基于正交试验法的中药溻渍干预脓毒症高热临床方案优化研究  

Optimization of clinical plan of traditional Chinese medicine stain intervention for sepsis with high fever based on orthogonal test

作　　者：张萃[1] 张兵 孟思璠 徐霞 赵利利 陆镇涛 高楠 关亚丽 刘容容 石福霞[1] ZHANG Cui;ZHANG Bing;MENG Sifan;XU Xia;ZHAO Lili;LU Zhentao;GAO Nan;GUAN Yali;LIU Rongrong;SHI Fuxia(Intensive Care Medicine of Guang'anmen Hospital,China Academy of Chinese Medical Sciences,Beijing 100053,China;General Department of Guang'anmen Hospital,China Academy of Chinese Medical Sciences,Beijing 100053;Nursing Department of Guang'anmen Hospital,China Academy of Chinese Medical Sciences,Beijing 100053)

机构地区：[1]中国中医科学院广安门医院重症医学科,北京100053 [2]中国中医科学院广安门医院综合科,北京100053 [3]中国中医科学院广安门医院护理部,北京100053

出　　处：《北京中医药》2024年第8期852-856,共5页Beijing Journal of Traditional Chinese Medicine

基　　金：中国中医科学院科技创新工程重大攻关项目(CI2021A03202)。

摘　　要：目的通过正交设计试验进行临床研究,从不同因素水平的中药溻渍干预脓毒症高热的临床方案中,优选出最佳方案。方法将90例符合纳入标准的脓毒症患者按照正交设计表随机分入9组。将药液浓度、药液温度、溻渍纱布湿度和溻渍部位作为因素,每个因素设置3个水平,随机分入L9(34)正交表安排的9组试验中。入组患者均接受中药溻渍干预方案,临床观察1个疗程,每个疗程4 h。通过观察患者膀胱温度变化评价技术干预效果。结果中药溻渍干预脓毒症高热的最佳方案是中药液浓度0.3 g/mL,温度25~30℃,溻渍纱布湿度≥80%,溻渍部位足阳明胃经+手阳明大肠经。结论通过正交试验法得出的中药溻渍最优方案可以在一定程度上提高临床干预脓毒症高热的效果,实现快速降低人体温度,并且减少在中药溻渍过程中出现不良反应,节省医疗资源,减轻患者经济负担,最终实现提高患者对中药溻渍治疗方案的依从性和满意度的目的。Objectve A clinical research was carried out through an orthogonal design test,in which the best scheme was selected from the clinical schemes for intervention of sepsis high fever with different factor levels of Chinese medicine collapse stain.Methods 90 sepsis patients who met the inclusion criteria were randomly divided into 9 groups according to the orthogonal design table.The concentration of the drug solution,the temperature of the drug solution,the humidity of the stained gauze,and the stained area were used as factors.Each factor was set at three levels and randomly divided into nine groups of experiments arranged in the L9(34)orthogonal table.All enrolled patients received traditional Chinese medicine stain intervention for 1 hour with 4 hours as one course of treatment.The effectiveness of technical intervention was evaluated by observing changes in bladder temperature in patients.Results The best plan for using traditional Chinese medicine stain to intervene sepsis with high fever was to use Chinese medicine solution with a concentration of 0.3 g/mL and a temperature of 25~30℃.The humidity of the stained gauze should be≥80%,and the stained area should be the Stomach Meridian of Foot Yangming and the Large Intestine Meridian of Hand Yangming.Conclusion The optimal solution for traditional Chinese medicine stain obtained through orthogonal experimental method can improve the effectiveness of clinical intervention for sepsis with high fever,as it could achieve rapid reduction of human body temperature,reduce adverse reactions during the process,save medical resources,reduce patient economic burden,and ultimately achieve the goal of improving patient compliance and satisfaction with the treatment plan for traditional Chinese medicine stain.

关 键 词：中药溻渍 脓毒症 高热 正交设计 

分 类 号：R248[医药卫生—中医临床基础]