四逆加人参汤对脓毒症急性阳虚证患者凝血功能影响的研究  

Study on the Effects of Sini Jia Renshen Decoction on Coagulation Function in Patients with Acute Yang Deficiency Syndrome Due to Sepsis

作　　者：张铄 梁静 张洁 陈石柳 王瑞花 Zhang Shuo;Liang Jing;Zhang Jie;Chen Shiliu;Wang Ruihua(Shanxi Hospital of Integrated Traditional Chinese and Western Medicine,Shanxi,Taiyuan 030013,China)

机构地区：[1]山西省中西医结合医院,山西中医药大学第三临床医院,山西太原030013 [2]山西中医药大学,山西晋中030602

出　　处：《中国中医急症》2025年第1期117-120,共4页Journal of Emergency in Traditional Chinese Medicine

基　　金：山西中医药大学第三临床学院科研项目(2022-L-05);国家中医优势专科建设单位项目。

摘　　要：目的 观察四逆加人参汤对脓毒症急性阳虚证患者凝血功能的影响。方法 71例患者随机分为对照组35例与观察组36例,均给予常规西医治疗,观察组加用四逆加人参汤,3 d后观察凝血功能指标血小板计数(PLT)、血浆凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、血浆纤维蛋白原(FIB)、D-二聚体、血栓弹力图指标,以及急性生理及慢性健康状况Ⅱ(APACHE Ⅱ)评分、序贯器官衰竭(SOFA)评分、感染指标降钙素原(PCT)和C反应蛋白(CRP)的变化,并观察血管活性药物使用时间、入住ICU时间、28 d病死率。结果 治疗3 d后,两组凝血指标、APACHE Ⅱ评分、SOFA评分、感染指标均有改善;观察组PLT、APTT、血栓弹力图指标凝血因子功能(R值)优于对照组(P<0.05);两组PT、FIB、D-二聚体、纤维蛋白聚合时间(K值)、纤维蛋白聚合速度(Angle)、血小板功能(MA值)、PCT、CRP、血管活性药物使用时间、入住ICU时间、28 d病死率差异均无统计学意义(P> 0.05)。结论 对脓毒症急性阳虚证患者在常规治疗基础上加用四逆加人参汤有助于改善PLT及部分凝血指标。Objective:To observe the effects of Sini Jia Renshen Decoction on the coagulation function in patients with acute yang deficiency syndrome due to sepsis. Methods:71 patients with acute deficiency syndrome due to sepsis admitted to the intensive care unit were randomly divided into a conventional control group(35 cases)and a obseration group(36 cases). Both groups received routine western medical treatment,while the obseration group additionally received the decoction. After 3 days of treatment,coagulation function indicators including platelet count(PLT),plasma prothrombin time(PT),activated partial thromboplastin time(APTT),plasma fibrinogen(FIB),D-dimer,and thromboelastography parameters,as well as Acute Physiology and Chronic Health Evaluation Ⅱ(APACHE Ⅱ)scores,Sequential Organ Failure Assessment(SOFA)scores,infection markers such as procalcitonin(PCT)and C-reactive protein(CRP),and the usage time of vasoactive drugs,ICU stay duration,and 28day mortality were observed. Results:After 3 days of treatment,the coagulation indicators,APACHE Ⅱ scores,SOFA scores,and infection markers improved in both groups. The obseration group showed better PLT,APTT,and thromboelastography parameters for coagulation factor function(R value)compared with the conventional treatment group(P< 0.05). There were no significant differences in PT,FIB,D-dimer,fibrin polymerization time(K value),fibrin polymerization velocity(Angle),platelet function(MA value),PCT,CRP,usage time of vasoactive drugs,ICU stay duration,and 28 day mortality between the two groups(P >0.05). Conclusion:Adding Sini Jia Renshen Decoction to the conventional treatment for patients with acute yang deficiency syndrome due to sepsis helps improve platelet count and some coagulation indicators.

关 键 词：脓毒症 急性虚证 四逆加人参汤 凝血指标 

分 类 号：R631[医药卫生—外科学]