锦红片联合西医常规疗法治疗急性腹腔感染脓毒症的临床观察  

Clinical observation of Jinhong Tablet combined with western medicine in the treatment of sepsis due to acute abdominal infection

作　　者：杨吉勇[1] 叶圳 梅丹[2] 谢金昆[1] 蔡滨[1] 张静喆[1] 顾宏刚[1] YANG Jiyong;YE Zhen;MEI Dan;XIE Jinkun;CAI Bin;ZHANG Jingzhe;GU llonggang(Department of General Surgery,Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200032,China;Department of General Surgery,Jinshan Branch,Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 201500,China)

机构地区：[1]上海中医药大学附属龙华医院普外科,上海200032 [2]上海中医药大学附属龙华医院金山分院普外科,上海201500

出　　处：《上海中医药大学学报》2020年第3期9-13,共5页Academic Journal of Shanghai University of Traditional Chinese Medicine

基　　金：国家自然科学基金资助项目(81173267)。

摘　　要：目的:观察锦红片联合西医常规疗法治疗急性腹腔感染脓毒症的临床疗效。方法:将62例急性腹腔感染脓毒症患者随机分为治疗组和对照组,每组31例。对照组在西医常规疗法的基础上加用锦红片安慰剂,治疗组在西医常规疗法的基础上加用锦红片。治疗14 d后,观察两组临床疗效,比较中医证候积分、急性生理与慢性健康(APACHE)Ⅱ评分、实验室指标的变化情况及并发症的发生率、病死率。结果:①治疗组、对照组并发症发生率分别为3.2%、35.5%,病死率分别为0.0%、19.4%,治疗组并发症发生率、病死率均低于对照组(P<0.05)。②治疗组、对照组总有效率分别为96.8%、64.5%,治疗组临床疗效优于对照组(P<0.05)。③治疗前后组内比较,治疗组中医证候总积分及各分项积分均降低(P<0.05),对照组发热、腹胀、气促、烦躁、排便不畅积分及中医证候总积分降低(P<0.05);组间治疗后比较,治疗组中医证候总积分及各分项积分低于对照组(P<0.05)。④治疗前后组内比较,治疗组APACHEⅡ评分降低(P<0.05),对照组APACHEⅡ评分差异无统计学意义(P>0.05);组间治疗后比较,治疗组APACHEⅡ评分低于对照组(P<0.05)。⑤治疗前后组内比较,治疗组白细胞计数(WBC)及血清肿瘤坏死因子-α(TNF-α)、白介素-2(IL-2)、C反应蛋白(CRP)、降钙素原(PCT)水平均降低(P<0.05),对照组WBC、TNF-α、CRP、PCT水平降低(P<0.05);组间治疗后比较,治疗组WBC、TNF-α、IL-2、CRP、PCT水平均低于对照组(P<0.05)。结论:与单纯西医常规疗法相比,加用锦红片有利于提高急性腹腔感染患者的临床疗效,改善患者的临床症状,减少并发症的发生,降低病死率;其机制可能与改善患者的急性炎症状态有关。Objective: To observe the clinical efficacy of Jinhong Tablet combined with western medicine in the treatment of sepsis due to acute abdominal infection. Methods: Sixty-two patients with sepsis due to acute abdominal infection were randomly divided into the treatment group and control group, 31 cases in each group. The control group was treated with Jinhong Tablet placebo based on the conventional therapy of western medicine, and the treatment group was treated with Jinhong Tablet based on the conventional therapy of western medicine, with a course of 14 days. The clinical efficacy was observed in both groups, and the changes of Chinese medical syndrome score, acute physiology and chronic health evaluation(APACHE) Ⅱ score, laboratory indexes as well as the incidence of complications and the mortality were compared. Results: ① The incidence rates of complications in the treatment group and control group were 3.2% and 35.5% respectively,and the mortality was 0.0% in the treatment group and 19.4% in the control group respectively. The incidence of complications and the mortality in the treatment group were lower than those in the control group(P<0.05).(2) The total effective rates of the treatment group and control group were 96. 8% and 64. 5% respectively,and the clinical efficacy of the treatment group was better than that of the control group(P<0.05).(3) Compared with those before treatment,the total score of Chinese medical syndrome and the scores of all items were decreased in the treatment group after treatment(P<0.05),the total score of Chinese medical syndrome and the scores of fever,abdominal distention,shortness of breath,dysphoria and poor defecation were decreased in the control group after treatment(P<0.05). After treatment,the total score of Chinese medical syndrome and the scores of all items in the treatment group were lower than those in the control group(P<0.05).(4) Compared with that before treatment,the APACHE Ⅱ score of the treatment group was decreased after treatment(P<0.05),but there wa

关 键 词：脓毒症 急性腹腔感染 锦红片 炎症反应 病死率 

分 类 号：R459.7[医药卫生—急诊医学]