目的 观察参麦注射液治疗老年糖尿病酮症酸中毒(diabetic ketoacidosis,DKA)的临床疗效。方法 选取2010-01至2014-01北京中医药大学第三附属医院急诊科治疗的DKA患者68例,随机分为观察组34例和对照组34例。对照组给予持续静脉注射小剂量胰岛素,并同时给予扩容、抗炎、纠正酸碱平衡和电解质紊乱治疗,观察组在对照组的治疗基础上加用参麦注射液。结果 观察组的血糖控制达标时间、尿酮体消失时间、胰岛素使用剂量和酸中毒纠正时间均显著少于对照组(P<0.05);两组患者治疗后的血钾、血钠、C反应蛋白(CRP)、血肌酐(SCr)、血尿素氮(BUN)水平均显著低于治疗前,动脉血气pH值水平均显著高于治疗前(P<0.05);观察组治疗后的血钾、血钠、CRP、SCr、BUN 均显著低于对照组,动脉血气pH值显著高于对照组(P<0.05);观察组的总有效率是91.17%,显著高于对照组的总有效率73.52%(P<0.05)。结论 参麦注射液治疗老年DKA,改善临床症状、控制血糖的效果优于单用胰岛素治疗,值得临床推广。

Objective To explore the clinical effect of Shenmai injection in emergent treatment of senile diabetic ketoacidosis.Methods sSixty-eight patients with diabetic ketoacidosis treated in our hospital between January 2010 and January 2014 were randomly divided into control group and treatment group, with 34 cases in each group. Patients in the control group were treated with small doses of continuous insulin intravenous drip,while patients in treatment group were additionally treated with Shenmai injection. The clinical efficacy was evaluated.The time taken to bring blood glucose under control、the time taken for urinary ketone to turn negative、 the dosage of insulin and pH recovery time in the two groups were compared.Results After treatment. the clinical efficacy in the control and treatment groups was 73.52% and 91.17% respectively, so there was significant difference between the two groups (P<0.05), After treatment, the serum potassium、 serum sodium、CRP、 SCr and BUN in the two groups were significantly lower. but pH in the two groups became significantly better. After treatment,the serum potassium、 serum sodium、CRP、SCr and BUN in the treatment group were more significantly decreased than in the control group(P<0.05), but pH in the treatment group was statistically significant increased compared with the control group (P<0.05).Conclusions Shenmai injection has curative effect in emergent treatment of diabetic ketoacidosis by improving clinical symptoms, which is worthy of clinical application.