四逆汤合来复汤加减治疗心源性休克的效果研究  

Study on the Therapeutic Efficacy of Modified Sini Decoction Combined with Laifu Decoction in the Treatment of Cardiogenic Shock

作　　者：董双虎 史俊丽 马悦茗 罗江 何青云 欧阳丽芬 龚志翔 王龙海 曾鹏 DONG Shuanghu;SHI Junli;MA Yueming;LUO Jiang;HE Qingyun;OUYANG Lifen;GONG Zhixiang;WANG Longhai;ZENG Peng(Department of Intensive Care Medicine,Jiangxi Provincial Hospital of Integrated Traditional Chinese and Western Medicine,Nanchang 330003,China;不详)

机构地区：[1]江西省中西医结合医院重症医学科,江西南昌330003

出　　处：《中国医学创新》2024年第19期30-34,共5页Medical Innovation of China

基　　金：江西省中医药管理局科技计划项目(2021A400)。

摘　　要：目的:探究四逆汤合来复汤加减治疗心源性休克患者的效果。方法:选择2021年7月—2023年8月江西省中西医结合医院收治的70例心源性休克患者,采用随机数字表法将其分为两组,各35例。对照组采用常规西药治疗,研究组在对照组治疗基础上采用四逆汤合来复汤加减治疗。对比两组临床疗效、临床指标、血流动力学指标、心衰及血气指标。结果:观察组治疗总有效率为91.43%,高于对照组的71.43%,差异有统计学意义(P<0.05)。治疗7 d后,观察组HR心率(HR)低于对照组,收缩压(SBP)、舒张压(DBP)、平均动脉压(MAP)水平均高于对照组,差异均有统计学意义(P<0.05)。治疗1个月后,观察组N末端-B型钠尿肽前体(NT-proBNP)、二氧化碳分压(PaCO_(2))水平均低于对照组,氧分压(PaO_(2))水平高于对照组,差异均有统计学意义(P<0.05)。治疗1个月后,两组pH值比较,差异无统计学意义(P>0.05)。观察组ICU住院时间短于对照组,去甲肾上腺素使用量少于对照组,差异均有统计学意义(P<0.05)。结论:四逆汤合来复汤加减治疗心源性休克患者的效果显著,有助于稳定机体血流动力学各指标水平,改善血气指标及心衰症状,缩短ICU住院时间及减少药物使用量,对减轻患者经济负担及促进患者预后恢复具有重要作用。Objective:To explore the effect of modified Sini Decoction combined with Laifu Decoction on patients with cardiogenic shock.Method:A total of 70 patients with cardiogenic shock admitted to Jiangxi Provincial Hospital of Integrated Traditional Chinese and Western Medicine from July 2021 to August 2023 were selected and divided into two groups by random number table method,with 35 cases in each group.The control group was treated with conventional western medicine,and the study group was treated with modified Sini Decoction combined with Laifu Decoction on the basis of control group.The clinical efficacy,clinical indexes,hemodynamic indexes,heart failure and blood gas indexes were compared between the two groups.Result:The total effective rate of the observation group was 91.43%,which was higher than 71.43%of the control group,the difference was statistically significant(P<0.05).After 7 d of treatment,heart rate(HR)level in observation group was lower than that in control group,systolic blood pressure(SBP),diastolic blood pressure(DBP),mean arterial pressure(MAP)level were higher than those in control group,the differences were statistically significant(P<0.05).After 1 month of treatment,the levels of N-terminal brain natriuretic peptide precursor(NT-proBNP)and partial pressure of carbon dioxide(PaCO_(2))in the observation group were lower than those in the control group,and the level of partial pressure of oxygen(PaO_(2))was higher than that in the control group,the difference were statistically significant(P<0.05).After 1 month of treatment,there was no significant difference in pH value between the two groups(P>0.05).The length of ICU stay in the observation group was shorter than that in the control group,and the use of Norepinephrine was less than that in the control group,the differences were statistically significant(P<0.05).Conclusion:Modified Sini Decoction combined with Laifu Decoction has a significant effect in the treatment of patients with cardiogenic shock,which helps to stabilize the level of variou

关 键 词：心源性休克 四逆汤合来复汤 阿司匹林 去甲肾上腺素 血流动力学指标 

分 类 号：R259[医药卫生—中西医结合]