益气活血汤联合乌司他丁治疗脓毒症心肌病的单中心随机对照研究  

A Single-center Randomized Controlled Study of Yiqi Huoxue Decoction Combined with Ulinastatin in the Treatment of Septic Cardiomyopathy

作　　者：杨根[1] 郭辉 胡巧 李婷[2] 刘华春[1] YANG Gen;GUO Hui;HU Qiao;LI Ting;LIU Huachun(Department of Critical Care Medicine,Lianjiang People's Hospital,Lianjiang 524400,China;不详)

机构地区：[1]廉江市人民医院重症医学科,广东廉江524400 [2]廉江市人民医院病案室,广东廉江524400

出　　处：《中国医学创新》2024年第34期19-23,共5页Medical Innovation of China

基　　金：2024年度广东省中医药局中医药科研项目(20241379)。

摘　　要：目的:分析益气活血汤联合乌司他丁治疗脓毒症心肌病(SC)的效果。方法:选择2022年1月—2024年3月廉江市人民医院收治的60例SC患者作为研究对象,依照随机数字表法分两组,各30例。对照组予以常规治疗,研究组在对照组基础上予以益气活血汤联合乌司他丁治疗。比较两组治疗效果、心功能指标[左室舒张末期内径(LVEDD)、左室射血分数(LVEF)、心脏指数(CI)]、心肌损伤指标[心肌肌钙蛋白I(cTnI)、N-末端B型利钠肽前体(NT-proBNP)、肌酸肌酶同工酶(CK-MB)]、急性生理与慢性健康状况Ⅱ(APACHEⅡ)评分、炎症因子水平[白细胞介素-6(IL-6)、白细胞介素-10(IL-10)]及患者转归情况。结果:研究组治疗总有效率高于对照组(P<0.05)。治疗1 d后,两组心肌损伤指标、心功能指标、APACHEⅡ评分、IL-6、IL-10比较,差异均无统计学意义(P>0.05);治疗7、10 d后,研究组LVEF、CI均高于对照组,LVEDD、cTnI、NT-proBNP、CK-MB、IL-6、IL-10均低于对照组(P<0.05);治疗10 d后,研究组APACHEⅡ评分低于对照组(P<0.05)。结论:益气活血汤联合乌司他丁治疗效果显著,可改善患者心肌损伤、心功能指标及炎症因子水平,降低死亡率,并缩短住院时间。Objective:To analyze the effect of Yiqi Huoxue Decoction combined with Ulinastatin in the treatment of septic cardiomyopathy(SC).Method:A total of 60 patients with SC admitted to Lianjiang People's Hospital from January 2022 to March 2024 were selected as the study objects,and they were divided into two groups according to random number table method,with 30 cases in each group.The control group was treated with routine treatment,and the study group was treated with Yiqi Huoxue Decoction combined with Ulinastatin on the basis of the control group.The therapeutic effect,cardiac function indexes[left ventricular end-diastolic diameter(LVEDD),left ventricular ejection fraction(LVEF),cardiac index(CI)],myocardial injury indexes[cardiac troponin I(cTnI),N-terminal pro-brain natriuretic peptide(NT-proBNP),creatine kinase MB(CK-MB)],acute physiological and chronic health statusⅡ(APACHEⅡ)scores,inflammatory factor levels[interleukin-6(IL-6),interleukin-10(IL-10)]and patient outcomes between the two groups were compared.Result:The total effective rate of study group was higher than that of control group(P<0.05).After 1 d of treatment,there were no significant differences in myocardial injury index,cardiac function index,APACHEⅡscore,IL-6 and IL-10 between the two groups(P>0.05).After 7,10 d of treatment,LVEF,CI in the study group were higher than those in the control group,LVEDD,cTnI,NTproBNP,CK-MB,IL-6 and IL-10 were lower than those in the control group(P<0.05).After 10 d of treatment,the APACHEⅡscore of the study group was lower than that of the control group(P<0.05).Conclusion:Yiqi Huoxue Decoction combined with Ulinastatin can improve myocardial injury,cardiac function index and inflammatory factors,reduce mortality and shorten hospital stay.

关 键 词：脓毒症心肌病 心肌损伤 心功能 益气活血汤 乌司他丁 

分 类 号：R459.7[医药卫生—急诊医学]