中医扶正治疗策略对脓毒症预后影响的病例对照研究  

Case-control study of reinforcing treatment in Chinese medicine strategies in the influence of sepsis prognosis

作　　者：叶家荣 刘云涛 李际强 李俊 YE Jiarong;LIU Yuntao;LI Jiqiang;LI Jun(The Second Clinical College of Guangzhou University of Chinese Medicine/The Second Affiliated Hospital of Guangzhou University of Chinese Medicine/Guangdong Provincial Hospital of Chinese Medicine,Guangzhou 510120,China;Guangdong Provincial Key Laboratory of Research on Emergency in TCM,Guangzhou 510120,China;The First Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510405,China)

机构地区：[1]广州中医药大学第二临床医学院/广州中医药大学第二附属医院/广东省中医院,广州510120 [2]广东省中医急症研究重点实验室,广州510120 [3]广州中医药大学第一附属医院,广州510405

出　　处：《中华中医药杂志》2024年第12期6898-6905,共8页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：广东省中医药局科研项目(No.20201143);广东省中医院临床研究专项(No.YN10101908);广东省自然科学基金面上项目(No.2020A1515010512)。

摘　　要：目的:探讨中医扶正治疗策略在脓毒症临床诊疗实践中的应用情况及其对脓毒症28 d预后的影响。方法:采用回顾性病例对照试验设计,以2013—2018年于广东省中医院确诊并住院的脓毒症患者为研究对象,探讨不同因素与脓毒症患者28 d预后的关系。结果:脓毒症患者的年龄越大、序贯器官衰竭(SOFA)评分及Charlson并发症指数(CCI)评分越高、致病因素为呼吸系统感染、住院期间接受输血浆、无创通气、心肺复苏、肾上腺素或参附注射液等治疗的比例越高,患者28d死亡风险越大;而致病因素为泌尿生殖感染、血流感染、肝胆感染或皮肤感染、住院期间接受连续肾脏替代疗法(CRRT)或透析、补虚药或黄芪注射液等治疗的比例越高,患者的28 d死亡风险则较小。结论:早期对感染部位进行识别,并运用扶正治疗策略有助于降低脓毒症患者的病死率,改善脓毒症患者的预后。Objective:To explore the application of reinforcing treatment in Chinese medicine strategies in the practice of clinical diagnosis and treatment of sepsis and its influence on the prognosis of sepsis 28 days.Methods:A retrospective casecontrol trial design was adopted.The patients with sepsis who were diagnosed and hospitalized in Guangdong Provincial Hospital of Chinese Medicine from 2013 to 2018 were selected as the research objects to explore the relationship between different factors and the 28-day prognosis of sepsis patients.Results:The older the sepsis patients,the higher sequential organ failure assessment(SOFA)score and Charlson comorbidity index(CCI)score,the higher the proportion of respiratory system infection risk factors,receiving plasma transfusion during hospitalization,non-invasive assisted ventilation,cardiopulmonary resuscitation,epinephrine or Shenfu Injection,the greater the risk of death at 28 days;while the higher the ratio of urogenital infection,bloodstream infection,liver and gallbladder infection or skin infection,continuous renal replacement therapy(CRRT)or dialysis,tonic or astragalus injection during hospitalization,the smaller the 28-day mortality risk of patients.Conclusion:Early identification of the site of infection and the application of reinforcing treatment in Chinese medicine strategies help to reduce the mortality of patients with sepsis and improve the prognosis of patients with sepsis.

关 键 词：脓毒症 中医扶正治疗策略 病例对照 预后 LOGISTIC分析 

分 类 号：R47[医药卫生—护理学]