温肾护脉汤治疗脓毒症阳脱证疗效观察  

Observation on the Therapeutic Effect of Wenshen Humai Decoction in the Treatment of Sepsiswith Yang Collapse Syndrome

作　　者：练志明 王震奎 黄钜明 丘文军 杨天化 陈仁山 丁雯 林志鹏 许声浩 LIAN Zhiming;WANG Zhenkui;HUANG Juming;QIU Wenjun;YANG Tianhua;CHEN Renshan;DING Wen;LIN Zhipeng;XU Shenghao(Department of Critical Care Medicine,Guangzhou Hospital of Integrated Traditional Chineseand Western Medicine,Guangzhou 510801,China)

机构地区：[1]广州市中西医结合医院重症医学科,广州510801

出　　处：《中西医结合研究》2025年第2期89-93,共5页Research of Integrated Traditional Chinese and Western Medicine

基　　金：广州市花都区科技计划项目(No.23-HDWS-30)。

摘　　要：目的探讨温肾护脉汤治疗脓毒症阳脱证的临床疗效及对炎症因子、免疫功能的影响。方法选取本院急诊科收治的160例脓毒症阳脱证患者,按随机数字表法分为观察组和对照组,每组80例。对照组给予西医常规治疗,观察组在对照组治疗基础上加用温肾护脉汤。治疗7 d后,比较2组患者临床疗效、中医证候积分、脓毒症相关性器官功能衰竭评价(sepsis-related organ failure assessment,SOFA)评分、急性生理学和慢性健康状况评价(acute physiology and chronic health evaluation,APACHE)II评分、血清炎症因子水平、免疫功能指标、重症监护病房(intensive care unit,ICU)住院时间及机械通气时间。结果治疗结束后,观察组总有效率为90.0%,显著高于对照组的77.5%(P<0.05)。观察组中医证候积分、SOFA评分、APACHE II评分及血清白细胞(white blood cell,WBC)、降钙素原(procalcitonin,PCT)、超敏C反应蛋白(hypersensitive C-reactive protein,hs-CRP)、肿瘤坏死因子(tumor necrosis factor,TNF)-α、白介素(interleukin,IL)-6水平均显著低于对照组(P<0.05)。观察组CD_(4)^(+)T细胞、CD_(3)^(+)T细胞比例及CD_(4)^(+)/CD_(8)^(+)细胞比值均显著高于对照组(P<0.05)。观察组ICU住院时间、机械通气时间均显著短于对照组(P<0.05)。结论温肾护脉汤能显著改善脓毒症阳脱证患者临床症状,降低炎症因子水平,增强细胞免疫功能,缩短ICU住院时间,降低病死率,疗效确切。Objective To explore the clinical efficacy of Wenshen Humai decoction in the treatment of sepsis with yang collapse syndrome and its effects on inflammatory factors and immune function.Methods One hundred and sixty sepsis patients with yang collapse syndrome admitted to the emergency department of our hospital were selected and divided into an observation group and a control group according to the random number table method,with 80 cases in each group.The control group received conventional Western medicine treatment,while the observation group received Wenshen Humai decoction on the basis of the control group's treatment.After 7 days of treatment,clinical efficacy,traditional Chinese medicine syndrome scores,sepsis-related organ failure assessment(SOFA)scores,acute physiology and chronic health evaluation(APACHE)II scores,serum inflammatory factors levels,immune function indicators,intensive care unit(ICU)hospitalization time and mechanical ventilation time were compared between two groups of patients.Results After treatment,the total effective rate in the observation group was 90.0%,which was significantly higher than 77.5%in the control group(P<0.05).The traditional Chinese medicine syndrome scores,SOFA scores,APACHE II scores and serum levels of white blood cells(WBC),procalcitonin(PCT),hypersensitive C-reactive protein(hs-CRP),tumor necrosis factor(TNF)-α,and interleukin(IL)-6 in the observation group were significantly lower than those in the control group(P<0.05).The proportion of CD_(4)^(+)T cells,CD_(3)^(+)T cells,and CD_(4)^(+)/CD_(8)^(+)cell ratio in the observation group were significantly higher than those in the control group(P<0.05).The ICU hospitalization time and mechanical ventilation time in the observation group were significantly shorter than those in the control group(P<0.05).Conclusion Wenshen Humai decoction could significantly improve the clinical symptoms of sepsis patients with yang collapse syndrome,reduce the levels of inflammatory factors,enhance cellular immune function,shorten ICU

关 键 词：温肾护脉汤 脓毒症 阳脱证 炎症因子 免疫功能 

分 类 号：R278[医药卫生—中医学]