新四逆汤治疗重症脓毒症临床研究  

Clinical Study on the Treatment of Severe Sepsis with New Frigid Extremities Decoction

作　　者：冯皓 李建杰 郑盼盼 FENG Hao;LI Jianjie;ZHENG Panpan(Zhengzhou Traditional Chinese Medicine Hospital,Zhengzhou,Henan,China,450007;Zhengzhou Central Hospital,Zhengzhou,Henan,China,450000)

机构地区：[1]郑州市中医院,河南郑州450007 [2]郑州市中心医院,河南郑州450000

出　　处：《河南中医》2025年第2期278-282,共5页Henan Traditional Chinese Medicine

基　　金：2024年度河南省中医药科学研究课题项目(2024ZY3096)。

摘　　要：目的:观察新四逆汤治疗重症脓毒症的临床疗效。方法:将80例重症脓毒症患者按照随机数字表法分为对照组和观察组,每组各40例。对照组采用连续性血液净化治疗,观察组在对照组治疗的基础上给予新四逆汤治疗。比较两组患者的临床疗效、住院时间、机械通气时间和治疗前后中医证候积分、序贯器官衰竭评估评分(sequential organ failure assessment, SOFA)、心功能指标[肌酸激酶(creatine kinase, CK)、乳酸脱氢酶(lactic dehydrogenas, LDH)]、肾功能指标[血尿素氮(blood urea nitrogen, BUN)、血肌酐(serum creatinine, Scr)]、肝功能指标[丙氨酸转氨酶(alanine transaminase, ALT)、天冬氨酸转氨酶(aspartateaminotransferase, AST)]、炎性因子[肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、可溶性髓系细胞触发受体-1(soluble myeloid cell triggered receptor-1,sTREM-1)、降钙素原(procalction, PTC)]变化情况。结果:观察组有效率为95.00%,对照组有效率为77.50%,两组有效率比较,差异具有统计学意义(P<0.05)。观察组住院时间、机械通气时间短于对照组(P<0.05)。两组患者治疗后中医证候积分、SOFA评分、CK、LDH、BUN、SCr、AST、ALT、TNF-α、PCT、sTREM-1均低于本组治疗前,且治疗后观察组低于对照组(P<0.05)。结论:新四逆汤治疗重症脓毒症,可明显缩短连续性血液净化治疗的时间,改善临床症状,减轻重要器官的功能损伤,降低机体炎症反应。Objective:To observe the clinical efficacy of New Frigid Extremities Decoction on severe sepsis.Methods:A total of 80 patients with severe sepsis were randomly divided into the control group and the observation group according to the random number table method,with 40 cases in each group.The control group was treated with continuous blood purification,while the observation group was treated with New Frigid Extremities Decoction on the basis of the control group′s treatment.The clinical efficacy,hospital stay,mechanical ventilation time,and the changes in TCM syndrome scores,sequential organ failure assessment(SOFA)scores,cardiac function indicators[creatine kinase(CK),and lactic dehydrogenase(LDH)],renal function indicators[blood urea nitrogen(BUN),and serum creatinine(Scr)],liver function indicators[alanine transaminase(ALT),and aspartate aminotransferase(AST)],TNF-α,PCT,and sTREM-1 before and after treatment were compared between the two groups.Results:The effective rate of the observation group was 95.00%,and that of the control group was 77.50%.The difference in the effective rate between the two groups was statistically significant(P<0.05).The hospital stay and mechanical ventilation time of the observation group were shorter than those of the control group(P<0.05).After treatment,the TCM syndrome scores,SOFA scores,CK,LDH,BUN,Scr,AST,ALT,TNF-α,PCT,and sTREM-1 of both groups were lower than those before treatment,and the above indicators of the observation group were lower than those of the control group(P<0.05).Conclusion:New Frigid Extremities Decoction can significantly shorten the time of continuous blood purification treatment,improve clinical symptoms,alleviate the functional damage of important organs,and reduce the inflammatory response of the body in the treatment of severe sepsis.

关 键 词：重症脓毒症 连续性血液净化 新四逆汤 

分 类 号：R278[医药卫生—中医学]