破格救心汤治疗脓毒性休克的疗效观察

目的观察破格救心汤治疗脓毒性休克的临床疗效。方法脓毒性休克患者92例随机分为对照组与观察组各46例。两组均给予常规治疗,观察组加用破格救心汤治疗。分析两组中医证候疗效,检测两组患者治疗前后的急性生理和慢性健康状况评分(APACHEⅡ)、全身感染相关器官功能衰竭评分(SOFA)、平均动脉压(MAP)、中心静脉血氧饱和度(SCvO2)、血乳酸(Lac)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、超敏C反应蛋白(hs-CRP)、降钙素原(PCT),并计算乳酸清除率,记录机械通气时间、血管活性药物使用时间、28 d病死率。结果观察组的中医疗效总有效率为84.78%,高于对照组的71.74%(P<0.05)。与治疗前比较,两组APACHEⅡ、SOFA评分及血清TNF-α、IL-6、hs-CRP、PCT均明显降低,且观察组降低更明显(P<0.05);与治疗前比较,两组MAP、ScvO2均明显升高,且观察组升高更明显(P<0.05);观察组12、24、48 h血Lac浓度及乳酸清除率均显著低于对照组(P<0.05);两组机械通气时间、血管活性药物使用时间、28 d病死率差异无统计学意义(P>0.05)。结论破格救心汤可以提高脓毒性休克患者的中医证候疗效,改善病情,显著减轻炎症反应。

Effects of Poge Jiuxin Decoction in the Treatment of Septic Shock

Objective:To observe the clinical efficacy of Poge Jiuxin Decoction in the treatment of septic shock.Methods:92 patients with septic shock were randomly divided into the control group and the observation group with 46 cases in each group.Both groups were given conventional treatment,and the observation group was treated with extra Poge Jiuxin Decoction.The curative effect of TCM syndromes of the two groups were calculated,the acute physiology and chronic health score(APACHEⅡ),systemic infection-related organ failure score(SOFA),mean arterial pressure(MAP),central venous blood oxygen saturation(SCvO2),blood lactate(Lac),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),high-sensitivity C-reactive protein(hs-CRP),procalcitonin(PCT)were detected before and after treatment in two groups,and the lactic acid clearance rate,record the time of mechanical ventilation,the time of using vasoactive drugs,and the 28-day mortality rate were calculated.Results:The total effective rate of TCM in the observation group was 84.78%,which was higher than 71.74%in the control group(P<0.05).Compared with before treatment,the two groups of APACHEⅡ,SOFA scores and serum TNF-α,IL-6,hsCRP,PCT reduced significantly(P<0.05),and the observation group decreased more significantly(P<0.05).Compared before treatment,both MAP and ScvO2 of the two groups increased significantly(P<0.05),and the observation group increased significantly(P<0.05).The 12,24,and 48 h blood Lac concentration and lactic acid clearance rate of the observation group were significantly lower than those of the control group(P<0.05).There were no statistically significant differences in time of mechanical ventilation,the vasoactive drug use time,and the 28-day mortality rate(P>0.05).Conclusion:Poge Jiuxin Decoction can improve the efficacy of TCM syndromes in patients with septic shock,improve the condition,and significantly reduce inflammation.