目的 探讨采用参附注射液治疗脓毒症对相关临床指标的影响。方法 选取2017-10至2021-10武警北京总队医院急诊医学科治疗后收住院的60例严重脓毒血症患者作为研究对象,随机分成观察组和对照组,每组30例。两组患者均按照指南给予补液扩容、抗感染等常规治疗措施。观察组在标准治疗的基础上,给予静脉滴注参附注射液治疗,1次/d,7 d为1个疗程,共治疗两个疗程。观察计录两组患者治疗前及住院治疗过程中血清CRP、PCT的变化,对治疗过程中APACHEⅡ评分、住院时间等进行对比分析。结果 观察组给予参附注射液治疗第3、7、10、14天,APACHEⅡ评分、SOFA评分、血清CRP和PCT浓度均显著低于对照组,差异有统计学意义(P<0.05);观察组患者总住院时间为(16.23±2.74)d,显著短于对照组[(21.67±3.52)d],差异有统计学意义(P<0.05)。结论 采用参附注射液治疗脓毒症,可改善相关指标,临床效果显著。
Abstract
Objective To observe the effect of Shenfu injection on relevant indicators in patients with sepsis. Methods A total of 60 patients with severe sepsis admitted after treatment into the Emergency Medicine Department of a Grade-A hospital in Beijing from October 2017 to October 2021 were selected as the study objects and randomly divided into observation group and control group, with 30 cases in each group. Patients in both groups were given conventional treatment measures such as fluid replenishment, expansion and anti-infection according to the guidelines. Observation group was given intravenous infusion of Shenfu injection on the basis of standard treatment, once a day, 7 days as a course of treatment, a total of two courses of treatment. The changes of serum CRP and PCT before treatment and during hospitalization of the two groups were observed, and the APACHEⅡ score and length of hospitalization during treatment were compared and analyzed. Results On the 3rd, 7th, 10th and 14th day of Shenfu injection treatment, APACHEⅡ score, SOFA score, serum CRP and PCT concentration in observation group were significantly lower than those in control group, with statistical significance (P<0.05). The total hospitalization time of observation group was (16.23±2.74) d, which was significantly shorter than that of control group [(21.67±3.52) d], and the difference was statistically significant (P＜0.05). Conclusions The treatment of sepsis with Shenfu injection can improve the relevant indexes, and the clinical effect is remarkable.
关键词
降钙素原 /
C-反应蛋白 /
参附注射液 /
脓毒症
Key words
procalcitionin /
C-reactive protein /
Shenfu injection /
sepsis
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
[1] Mithal L B, Palac H L,Yogev R,et al. Cord blood acute phase reactants predict early onset neonatal sepsis in preterm in fants [J]. PLoS One, 2017,12 (1):e0168677.
[2] Bray C, Kennedy C.Improving timely sepsis care using the surviving sepsis campaign one-hour bundle in a rural emergency department[J]. J Am Assoc Nurse Pract, 2020,20:246-253.
[3] Pan J,Peng M,Liao C,et al.Relative efficacy and safety of earlylactate clearance-guided therapy resuscitation in patients with sep-sis:a meta-analysis[J]. Medicine(Baltimore),2019,98(8):e14453.
[4] Levy M M,Evans L E,Rhodes A.The surviving sepsis campaign bundle: 2018 update [J].Crit Care Med,2018,46(6);997-1000.
[5] 胡 超,张 谦. 参附注射液改善脓毒症患者微循环的研究进展. 中国中医急症,2021,30(8): 1501-1504.
[6] Singer M, Deutschan C S, Seymour C W, et al. The third international consensus definitions for sepsis and septic shock (Sepsis-3) [J].JAMA,2016,315(8):801-810.
[7] 尹彦芬,容维娜,张 霞,等.脓毒症患者血清降钙素元、C-反应蛋白与凝血功能、病情评分的关系及预后的影响因素分析[J].现代生物学进展,2021,7(21):1333-1337.
[8] 王 力. 脓毒症患者炎症因子、内皮细胞损伤和凝血指标的相关性分析[J]. 现代实用医学,2021,33(3):382-384.
[9] Ryoo S M,Han K S,Ahn S,et al. The usefulness of C-re-active protein and procalcitonin to predict prognosis in septic shock patients:A multicenter prospective registry-based observational study [J]. Sci Rep,2019,9(1):6579.
[10] 樊 霞,韩忠学,付景林.烧伤脓毒症患者外周 C-反应蛋白和 CD64 水平动态变化[J]. 武警医学,2015,26(4):387-390.
[11] 中国医疗保健国际交流促进会急诊医学分会,中华医学会急诊医学分会,中国医师协会急诊医师分会,等.中国脓毒症早期预防与阻断急诊专家共识[J].临床急诊杂志,2020,21(7):517-529.
[12] 闵玉娣,孔令斌.脓毒症诊断及集束化治疗依从性的研究进展[J]. 中华诊断学电子杂志,2021,9(2):133-136.
[13] 曾德金,郭应军.参附注射液对感染性休克患者血流动力学及氧代谢影响的临床研究[J].中医临床研究,2019,11(35):102-104.
[14] Zhu J,Song W,Xu S,et al. Shenfu injection promotes vasodilation by enhancing eNOS activity through the PI3K/Akt signaling pathway in vitro[J]. Front Pharmacol,2020(11):121.
[15] 卫靖靖,郑超楠,乔利杰,等.基于网络药理学探讨参附汤治疗慢性心力衰竭的作用机制[J].中药药理与临床,2020,36(4):88-93.
[16] 徐 松,姚 兰,侯 国,等.参附注射液联合去甲肾上腺素对脓毒症休克兔舌下微循环的影响[J].微循环杂志,2020,30(1):5-10.
[17] 王鸿燕,赵月娥,林泽辉,等.参附注射液联合糖皮质激素治疗脓毒症的疗效观察.中国中医急症,2021,30(3):518-520.
[18] 卓道勤,闵 磊,张丹阳,等.参附注射液对严重脓毒症患者血流动力学干预作用的临床研究[J].中国中医药科技,2018,25(1):15-16,20.
PDF(945 KB)
