托里消毒散治疗气虚毒损型脓毒症的疗效观察  

Efficacy Observation on Tuoli Xiaodu Powder in the Treatment of Sepsis with Syndrome of Qi Deficiency and Toxin Damage

作　　者：王春林 项中亚 王再红 王丽萍 Wang Chunlin;Xiang Zhongya;Wang Zaihong;Wang Liping(Quzhou Traditional Chinese Medicine Hospital,Zhejiang,Quzhou 324002,China)

机构地区：[1]浙江省衢州市中医医院,浙江衢州324002 [2]浙江中医药大学,浙江杭州310053

出　　处：《中国中医急症》2024年第11期1998-2001,共4页Journal of Emergency in Traditional Chinese Medicine

基　　金：第五批全国中医临床优秀人才研修项目(国中医药人教函[2022]1号);浙江中医药大学校级科研项目附属医院科研专项(2021FSYYZZ34)。

摘　　要：目的观察托里消毒散对脓毒症患者的临床疗效,并探讨其可能的作用机制。方法收集脓毒症患者57例,采用区组随机法分为观察组与对照组,其中观察组29例与对照组28例。对照组参照西医临床指南予以综合治疗方案(如脓毒症集束化治疗、维持水/电解质酸碱平衡等),观察组在对照组的基础上加用托里消毒散。比较两组治疗前后的中医证候评分、总有效率、28 d死亡率、器官功能指标(SOFA评分)、APACHEⅡ评分、炎症指标[降钙素原(PCT)、超敏C反应蛋白(hs-CRP)、白细胞计数(WBC)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)]。结果治疗后,中医证候评分、总有效率、SOFA评分、PCT、hs-CRP、TNF-α、IL-6相比具有统计学差异(P<0.05);两组WBC、APACHEⅡ评分及28 d死亡率未见统计学差异(P>0.05);治疗后观察组APACHEⅡ评分较治疗前明显下降,组内比较有统计学差异(P<0.05)。结论托里消毒散能降低脓毒症患者的中医证候评分,改善气虚毒损症状和器官功能,减轻炎症反应。Objective:To evaluate the clinical efficacy of Tuoli Xiaodu Powder in patients with sepsis and to explore its possible therapeutic mechanism.Methods:A total of 57 patients with sepsis were collected and randomly divided into an experimental group and a control group using block randomization method,with 29 patients in the experimental group and 28 patients in the control group.The control group received a comprehensive treatment plan in accordance with the clinical guidelines(such as bundle therapy for sepsis,and maintenance of water electrolyte acid-base balance),while the experimental group received Tuoli Xiaodu Powder in addition to the control group.The traditional Chinese medicine syndrome score,total effective rate,28 day mortality rate,sequential organ failure assessment(SOFA)score,APACHE II score and inflammatory markers(PCT,hs-CRP,WBC,IL-6,TNF-α)before and afer treatment were compared in two groups.Results:After treatment,there was a statistically significant difference in the TCM syndrome score,total effective rate,SOFA score,PCT,hs-CRP,TNF-αand IL-6 between the two groups(P<0.05);there was no statistically significant difference in WBC,APACHE II scores,and 28 day mortality rate between the two groups(P>0.05);after treatment,the APACHE II score in the experimental group decreased significantly compared with before treatment,and there was a statistically significant dfference within the group(P<0.05).Conclusion:Tuoli Xiaodu Powder can reduce the traditional Chinese medicine syndrome score of sepsis patients,improve their clinical symptoms of qi deficiency and toxin damage,and improve the organ function,reducing inflammatory reactions.

关 键 词：脓毒症 托里消毒散 气虚毒损型 器官功能 炎症 

分 类 号：R63[医药卫生—外科学]