参附注射液联合早期连续血液净化治疗脓毒症休克临床研究
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Clinical Study on Shenfu Injection Combined with Early Continuous Blood Purification for Septic Shock
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    摘要:

    目的:观察参附注射液联合早期连续血液净化治疗脓毒症休克的临床疗效及对氧代谢、微循环的 影响。方法:选择100 例脓毒症休克患者为研究对象,随机分为对照组和治疗组各50 例。对照组采用早期连 续血液净化治疗,治疗组在对照组基础上采用参附注射液治疗。比较2 组治疗前后序贯性器官衰竭(SOFA) 和急性生理学与慢性健康状况系统(APACHEⅡ) 评分,血气指标[氧输送量(DO2)、氧消耗量(VO2)、氧摄 取率(O2ER)] 水平,舌下微循环指标[总血管密度(TVD)、小血管灌注比(PPV)、灌注的小血管密 度(PVD)、微血管血流指数(MFI)] 水平。结果:治疗组总有效率为90.00%,对照组为74.00%,2 组比 较,差异有统计学意义(P<0.05)。治疗前,2 组SOFA、APACHEⅡ评分比较,差异均无统计学意义(P> 0.05)。治疗后,2 组SOFA、APACHEⅡ评分均较治疗前降低(P<0.05),且治疗组2 项评分均低于对照 组(P<0.05)。治疗前,2 组DO2、VO2、O2ER 水平比较,差异无统计学意义(P>0.05)。治疗后,2 组DO2、 VO2 水平均较治疗前升高(P<0.05),O2ER 水平较治疗前降低(P<0.05);且治疗组DO2、VO2 水平高于对照 组(P<0.05),O2ER 水平低于对照组(P<0.05)。治疗前,2 组TVD、PVD、PPV、MFI 水平比较,差异均无 统计学意义(P>0.05);治疗后,2 组上述4 项舌下微循环指标均较治疗前升高(P<0.05),且治疗组上述各 项指标均高于对照组(P<0.05)。结论:参附注射液联合早期连续血液净化治疗脓毒症休克具有良好疗效,对 机体氧代谢及微循环状态有明显的改善作用,从而有效缓解病情进展。

    Abstract:

    Abstract: Objective: To observe the clinical effect of the therapy of Shenfu Injection combined with early continuous blood purification on septic shock and its effect on aerobic metabolism and microcirculation. Methods:A total of 100 patients with septic shock were selected as the study objects and randomly divided into the control group and the treatment group,with 50 cases in each group. The control group was given early continuous blood purification for treatment,and the treatment group was additionally treated with Shenfu Injection based on the treatment of the control group. Before and after treatment,the scores of Sequential Organ Failure Assessment (SOFA) and Acute Physiology and Chronic Health Evaluation Scoring System (APACHE Ⅱ), and the levels of blood gas indexes, including oxygen delivery (DO2), oxygen consumption (VO2) and oxygen extraction ratio (O2ER) and sublingual microcirculation indexes, including total vessel density (TVD),proportion of perfused vessels (PPV),perfused vessel density (PVD) and microvascular flow density (MFI) were compared between the two groups. Results:The total effective rate was 90.00% in the treatment group and 74.00% in the control group,the difference being significant (P<0.05). Before treatment,there was no significant difference being found in the comparisons of scores of SOFA and APACHE Ⅱ between the two groups (P>0.05). After treatment, the scores of SOFA and APACHEⅡ in both groups were decreased when compared with those before treatment (P<0.05),and the above two scores in the treatment group were lower than those in the control group (P<0.05). Before treatment,there was no significant difference being found in the comparisons of levels of DO2,VO2 and O2ER between the two groups (P>0.05). After treatment,the levels of DO2 and VO2 in both groups were increased when compared with those before treatment (P<0.05), and the O2ER levels were decreased when compared with those before treatment (P<0.05); the levels of DO2 and VO2 in the treatment group were higher than those in the control group (P<0.05),and the O2ER level was lower than that in the control group (P<0.05). Before treatment,there was no significant difference being found in the comparisons of levels of TVD,PVD,PPV and MFI between the two groups (P>0.05). After treatment,the levels of above four sublingual microcirculation indexes in both groups were increased when compared with those before treatment (P<0.05),and the above four levels in the treatment group were higher than those in the control group (P<0.05). Conclusion: The therapy of Shenfu Injection combined with early continuous blood purification has a good curative effect on patients with septic shock, which can significantly improve the aerobic metabolism and microcirculation of the body and thus effectively mitigate the state of disease.

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李润,袁方,赵坤芳,孙新帅.参附注射液联合早期连续血液净化治疗脓毒症休克临床研究[J].新中医,2023,55(22):69-73

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  • 在线发布日期: 2023-11-28
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