温阳祛毒方对重症感染患者血清炎症因子和免疫指标水平的影响及意义  

Effect and significance of Wenyang Qudu formula on serum inflammatory factors and immune index in patientswith severeinfections

作　　者：许智晶 王聪梅 耿玉安 齐路 师延刚 张慧铭 张颖 钟医航 刘瑞芳 Xu Zhijing;Wang Congmei;Gen Yu'an;Qi Lu;Shi Yangang;Zhang Huiming;Zhang Ying;Zhong Yihang;Liu Ruifang(Department of Emergency and Critical Care Medical Center,the Third People's Hospital of Henan Province,Zhengzhou 450006,Henan,China)

机构地区：[1]河南省直第三人民医院急重症医学中心,河南郑州450006

出　　处：《中国中西医结合急救杂志》2024年第1期20-23,共4页Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care

基　　金：河南省医学科学院青年医学科研人员研究项目(QNYJ2023011);河南省医学科技攻关计划联合共建项目(LHGJ20230671);河南省医学科技攻关计划项目(2018020580)。

摘　　要：目的观察温阳祛毒方对重症感染患者血清因子和免疫指标水平的影响。方法选择2023年1月至12月河南省直第三人民医院收治的86例重症感染患者作为研究对象。按患者档案顺序纳入,奇数为研究组,偶数为对照组,每组43例,对照组给予头孢哌酮舒巴坦钠治疗,研究组在对照组基础上加用温阳祛毒方[药物组成:制附子(先煎)30g,茯苓30g,白芍15g,赤芍15g,炒白术30g,干姜9g,炙甘草9g,桂枝15g,掌劳子15g,生龙骨15g,生牡蛎15g,党参12g,当归12g,细辛3g,五味子6g,大枣12g]治疗,水煎服,每日1剂,早晚各1次,连续服用7d。比较两组发热、呼吸困难、尿频尿急、咳痰程度等中医症状积分水平和血清中白细胞介素-10(IL-10)、C-反应蛋白(CRP)、嗜酸粒细胞(EOS)及免疫功能指标[免疫球蛋白E(IgE)、CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)]水平的差异,并观察不良反应发生情况。结果两组治疗后中医症状(发热、呼吸困难、尿频尿急、咳痰程度)积分和IL-10、CRP、EOS水平以及IgE、CD8^(+)均较治疗前明显降低,CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)均较治疗前明显升高,且研究组治疗后发热、呼吸困难、尿频尿急、咳痰程度积分和IL-10、CRP、EOS水平以及IgE、CD8^(+)均明显低于对照组[发热积分(分):1.36±0.30比2.57±0.46,呼吸困难积分(分):1.22±0.31比2.26±0.75,尿频尿急积分(分):1.30±0.39比2.33±0.82,咳痰程度积分(分):1.19±0.77比2.51±0.85,IL-10(ng/L):9.03±1.67比10.51±2.40,CRP(mg/L):4.68±1.33比7.82±2.53,E0S(×10^(9)/L):0.30±0.04比0.46±0.10,IgE(mg/L):104.62±10.73比135.68±14.64,CD8^(+):0.228±0.016比0.258±0.020,均P<0.05],CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平均明显高于对照组(CD3^(+):0.636±0.044比0.567±0.055,CD4^(+):0.537±0.054比0.398±0.045,CD4^(+)/CD8^(+):1.76±0.51比1.55±0.39,均P<0.05)。治疗结束后发现研究组未出现不良反应,对照组出现恶心呕吐1例,胸闷1例,研究组和对照组不良反应发生率比�Objective To explore effect of Wenyang Qudu formula on serum inflammatory factors and immune index in patients with severe infections.Methods A total of 86 severe infection patients admitted to the Third People's Hospital of Henan Province from January to December 2023 were selected as the research subjects.According to the patient file order,odd numbers were the study group,and even numbers were the control group,with 43 cases in each group.The control group was treated with cefoperazone sulbactam sodium,while the study group was treated with Wenyang Qudu formula in addition to the control group[drug composition:Prepared aconite(first decocted)30 g,Poria cocos 30 g,White peony 15 g,Red peony 15 g,Stir fried atractylodes macrocephala 30 g,Dried ginger 9 g,Roasted licorice 9 g,Cassia twig 15 g,Semen lepidii 15 g,Dragon's bone 15 g,Raw oyster 15 g,Codonopsis pilosula 12 g,Angelica sinensis 12 g,Asarum 3 g,Schisandra chinensis 6 g,and Jujube 12 g].Brew in water,and took one dose daily,once in the morning and once in the evening,for a continuous period of 7 days.The differences in the scores of traditional Chinese medicine symptoms such as fever,dyspnea,frequent urination,urgency,and degree of sputum production,serum levels of interleukin-10(IL-10),C-reactive protein(CRP),eosinophils(EOS),and immune function indicators[immunoglobulin E(IgE),CD3^(+),CD4^(+),CD8^(+),CD4^(+)/CD8^(+)]were compared between two groups after treatment,and observed the occurrence of adverse reactions.Results After treatment,the traditional Chinese medicine symptom scores(fever,dyspnea,frequent urination and urgency,degree of sputum production),as well as IL-10,CRP,EOS levels,IgE,and CD8^(+)were significantly reduced in both groups compared to before treatment,CD3^(+),CD4^(+),and CD4^(+)/CD8^(+)were significantly increased compared to before treatment.In addition,the study group had significantly lower scores of fever,dyspnea,frequent urination and urgency,degree of sputum production,IL-1o,CRP,EOS levels,IgE,and CD8^(+)compared to the control

关 键 词：重症感染 温阳祛毒方 血清因子 免疫功能 

分 类 号：R459.7[医药卫生—急诊医学]