茯苓四逆汤对脓毒性心肌病患者免疫麻痹的干预作用  

The Interventional Effect of Fuling Sini Decoction on Immune Paralysis in Patients with Septic Cardiomyopathy

作　　者：黄发根 王评 曾圆圆 黄永莲 陈冬杰 黄兰琳 Huang Fagen;Wang Ping;Zeng Yuanyuan;Huang Yonglian;Chen Dongjie;Huang Lanlin(Shenzhen Hospital of Beijing University of Chinese Medicine(Longgang),Guangdong,Shenzhen 518172,China)

机构地区：[1]北京中医药大学深圳医院(龙岗),广东深圳518172

出　　处：《中国中医急症》2025年第1期89-92,共4页Journal of Emergency in Traditional Chinese Medicine

基　　金：广东省中医药局科研项目(20211349)。

摘　　要：目的 观察茯苓四逆汤对脓毒性心肌病(SCM)患者免疫麻痹的干预作用。方法 60例患者按随机数字表法分为对照组与治疗组各30例。两组均给予常规治疗,治疗组在常规治疗基础上加用茯苓四逆汤,两组疗程均为8 d。观察对比两组治疗前、治疗第4天、治疗第8天无创血流动力学监测心输出量(CO)、心脏功能指数(CPI)、格兰夫-高尔指数(GGI)变化;对比治疗前、治疗第4天,治疗第8天免疫指标淋巴细胞亚群(CD4+、CD8+、CD4+/CD8+)、自然杀伤细胞(NK细胞)、单核细胞HLA-DR、白细胞介素-10(IL-10)的变化。结果 治疗组在治疗第4天、治疗第8天心功能指标CO、CPI、GGI明显优于对照组(P<0.05或P<0.01);治疗第4天、第8天时治疗组免疫抑制指标IL-10明显低于对照组(P<0.05或P<0.01);治疗组免疫指标CD4+、CD4+/CD8+、NK、HLA-DR在治疗第4天、第8天时明显高于对照组(P<0.05或P<0.01)。结论 茯苓四逆汤能增强患者免疫功能,改善免疫麻痹状态并改善心功能。Objective:To observe the interventional effect of Fuling Sini Decoction on immune paralysis in patients with septic cardiomyopathy(SCM). Methods:60 patients were randomly divided into a control group and a treatment group using a random number table method,with 30 patients in each group. Both groups received conventional treatment. In addition to the conventional treatment,the treatment group was given Fuling Sini Decoction.The course of treatment for both groups was 8 days. The non-invasive hemodynamic monitoring indicators,including cardiac output(CO),cardiac power index(CPI),and Grahame-Gould Index(GGI),before treatment,on day 4of treatment,and on day 8 of hospitalization were compared. The immune parameters,including lymphocyte subsets(CD4+,CD8+,CD4+/CD8+ ratio),natural killer(NK)cells,monocyte HLA-DR expression,and interleukin-10(IL-10),before treatment,on day 4 of treatment,and on day 8 of treatment were also compared. Results:On day4 and day 8 of treatment,the heart function indicators CO,CPI,and GGI in the treatment group were significantly better than those in the control group(P< 0.05 or P< 0.01). On day 4 and day 8 of treatment,the levels of the immunosuppressive marker IL-10 in the treatment group were significantly lower than those in the control group(P<0.05 or P< 0.01). The immune parameters CD4+,CD4+/CD8+ ratio,NK cells,and HLA-DR expression in the treatment group were significantly higher than those in the control group on day 4 and day 8 of treatment(P< 0.05or P< 0.01). Conclusion:Fuling Sini Decoction can enhance the immune function of patients,improve the state of immune paralysis,and improve cardiac function in patients with sepsis-induced cardiomyopathy.

关 键 词：脓毒症心肌病 免疫麻痹 心功能 茯苓四逆汤 

分 类 号：R542.2[医药卫生—心血管疾病]