四逆升降散对脓毒症毛细血管渗漏综合征患者凝血功能的影响  

Effect of Sini Shengjiang Powder on Coagulation Function in Patients with Sepsis Capillary Leakage Syndrome

作　　者：林柏柏 赵雷[1] 丁纯蕾[1] 钱义明[1] 张琼[1] 谭美春 陆云霞 沈梦雯[1] Lin Baibai;Zhao Lei;Ding Chunlei;Qian Yiming;Zhang Qiong;Tan Meichun;Lu Yunxia;Shen Mengwen(Yueyang Hospital of Integrated Traditional Chinese and Western Medicine Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200437,China)

机构地区：[1]上海中医药大学附属岳阳中西医结合医院,上海200437 [2]上海市宝山区中西医结合医院,上海201999

出　　处：《中国中医急症》2024年第11期1934-1937,共4页Journal of Emergency in Traditional Chinese Medicine

基　　金：国家自然科学基金项目(82304933);上海市卫生健康委员会临床研究专项(202140202);上海中医药大学预算内科研项目(2021LK096);上海市宝山区医学重点专科及特色品牌建设项目(BSZK-2023-A01);上海市宝山区卫生健康委员会临床科研项目(BSZK-2023-A01)。

摘　　要：目的观察四逆升降散对脓毒症毛细血管渗漏综合征患者凝血功能的影响。方法将92例受试者随机分为对照组与治疗组各46例。在常规治疗基础上,对照组加用四逆升降散安慰剂,治疗组加用四逆升降散,治疗7d。比较两组受试者治疗前、治疗第3天、治疗第7天血栓弹力图、血小板计数(PLT)、凝血功能四项、纤维蛋白原降解产物(FDP)、D二聚体(D-Di)。结果治疗后治疗组PLT、血小板强度(MA)、血栓形成动力学(Angle)凝血综合指数(CI)、D-Di数值均下降,反应时间(R)、动力学时间(K)、凝血酶时间(TT)、活化部分凝血酶时间(APTT)、凝血酶原时间(PT)数值均上升,与对照组治疗第7天比较差异有统计学意义(P<0.05),纤维蛋白原(FIB)、FDP差异无统计学意义(P>0.05)。结论四逆升降散能够改善脓毒症毛细血管渗漏综合征患者的高凝状态,但是不会造成低凝或出血表现。Objective:To observe the effect of Sini Shengjiang Powder on coagulation function in patients with sepsis capllary leakage syndrome.Methods:92 participants were randomly divided into a control group and a treatment group,with 46 participants in each group.On the basis of routine treatment,the control group received a placebo of Sini Shengjiang Powder,while the treatment group received the actual Sini Shengjiang Powder.The treatment lasted for 7 days.Thromboelastography(TEG),platelet count(PLT),four coagulation parameters,fibrinogen degradation products(FDP),and D-dimer(D-Di)were compared between the two groups before treatment(DO),on day 3,and on day 7 of treatment.Results:After treatment,PLT,platelet strength(MA),thrombogenesis dynamics(Angle),coagulation composite index(CI),and D-Di values decreased in the treatment group,while reaction time(R),kinetic time(K),thrombin time(TT),activated partial thromboplastin time(APTT),and prothrombin time(PT)values increased.These changes were statistically significant when compared with the control group on day 7(P<0.05).There were no statistically significant differences in fibrinogen(FIB)and FDP levels(P>0.05).Conclusion:Sini Shengjiang Powder can improve the hypercoagulable state in patients with sepsis-associated capillary leak syndrome without causing hypocoagulability or bleeding manifestations.

关 键 词：脓毒症毛细血管渗漏综合征 活血利水 凝血功能 四逆升降散 血不利则为水 

分 类 号：R631[医药卫生—外科学]