| 王立杰,李佳静,马新,等.独参汤对脓毒性休克病人血流动力学及免疫功能的影响[J].安徽医药,2025,29(12):2523-2528. |
| 独参汤对脓毒性休克病人血流动力学及免疫功能的影响 |
| Effect of Dushen decoction on hemodynamics and immune function in patients with septic shock |
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| DOI：10.3969/j.issn.1009-6469.2025.12.041 |
| 中文关键词: 休克，脓毒性 独参汤 连续性肾脏替代治疗 血流动力学 免疫功能 素-6 |
| 英文关键词: Shock, septic Dushen decoction Continuous renal replacement therapy Hemodynamics Immune function |
| 基金项目:承德市科技计划项目( 202301A024) |
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| 中文摘要: |
| 目的分析独参汤联合连续性肾脏替代治疗( CRRT)对脓毒性休克病人血流动力学以及免疫功能的影响。方法前瞻性选取 2021年 1月至 2023年 3月入住承德市中医院重症加强护理病房( ICU)的脓毒性休克病人 80例作为研究对象，按照随机数字表法将其分为汤药组和对照组，每组各 40例；对照组给予 CRRT治疗，汤药组给予独参汤联合 CRRT治疗；比较两组临床疗效、中医症候积分、血流动力学、血乳酸、免疫功能、炎症因子等指标。结果汤药组临床总有效率为 87.50%(35/ 40)，显著高于对照组 67.50%(27/40)(P<0.05)；治疗后两组中医症候积分以及急性生理学和慢性健康状况评价 Ⅱ(APACHE Ⅱ)评分、序贯器官衰竭( SOFA)评分较治疗前显著下降( P<0.05)，治疗后汤药组中医症候积分［( 10.58±3.66)分比( 12.94±3.73)分］、 APACHE Ⅱ评分［( 13.46±4.50)分比( 16.18±5.21)分］、 SOFA评分［( 6.39±2.81)分比( 8.04±3.42)分］显著低于对照组(P<0.05)；在组间与时间上脓毒性休克病人血乳酸含量不存在交互作用，差异无统计学意义( P>0.05)在组间、时间上血乳酸含量比较差异有统计学意义( P<0.05)；治疗后两组心率、 T抑制细胞( CD8+)、降钙素原、白细胞介IL-6)、 C反应蛋白(CRP)较治疗前显著下降，平均动脉压( MAP)、中心静脉压( CVP)、心排出量、 T辅助细胞( CD4+)、 CD4+/CD8+较治疗前显著升高( P<0.05)，治疗后汤药组心率、 CD8+、降钙素原、 IL-6、CRP显著低于对照组， MAP、CVP、心排出量、 CD4+、CD4+/CD8+显著高于对照组。结论独参汤治疗脓毒性休克可以有效降低病人中医症候积分、血乳酸含量，提高病人免疫功能，改善病人血流动力学，抑制炎症反应，疗效显著。 |
| 英文摘要: |
| Objective To analyze the effect of Dushen decoction combined with continuous renal replacement therapy (CRRT) on he-modynamics and immune function in patients with septic shock.Methods Eighty patients with septic shock, who were admitted to theIntensive Care Unit (ICU) of Chengde Hospital of Traditional Chinese Medicine from January 2021 to March 2023, were collected pro-spectively as the research subjects. They were assigned to a decoction group or a control group according to random number table meth-od, with 40 patients in each group. The control group was treated with CRRT, while the decoction group was treated with Dushen decoc-tion combined with CRRT. A comparison was made of the clinical efficacy, TCM symptom scores, hemodynamics, blood lactate, im-mune function, and inflammatory factors between the two groups.Results The total clinical effective rate of the decoction group was87.50% (35/40), which was obviously higher than 67.50% (27/40) of the control group (P<0.05). After treatment, the traditional Chinesemedicine (TCM) syndrome scores, acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) scores, and sequential organ failureassessment (SOFA) scores of the two groups greatly decreased compared to those before treatment (P<0.05), and after treatment, the TCM syndrome score [(10.58±3.66) points vs. (12.94±3.73) points], APACHE Ⅱ score [(13.46±4.50) points vs. (16.18±5.21) points], and SOFA score [(6.39±2.81) points vs. (8.04±3.42) points] in the decoction group were greatly lower than those in the control group (P< 0.05). There was no interaction among groups and time in the blood lactate content of septic shock patients (P>0.05), but there was an obvious difference in blood lactate content among groups and time (P<0.05). After treatment, heart rate (HR), CD8+ , procalcitonin (PCT), interleukin-6 (IL-6), and C-reative protein (CRP) in both groups obviously decreased compared with those before treatment,while mean arterial pressure (MAP), central venous pressure (CVP), cardiac output, CD4+, and CD4+/CD8+ obviously increased com-pared with those before treatment (P<0.05). After treatment, HR, CD8+, PCT, IL-6, and CRP in the decoction group were greatly lower than those in the control group, while MAP, CVP, cardiac output, CD4+, and CD4+/CD8+ were greatly higher than those in the control group.Conclusion In the treatment of septic shock, Dushen decoction can effectively reduce the traditional Chinese medicine syn-drome score and blood lactate content of patients, improve their immune function and hemodynamics, and inhibit inflammatory reac-tions, thus achieving a great therapeutic effect. |
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