生脉散联合清瘟败毒饮对脓毒症(气阴两虚证)老年患者免疫功能的影响  

Effect of Shengmai Powders Combined with Qingwen Baidu Decoction on Immune Function in Elderly Patients with Sepsis(Syndrome of Deficiency of Both Qi and Yin)

作　　者：宋苏沛 姜莹[1] 拾晴 张芳芹 黄森 周文博 薛明[1] Song Supei;Jiang Ying;Shi Qing;Zhang Fangqin;Huang Sen;Zhou Wenbo;Xueming(Xuzhou City Hospital of Traditional Chinese Medicine,Xuzhou Traditional Chinese Medicine Hospital Affiliated to Nanjing University of Chinese Medicine,Jiangsu,Xuzhou 221003,China)

机构地区：[1]江苏省徐州市中医院,南京中医药大学附属徐州医院,江苏徐州221003

出　　处：《中国中医急症》2025年第4期642-645,共4页Journal of Emergency in Traditional Chinese Medicine

基　　金：徐州市科技局新型临床诊疗技术攻关项目(KC21243)。

摘　　要：目的观察生脉散联合清瘟败毒饮对老年脓毒症(气阴两虚证)患者免疫功能的影响。方法脓毒症患者60例采用随机数字表法分为观察组与对照组各30例。对照组采用西医常规治疗,观察组在对照组的基础上采用生脉散联合清瘟败毒饮治疗。疗程14 d。比较两组患者治疗前后急性生理与慢性健康(APACHEⅡ)评分和中医证候积分,比较两组患者治疗前后总T淋巴细胞(CD3+)、辅助/诱导T淋巴细胞(CD4+)、抑制/杀伤T淋巴细胞(CD8+)、B淋巴细胞(B细胞)、自然杀伤细胞(NK细胞)水平,比较两组患者机械通气时间和ICU停留时间。结果两组患者治疗后,APACHEⅡ评分较前下降(P<0.01),观察组患者在治疗3、7 d后的APACHEⅡ评分低于对照组(P<0.05或P<0.01),治疗7、14 d后的中医证候积分低于对照组(P<0.05或P<0.01)。两组患者治疗后,CD3+、CD4+、CD8+、B细胞、NK细胞水平均升高(P<0.05),观察组患者在治疗7、14 d的CD3+、CD4+、CD8+、B细胞、NK细胞的水平高于对照组(P<0.05)。观察组患者机械通气时间和ICU停留时间短于对照组(P<0.05)。结论生脉散联合清瘟败毒饮加减治疗可以降低老年脓毒症(气阴两虚证)患者APACHEⅡ评分和中医证候积分,增强免疫功能,缩短机械通气时间和ICU停留时间。Objective:To observe the effects of Shengmai Powder combined with Qingwen Baidu Decoction on immune function in elderly patients with sepsis(syndrome of deficiency of both qi and yin).Methods:60 elderly patients diagnosed with sepsis were randomly divided into an observation group and a control group,each consisting of 30 patients.The control group received standard Western medical treatment,while the treatment group received Shengmai Powder combined with Qingwen Baidu Decoction in addition to the same Western treatment.The course of treatment lasted for 14 days.Changes in Acute Physiology and Chronic Health Evaluation I(APACHE I)scores and TCM syndrome scores before and after treatment were compared between the two groups.Changes in total T lymphocytes(CD3+),helper/inducer T lymphocytes(CD4+),suppressor/cytotoxic T lymphocytes(CD8+),B lymphocytes(B cells),and natural killer cells(NK cells)were compared before and after treatment.Mechanical ventilation time and ICU stay duration were also compared between the two groups.Results:After treatment,APACHEⅡscores decreased significantly in both groups(P<0.01).The APACHEⅡscores at 3 and 7 days after treatment in the observation group were lower than those in the control group(P<0.05 or P<0.01).The TCM syndrome scores at 7 and 14 days after treatment in the observation group were also lower than those in the control group(P<0.05 or P<0.01).Levels of CD3+,CD4+,CD8+,B cells,and NK cells increased significantly in both groups after treatment(P<0.05),but the levels in the observation group at 7 and 14 days after treatment were higher than those in the control group(P<0.05).Mechanical ventilation time and ICU stay duration were shorter in the observation group compared with the control group(P<0.05).Conclusion:Shengmai Powder combined with Qingwen Baidu Decoction can reduce APACHEI scores and TCM syndrome scores in elderly patients with sepsis(syndrome of deficiency of both qi and yin),enhance immune function,and shorten mechanical ventilation time and ICU stayduration.

关 键 词：脓毒症 生脉散 清瘟败毒饮 老年患者 气阴两虚 APACHEⅡ评分 免疫功能 

分 类 号：R631[医药卫生—外科学]