温阳利水法治疗感染性休克液体复苏后患者体液潴留临床研究  

Clinical study on the treatment of fluid retention after fluid resuscitation for septic shock based on warming yang to promote diuresis method

作　　者：薛敏[1] 晏莉 杨芳 王俊 XUE Min;YAN Li;YANG Fang;WANG Jun(Department of Critical Care Medicine,Sichuan Second Hospital of Traditional Chinese Medicine,Chengdu 610031,China)

机构地区：[1]四川省第二中医医院重症医学科,四川成都610031

出　　处：《陕西中医》2024年第8期1070-1073,共4页Shaanxi Journal of Traditional Chinese Medicine

基　　金：四川省中医药管理局科研项目(2021MS309)。

摘　　要：目的:分析温阳利水法治疗感染性休克液体复苏后体液潴留的临床效果。方法:选取80例感染性休克患者,患者接受液体复苏后均出现不同程度体液潴留,采用随机数字表法分为对照组(n=40,接受西药治疗)和观察组(n=40,对照组治疗基础上采用加味真武汤治疗),比较两组患者疗效、中医证候积分、中心静脉压(CVP)、氧合指数(PaO_(2)/FiO_(2))、下腔静脉内径(IVC)及呼吸变异度(RVI)。结果:观察组治疗总有效率及各项中医证候积分优于对照组(均P<0.05)。液体复苏后T1、T2、T3观察组CVP水平低于对照组,PaO_(2)/FiO_(2)水平高于对照组(均P<0.05)。治疗后观察组RVI大于对照组,IVC最小内径(IVCmin)小于对照组(均P<0.05)。结论:真武汤治疗感染性休克液体复苏后体液潴留患者效果显著,可改善患者中医症状及容量状态。Objective:To analyze the clinical effect of warming yang to promote diuresis method in the treatment of fluid retention after fluid resuscitation for septic shock.Methods:Eighty patients with septic shock who developed fluid retention after fluid resuscitation were selected.They were divided into the control group(40 patients treated with western medicine)and the observation group(40 patients treated with modified Zhenwu decoction on the basis of the treatment of control group).Therapeutic effects,TCM syndrome score,central venous pressure(CVP),oxygenation index(PaO_(2)/FiO_(2)),inferior vena cava(IVC)diameter,and respiratory variability index(RVI)were compared between the two groups.Results:The total effective rate of treatment and TCM syndrome scores in the observation group were better than those in the control group(all P<0.05).T1,T2 and T3 after fluid resuscitation,CVP in the observation group was lower than that in the control group,and PaO_(2)/FiO_(2)was higher than that in the control group(all P<0.05).After treatment,RVI of the observation group was higher than that of the control group,and the minimum diameter of IVC(IVCmin)was smaller than that of the control group(all P<0.05).Conclusion:Zhenwu decoction is effective in the treatment of patients with fluid retention after fluid resuscitation for septic shock.It can improve the patients’TCM symptoms and volume status.

关 键 词：感染性休克 液体复苏 体液潴留 温阳利水法 真武汤 中医证候积分 

分 类 号：R278[医药卫生—中医学]