Ⅲ 组织型纤溶酶原激活物 纤溶酶原激活物抑制物-1 

分 类 号：R259[医药卫生—中西医结合]