四逆汤治疗脓毒症相关毛细血管渗漏综合征疗效观察  

Efficacy observation of Sini decoction on sepsis-induced capillary leak syndrome

作　　者：刘伟[1] 续自凤 李琪[1] 薛彦霞 LIU Wei;XU Zi-feng;LI Qi(Linyi Hospital of Traditional Chinese Medicine,Shandong Province,Linyi 276002,China)

机构地区：[1]山东省临沂市中医医院,临沂276002

出　　处：《山西中医》2025年第2期12-14,共3页Shanxi Journal of Traditional Chinese Medicine

基　　金：全国老中医药专家李琪学术经验继承工作项目。

摘　　要：目的:观察四逆汤治疗脓毒症相关毛细血管渗漏综合征的临床疗效。方法:将102例脓毒症相关毛细血管渗漏综合征患者随机分为两组。对照组48例予常规基础治疗;治疗组54例在对照组的基础上予四逆汤。两组均治疗7天。观察两组患者治疗前、治疗3天、治疗7天的白介素-6(IL-6)、白介素-10(IL-10)、肿瘤坏死因子-α(TNF-α)、乳酸(Lac)、C-反应蛋白(CRP)、降钙素原(PCT)水平,急性生理学与慢性健康状况Ⅱ(APACHEⅡ)评分,渗漏指数(CLI)(CRP/ALB),及两组患者7天、28天死亡率。结果:治疗第7天,治疗组总有效率88.89%,对照组总有效率70.83%,两组比较差异有统计学意义(P﹤0.05)。治疗第3天、第7天,两组患者IL-6、IL-10、TNF-α、Lac、CRP、PCT、APACHEⅡ评分、CLI均较治疗前有所下降(P﹤0.05),且治疗组治疗第7天,上述指标明显优于对照组,差异有统计学意义(P﹤0.05);治疗组7天死亡率明显低于对照组(P﹤0.05);28天死亡率,治疗组虽低于对照组,但差异无统计学意义(P﹥0.05)。结论:四逆汤治疗脓毒症相关毛细血管渗漏综合征可以减轻机体炎症反应,改善因毛细血管渗漏导致的多器官功能障碍,快速纠正休克,降低脓毒症早期死亡率,改善患者的预后。Objective:To observe the clinical efficacy of Sini decoction on sepsis-induced capillary leak syndrome.Methods:102 cases of patients with sepsis-induced capillary leak syndrome were randomly divided into two groups.48 cases of control group were treated by routine basic therapy,while 54 cases of treatment group were treated plus with Sini decoction on the basis of control group.Both groups were treated for 7 days.The levels of interleukin-6(IL-6),interleukin-10(IL-10),tumor necrosis factor-α(TNF-α),lactic acid(Lac),C-reactive protein(CRP)and procalcitonin(PCT)as well as the scores of acute physiology and chronic health status II(Apache II),leckage index(CLI)(CRP/ALB)and the 7-and 28-day mortality rate of patients were observe in two group before the patients were treated and after the patients were treated for 3 days and 7 days.Results:On the 7th day of treatment,the total effective rate of treatment group was 88.89%,while that of control group was 70.83%,and the comparative difference between two groups was statistically significant(P﹤0.05).In both groups on the 3rd and 7th day of treatment,the scores of IL-6,IL-10,TNF-α,Lac,CRP,PCT and APACHEⅡas well as CLI of patients were decreased compared with pre-treatment(P﹤0.05);and on the 7th day of treatment,the above indexes of treatment group were significantly better than those of control group,and the difference was statistically significant(P﹤0.05).The 7-day mortality rate of treatment group was significantly lower than that of control group(P<0.05);the 28-day mortality rate of treatment group was lower than that of control group,but the difference was statistically unsignificant(P﹥0.05).Conclusion:Sini decoction for treating sepsis-induced capillary leak syndrome can reduce the inflammatory reaction of body,improve the multiple organ dysfunction caused by capillary leak,quickly correct shock,reduce the mortality rate of early sepsis and enhance the prognosis of patients.

关 键 词：脓毒症相关毛细血管渗漏综合征 多器官功能障碍综合征 四逆汤 中医药疗法 

分 类 号：R278[医药卫生—中医学]