大黄解毒汤联合血液净化对重症急性有机磷中毒患者心肾功能及hs-CRP、IL-1β、TNF-α水平的影响  

Effects of Dahuang Jiedu Decoction Combined with Blood Purification on Cardiorenal Function and hs-CRP,IL-1β and TNF-α in Patients with Severe Acute Organophosphorus Pesticide Poisoning

作　　者：高勤虎 邹洁 管红宝 胡逸群 GAO Qin-Hu;ZOU Jie;GUAN Hong-Bao;HU Yi-Qun(Emergency Medical Department of Fuyang Cancer Hospital,Fuyang 236000 Anhui,China;Anhui Academy of Agricultural Sciences,Hefei 230000 Anhui,China)

机构地区：[1]阜阳市肿瘤医院急诊医学科,安徽阜阳236000 [2]安徽省农业科学院,安徽合肥230000

出　　处：《广州中医药大学学报》2023年第8期1922-1927,共6页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：安徽省自然科学基金项目(编号:2108085QC117)。

摘　　要：【目的】探讨大黄解毒汤联合血液净化对重症急性有机磷中毒(AOPP)患者心肾功能及超敏C反应蛋白(hs-CRP)、白细胞介素1β(IL-1β)、肿瘤坏死因子α(TNF-α)水平的影响。【方法】将120例重症AOPP患者随机分为研究组和对照组,每组各60例。2组患者均给予洗胃、补液、催吐等常规治疗,对照组同时予以血液净化治疗,研究组在对照组的基础上予以大黄解毒汤联合治疗,疗程为7 d。观察2组患者治疗前后心功能指标[心脏指数(CI)、左室射血分数(LVEF)、舒张早期与晚期最大血流速度比值(E/A)]、肾功能指标[血尿素氮(BUN)、血肌酐(Scr)]、血清炎性因子hs-CRP、TNF-α、IL-1β水平及中医证候积分的变化情况,并比较2组患者的不良反应发生情况。【结果】(1)治疗后,2组患者的CI、LVEF、E/A水平均较治疗前明显升高(P<0.05),且研究组的升高幅度均明显优于对照组(P<0.01)。(2)治疗后,2组患者的BUN、Scr、hs-CRP、IL-1β、TNF-α水平均较治疗前明显下降(P<0.05),且研究组的下降程度均明显优于对照组(P<0.01)。(3)治疗后,2组患者的中医证候积分均较治疗前明显下降(P<0.05),且研究组的下降幅度明显优于对照组(P<0.01)。(4)研究组的不良反应发生率为5.00%(3/60),对照组为11.67%(7/60),组间比较,差异无统计学意义(P>0.05)。【结论】应用大黄解毒汤联合血液净化治疗重症AOPP患者,可促进心肾功能恢复,缓解机体炎症状态,减轻患者临床症状。Objective To investigate the effects of Dahuang Jiedu Decoction combined with blood purification on cardiorenal function and the levels of hypersensitive C-reactive protein(hs-CRP),interleukin 1β(IL-1β)and tumor necrosis factorα(TNF-α)in patients with severe acute organophosphorus pesticide poisoning(AOPP).Methods A total of 120 patients with severe AOPP were randomly divided into study group and control group,with 60 patients in each group.The patients in the two groups were given conventional treatment such as gastric lavage,fluid infusion and emesis.And additionally,the control group was treated with blood purification and the study group was treated with Dahuang Jiedu Decoction combined with blood purification.Both groups were treated for 7 days.Changes in the indexes of cardiac function of cardiac index(CI),left ventricular ejection fraction(LVEF),and ratio of maximum blood flow velocity in early and late diastole(E/A),renal function indexes of blood urea nitrogen(BUN)and serum creatinine(Scr),serum inflammatory factors of hs-CRP,TNF-αand IL-1βlevels and traditional Chinese medicine(TCM)syndrome scores in the two groups were observed before and after treatment.Meanwhile,the adverse reactions of the two groups were compared.Results(1)After treatment,the cardiac function indexes of CI,LVEF and E/A in the two groups were significantly increased compared with those before treatment(P<0.05),and the increase degree in the study group was significantly superior to that in the control group(P<0.01).(2)After treatment,the levels of BUN,Scr,hs-CRP,IL-1βand TNF-αin both groups were significantly decreased compared with those before treatment(P<0.05),and the decrease degree in the study group was significantly superior to that in the control group(P<0.01).(3)After treatment,the TCM syndrome scores of patients in both groups were significantly decreased compared with those before treatment(P<0.05),and the decrease degree in the study group was significantly superior to that in the control group(P<0.01).(4)The inc

关 键 词：大黄解毒汤 血液净化 急性有机磷中毒 心肾功能 超敏C反应蛋白 白细胞介素1Β 肿瘤坏死因子Α 

分 类 号：R595.4[医药卫生—内科学]