“四证四法”防治脓毒症心功能障碍的临床观察  

“Four Syndrome Patterns and Four Treatments”for the Prevention and Treatment of Sepsis-induced Myocardial Dysfunction in Septic Patients

作　　者：苏懿[1] 罗艳霞[1] 赖彩辉 胡惠娟[1] 马明远[1] Su Yi;Luo Yanxia;Lai Caihui;Hu Huijuan;Ma Mingyuan(Foshan Hospital of Traditional Chinese Medicine,Guangdong,Foshan 528000,China)

机构地区：[1]广东省佛山市中医院,广州中医药大学第八临床医学院,广东佛山528000

出　　处：《中国中医急症》2023年第2期285-288,共4页Journal of Emergency in Traditional Chinese Medicine

基　　金：佛山市医学类科技攻关项目(1920001000307);佛山市竞争性扶持人才项目;佛山市工程技术研究中心认定项目(2120001009347)。

摘　　要：目的观察“四证四法”对脓毒症患者心功能障碍的防治效果。方法将80例脓毒症患者按随机数字表法分为两组,观察组在对照组基础上用“四证四法”治疗。比较两组脓毒症心功能障碍(SIMD)发生率、心肌损伤和炎症指标变化和关系。结果治疗后观察组SIMD发生率为41.03%,明显低于对照组的68.57%(P<0.05);观察组患者白细胞介素-6(IL-6)、白细胞介素-10(IL-10)、降钙素原(PCT)、肌钙蛋白Ⅰ(c TnⅠ)和N端B型脑钠肽前体(NT-proBNP)均低于治疗前(P<0.05),且观察组治疗后指标低于对照组(P<0.05);观察组血管活性药物使用时间短于对照组(P<0.05);患者的IL-6水平与NT-proBNP、PCT、IL-10水平均呈正相关,与左室射血分数(LVEF)呈负相关(P<0.05)。NT-proBNP水平与LVEF呈负相关,和PCT则呈正相关(P<0.01)。结论“四证四法”可以减低脓毒症患者SIMD的发生率,其作用机制可能与改善心肌损伤和调节炎症因子释放有关。Objective:To observe the effects of“four syndrome patterns and four treatments”on cardiac dysfunction of septic patients.Methods:A total of 80 patients with sepsis were divided into two groups according to random number table method.The observation group was treated with"four syndrome patterns and four treatments"on the basis of the control group.The incidence of sepsis-induced myocardial dysfunction(SIMD),the changes and relationship of myocardial injury and inflammatory indicators were compared and analyzed between the two groups.Results:After treatment,the incidence of SIMD in the observation group was 41.03%,which was significantly lower than 68.57%in the control group(P<0.05);the interleukin-6(IL-6),interleukin-10(IL-10),PCT,cTnI and NT-proBNP in observation group were lower than before treatment(P<0.05),and control group(P<0.05).After treatment,the duration of vasoactive drugs in the observation group was shorter than that in the control group(P<0.05).The IL-6 levels were positively correlated with NT-proBNP,PCT and IL-10 levels,and negatively correlated with LVEF(P<0.05).The level of NT-proBNP was negatively correlated with LVEF,and positively correlated with PCT(P<0.01).Conclusion:“Four syndrome patterns and four treatments”can reduce the incidence of cardiac dysfunction in patients with sepsis,and its mechanism may be related to improving myocardial injury and regulating the release of inflammatory factors.

关 键 词：脓毒症心功能障碍 四证四法 心肌损伤 炎症 

分 类 号：R631[医药卫生—外科学]