参附汤合生脉散治疗脓毒症休克阴竭阳脱证  

Curative effect of Shenfu Decoction combined with Shengmai Powders in the treatment of septic shock with the syndrome of depletion of yin causing yang collapse

作　　者：黄元庆[1] 周明亮 周皓岚[2] HUANG Yuanqing;ZHOU Mingliang;ZHOU Haolan(Department of Critical Care Medicine,Bazhong Hospital of Traditional Chinese Medicine,Bazhong 636000,China;Department of General Surgery,Bazhong Hospital of Traditional Chinese Medicine,Bazhong 636000,China)

机构地区：[1]四川省巴中市中医院重症医学科,四川巴中636000 [2]四川省巴中市中医院普外科,四川巴中636000

出　　处：《长春中医药大学学报》2022年第10期1117-1121,共5页Journal of Changchun University of Chinese Medicine

基　　金：四川省中医药管理局科学技术研究专项课题(2020LC0003)。

摘　　要：目的探讨参附汤合生脉散治疗脓毒症休克阴竭阳脱证疗效。方法采用随机数表法将110例脓毒症休克阴竭阳脱证患者分为对照组与观察组,各55例。对照组采用西医常规治疗方法,观察组在对照组治疗基础上给予参附汤合生脉散治疗。观察治疗前和治疗后2组3 h、12 h、24 h、48 h、72 h血乳酸水平、PaO_(2)/FiO_(2)、平均动脉压(MAP)、心率(HR)及尿量、APACHEII评分、SOFA评分,统计2组血管活性药总量、受损器官数目、维持血压稳定时间、ICU住院时间及28 d病死率,对比2组治疗后总有效率和治疗方案的安全性。结果观察组治疗后3 h、12 h、24 h、48 h、72 h血乳酸、HR水平、APACHEII评分、SOFA评分、血管活性药总量、受损器官数目、维持血压稳定时间、ICU住院时间及28 d病死率均低于对照组,PaO_(2)/FiO_(2)、MAP、尿量均高于对照组(P<0.05);观察组总有效率(87.27%,48/55)显著高于对照组总有效率(70.91%,39/55)(P<0.05);2组均未出现严重药物相关不良反应。结论在常规西医治疗基础上联合参附汤合生脉散治疗,能够减少血管活性药物的使用总量,缩短血压维持稳定时间和ICU住院时间,增加尿量,快速纠正休克症状,降低病死率,改善临床预后。Objective To explore the curative effect of Shenfu Decoction combined with Shengmai Powders in the treatment of septic shock with the syndrome of depletion of yin causing yang collapse.Methods A total of 110 septic shock patients with the syndrome of depletion of yin causing yang collapse were randomly divided into a control group and an observation group,with 55 cases in each group.The control group was given the conventional western medicine treatment,while the observation group was treated with Shenfu Decoction and Shengmai Powders on the basis of the control group.The levels of blood lactate,PaO_(2)/FiO_(2),mean arterial pressure(MAP),heart rate(HR),urine volume,APACHEII score,and SOFA scores were observed before and after treatment in the two groups at 3 h,12 h,24 h,48 h,and 72 h,and the total amount of vasoactive drugs,the number of damaged organs,the time to maintain stable blood pressure,the length of ICU stay and the 28-day mortality rate in the two groups were counted,and the total effective rate and the safety of the treatment plan were compared between the two groups.Results The levels of blood lactate,HR,APACHEII scores,SOFA scores,total amount of vasoactive drugs,number of damaged organs,time to maintain the stable blood pressure,and the ICU stay and the 28-day mortality in the observation group after treatment were lower than those in the control group,while the levels of PaO_(2)/FiO_(2),MAP and urine volume were higher than those in the control group(P<0.05).The total effective rate of the observation group(87.27%,48/55)was significantly higher than that of the control group(70.91%,39/55)(P<0.05).No serious drug-related adverse reactions occurred in the two groups.Conclusion Based on a routine western medicine treatment,the application of Shenfu Decoction and Shengmai Powders can reduce the total use of vasoactive drugs,shorten the time of maintaining the stable blood pressure and ICU hospitalization,increase the urine volume,quickly correct shock symptoms,reduce the mortality and improve the clin

关 键 词：脓毒症休克 阴竭阳脱证 参附汤合生脉散 血管活性药物 血乳酸 氧合指数 

分 类 号：R441.9[医药卫生—诊断学]