复苏合剂对感染性休克患者舌下微循环及相关因素的影响

Effect of Fusu Agent on Sublingual Microcirculation in Sepsis Shock Patients

目的探讨感染性休克患者加用中药复苏合剂对舌下微循环及相关因素的影响。方法筛选162例受试者,采用随机数字表法分组,将纳入的81例感染性休克患者分为常规组40例和复苏合剂组41例,两组均按照2016年感染性休克的治疗指南进行治疗,复苏合剂组同时加用中药复苏合剂10 g,每日3次,口服/鼻饲,疗程5天。监测两组患者0、24、72、120 h舌下微循环指标:包括血管总密度(TVD)、灌注血管密度(PVD)、血管灌注比例(PPV)、血管平均血流指数(MFI)的变化;观察28天病死率及ICU住院时间。结果与常规组同期比较,复苏合剂组治疗72、120 h时MFI值升高(P<0.05,P<0.01),治疗24、72 h时PPV值升高(P<0.05,P<0.01);TVD、PVD值在各时间有所升高,但差异均无统计学意义(P>0.05)。复苏合剂组ICU住院时间较常规组缩短(P<0.05);复苏合剂组28天病死率低于常规组(29.3%vs.37.5%),但差异无统计学意义(P=0.5042)。结论复苏合剂可以改善感染性休克患者的微循环障碍,缩短ICU住院时间。

Objective To observe the effect of Fusu Agent on microcirculation and other related factors in sepsis shock patients.Methods A total of 162 patients were screened,81 sepsis shock patients were randomly assigned to the conventional therapy group(40 cases)and the Fusu Agent group(41 cases)according to the random digit table.Patients in both groups were treated following Surviving Sepsis Campaign 2016 guide.Patients in the Fusu Agen group additionally took 10 g of Fusu Agen throught oral or nasal feeding,3 times per day,All treatment lasted for 5 days.The indexes of sublingual microcirculation were monitored at 0 h,24 h,72 h and 120 h,including total density of small vessels(TVD),perfused density of small vessels(PVD),proportion of perfused small vessels(PPV)and mean flow index of small vessels(MFI).Twentyeight-day fatality rate and ICU hospitalization time were observed.Results Compared with the conventional therapy group at the same time,the MFI increased at 72 h and 120 h in Fusu Agen group(P<0.05,P<0.01).The PPV of Fusu agen group was higher than that of conventional therapy group at the same time at 24 h and 72 h(P<0.05,P<0.01).The TVD and PVD of Fusu Agen group were higher than those of conventional therapy group,but the difference was not statistically significant(P>0.05).The ICU hospitalization time of Fusu Agen group was shorter than that of conventional therapy group(P<0.05);The 28 day mortality in Fusu Agen group was lower than that in conventional therapy group(29.3%vs.37.5%),but the difference was not statistically significant(P=0.5042).Conclusion Fusu Agent could improve the microcirculation disorder in sepsis shock patients,shorten the ICU stay time.