四逆升降散改善脓毒症毛细血管渗漏综合征的临床研究  

Clinical Observation of Sini Shengjiang Powder in Sepsis Capillary Leakage Syndrome

作　　者：沈梦雯[1] 林柏柏 朱亮[1] 赵雷[1] 钱风华[1] 钱义明[1] Shen Mengwen;Lin Baibai;Zhu;Liang;Zhao Lei;Qian Fenghua;Qian Yiming(Yueyang Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai University of Traditional Chinese Medicine,Shanghai 200437,China)

机构地区：[1]上海中医药大学附属岳阳中西医结合医院,上海200437 [2]上海市宝山区中西医结合医院,上海201999

出　　处：《中国中医急症》2022年第3期391-394,共4页Journal of Emergency in Traditional Chinese Medicine

基　　金：上海市卫生健康委员会、上海市中医药管理局中医重点专科培育项目[ZY(2018-2020)-FWTX-7001];上海市卫生健康委员会科研课题计划(201940205);上海中医药大学附属岳阳中西医结合医院科研项目(2019YYQ07)。

摘　　要：目的观察四逆升降散改善脓毒症毛细血管渗漏综合征的临床应用效果。方法92例患者随机分为两组各46例,对照组在常规治疗基础上加用四逆升降散安慰剂;治疗组在常规治疗基础上加用四逆升降散。两组疗程均为7 d。分别于治疗前、治疗后比较两组患者血管内皮生长因子(VEGF)、血管生成素-2(Ang-2)、毛细血管渗漏指数(CLI)、肿瘤坏死因子-α(TNF-α)、白细胞介素-1β(IL-1β)、白细胞介素-6(IL-6)、急性生理与慢性健康评分(APACHEⅡ)、序贯器官衰竭评分(SOFA)、中医证候评分。同时随访后续CRRT使用率、28 d死亡率、住院天数。结果治疗后治疗组VEGF、Ang-2、TNF-α、IL-1β、IL-6、APACHEⅡ、SOFA、中医证候评分均有改善,与对照组比较,差异有统计学意义(P<0.05)。治疗组CRRT使用率、28 d死亡率、住院天数均低于对照组,差异有统计学意义(P<0.05)。结论四逆升降散能够有效干预脓毒症毛细血管渗漏综合征患者炎症因子及血管渗漏指标,从而改善患者预后。Objective:To observe the clinical effect of Sini Shengjiang Powder in improving sepsis capillary leakage syndrome.Methods:A total of 92 cases were randomly divided into two groups,46 cases in the control group and 46 cases in the treatment group.The treatment group was treated with Sini Shengjiang Powder on the basis of conventional treatment,while the control group was treated with placebo.The treatment lasted for 7 days.Vascular endothelial growth factor(VEGF),angiopoietin-2(Ang-2),capillary leakage index(CLI)and tumor necrosis factor-α(TNF-α)、Interleukin-1β(IL-1β),Interleukin-6(IL-6)were compared between the two groups before and after treatment,as well as the acute physiology and chronic health score(APACHEⅡ),sequential organ failure score(SOFA),TCM syndrome score.At the same time,the follow-up CRRT utilization rate,28-day mortality rate and hospitalization days were compared.Results:After treatment,VEGF,Ang-2 and TNF-α,IL-1β,IL-6,APACHEⅡ,SOFA and TCM syndrome score in the treatment group decreased,and the difference was statistically significant compared with the control group(P<0.05).The use rate of CRRT,28-day mortality and hospitalization days in the treatment group were lower than those in the control group,and the difference was statistically significant(P<0.05).Conclusion:Sini Shengjiang Powder can effectively intervene inflammatory factors and vascular leakage indexes in patients with sepsis capillary leakage syndrome,so as to improve the prognosis of patients.

关 键 词：脓毒症 毛细血管渗漏综合征 中药 升清降浊 活血利水 

分 类 号：R631[医药卫生—外科学]