温脾汤对热毒内盛型脓毒症病人疗效及对心肌损伤的改善及对炎症的抑制作用  

Efficacy of Wenpi decoction on patients with dominance of heat in the interior type sepsis and its inhibitory effects on myocardial injury and inflammation

作　　者：蒋贇[1] 尹金磊[1] 郭磊[1] JIANG Yun;YIN Jinlei;GUO Lei(Department of Traditional Chinese Medicine and Pharmacy,Nanyang Central Hospital,Nanyang,Henan 473000,China)

机构地区：[1]南阳市中心医院中药药学部,河南南阳473000

出　　处：《安徽医药》2023年第8期1676-1680,共5页Anhui Medical and Pharmaceutical Journal

基　　金：河南省医学科技攻关计划联合共建项目(LHGJ20190217)。

摘　　要：目的探究温脾汤对热毒内盛型脓毒症病人疗效及对心肌损伤的改善及对炎症的抑制作用。方法选取2019年4月至2021年4月南阳市中心医院收治的84例热毒内盛型脓毒症病人,采用随机数字表法分为常规组(42例)和中药组(42例)。其中常规组给予常规西药治疗,中药组给予温脾汤联合西药常规治疗。比较两组病人中医证候积分,炎性指标[降钙素原(PCT)、C反应蛋白(CRP)、肿瘤坏死因子(TNF-α)],疾病严重程度[急性生理学与慢性健康状况评分(APACHEⅡ评分)],心肌功能[心肌肌钙蛋白(cTnI)、肌酸激酶同工酶(CKMB)]及临床疗效。结果两组治疗后中医证候积分[中药组(9.12±1.35)分比(20.76±2.56)分、常规组(14.76±1.78)分比(21.01±2.61)分]、血清PCT[中药组(0.85±0.23)µg/L比(2.56±0.85)µg/L、常规组(1.32±0.51)µg/L比(2.48±0.78)µg/L]、CRP[中药组(21.58±2.45)g/L比(89.23±5.76)g/L、常规组(27.64±3.01)g/L比(88.45±5.68)g/L]、TNF-α[中药组(17.01±2.11)ng/L比(38.49±4.25)ng/L、常规组(24.68±2.76)ng/L比(37.86±4.16)ng/L]、cTnI[中药组(0.58±0.21)µg/L比(1.42±0.56)µg/L、常规组(0.96±0.32)µg/L比(1.48±0.61)µg/L]、CKMB水平[中药组(11.34±1.32)U/L比(28.42±2.78)U/L、常规组(15.67±1.84)U/L比(29.14±2.82)U/L]、APACHEⅡ评分[中药组(12.43±1.34)分比(17.56±2.21)分、常规组(14.76±1.67)分比(17.89±2.29)分]均较治疗前降低,且中药组降低常规组,差异有统计学意义(P<0.05);中药组临床疗效(92.86%)高于常规组(71.43%),差异有统计学意义(P<0.05)。结论温脾汤治疗热毒内盛型脓毒症可有效减轻病人心肌损伤,改善临床症状,降低炎症反应,疗效显著。Objective To explore the efficacy of Wenpi decoction on patients with dominance of heat in the interior type sepsis and its improvement on myocardial injury and its inhibition on inflammation.Methods A total of 84 patients with dominance of heat in the interior type sepsis in Nanyang Central Hospital from April 2019 to April 2021 were selected and assigned into conventional group(42 cases)and traditional Chinese medicine group(42 cases)by random number table method.Among them,the conventional group was given conventional western medicine treatment,and the traditional Chinese medicine group was given Wenpi decoction combined with western medicine conventional treatment.The TCM syndromes scores,inflammatory indexes[procalcitonin(PCT),C-reactive protein(CRP),tumor necrosis factor(TNF-α)],and disease severity[Acute Physiology And Chronic Health Evaluation scoring system(APACHEⅡ)score],myocardial function[cardiac troponin(cTnI),creatine kinase isoenzyme(CKMB)]and clinical efficacy were compared between the two groups.Results After treatment,TCM symptom scores[traditional Chinese medicine group:(9.12±1.35)points vs.(20.76±2.56)points,conventional group:(14.76±1.78)points vs.(21.01±2.61)points],serum PCT[traditional Chinese medicine group:(0.85±0.23)µg/L vs.(2.56±0.85)µg/L,conventional group:(1.32±0.51)µg/L vs.(2.48±0.78)µg/L],CRP[traditional Chinese medicine group:(21.58±2.45)g/L vs.(89.23±5.76)g/L,conventional group:(27.64±3.01)g/L vs.(88.45±5.68)g/L],TNF-α[traditional Chinese medicine group:(17.01±2.11)ng/L vs.(38.49±4.25)ng/L,conventional group:(24.68±2.76)ng/L vs.(37.86±4.16)ng/L],cTnI[traditional Chinese medicine group:(0.58±0.21)µg/L vs.(1.42±0.56)µg/L,conventional group:(0.96±0.32)µg/L vs.(1.48±0.61)µg/L],CKMB[traditional Chinese medicine group:(11.34±1.32)U/L vs.(28.42±2.78)U/L,conventional group:(15.67±1.84)U/L vs.(29.14±2.82)U/L],and APACHEⅡscore[traditional Chinese medicine group:(12.43±1.34)points vs.(17.56±2.21)points,conventional group:(14.76±1.67)points vs.(17.89�

关 键 词：脓毒症 热毒内盛型 温脾汤 心肌损伤 炎症 

分 类 号：R278[医药卫生—中医学]