血府逐瘀汤加减对脓毒症凝血功能障碍的影响

Effect of Xuefu Zhuyu Decoction(血府逐瘀汤)on Coagulation Dysfunctionin Patients with Sepsis

目的在探讨血府逐瘀汤加减对脓毒症患者凝血功能障碍的影响。方法将68例脓毒症患者按随机数字表法分为对照组(给予常规西医治疗)和治疗组(在常规西医治疗的基础上给予血府逐瘀汤加减治疗)各34例,对比两组治疗前后中医证候积分、SOFA评分、APACHEⅡ评分、凝血功能及炎性因子水平,统计临床疗效。结果治疗前,两组急躁易怒、皮肤瘀斑或出血、刺痛拒按、疲乏无力、痛处固定不移或神昏、SOFA评分、APACHEⅡ评分、活化部分凝血活酶时间(APTT)、纤维蛋白原(FBI)、凝血酶时间(TT)、凝血酶原时间(PT)、白细胞介素-10(IL-10)、肿瘤坏死因子-α(TNF-α)、内皮细胞特异性分子-1(EAM-1)水平比较(P>0.05);治疗后,两组急躁易怒、皮肤瘀斑或出血、刺痛拒按、疲乏无力、痛处固定不移或神昏、SOFA评分、APACHEⅡ评分、APTT、FBI、TT、PT、IL-10、TNF-α、EAM-1水平均较治疗前改善,与对照组相比,治疗组临床疗效、急躁易怒、皮肤瘀斑或出血、刺痛拒按、疲乏无力、痛处固定不移或神昏、SOFA评分、APACHEⅡ评分、APTT、FBI、TT、PT、IL-10、TNF-α、EAM-1水平更优(P<0.05)。结论血府逐瘀汤加减可有效改善脓毒症患者凝血功能障碍,可降低炎性因子水平,缓解临床症状,疗效显著。

Objectite To investigate the ffct of Xuefu Zhuyu Decoction(血府逐瘀汤)on coagulation dysfunction in patients with sepsis.Methods Sixty-eight patients with sepsis according to random number table method were dirided into the control group(conventional western medicine therapy)and treatment group(on the basis of conventional western medicine treatment com-bined with Xuefu Zhuyu Decoction)34 cases in each group.Before and after treatment,TCM syndrome integral,Sequential Organ Failure Assessment(SOFA)score,acute physiology and chronic health evaluations II(APACHE II)score,blood coagulation function and inflammatory factor levels and clinical curative efct of two groups were compared.Results Before treatment,the.scroes of irit ability,skin ecchymosis or bleeding,pain rejection,fati gue,pain fixed or diziness,S0FA score,APACHE II score,the levels of activated partial thrombopl stin time(APTT),fibrinogen(FBI),thrombin time(TT),prothrombin time(PT),inter-leukin-10(IL-10),tumor necrosis factor-a(TNF-a)and endothelial specific molecule-1(EAM-1)in two groups were not significant(P>0.05).After treatment,the scores of iritability,skin ecchymosisσr bleeding,pain rejection,fatigue and weakness,pain fixed or dizziness,SOFA score,APACHE II score,the levels of APTT,FBI,TT,PT,IL-10,TNF-a and EAM-1 in two groups were improved compared with those before treatment.The treatment group had better clinical eficacy on the scores of iritabilityt,skin petechiae or bleeding,pain rejection,fatigue and weakness,fixed pain or diziness,SOFA score,A-PACHE II score,the levels of APTT,FBI,TT,PT,IL-10,TNF-a and EAM-1(P<0.05).Conclusion Xuefu Zhuyu Decoc-tion can flectively improve coagulation dysfunction in patients with sepsis,reduce the levels of inflammatory factors and relieve clinical symptoms.