生脉注射液和复方丹参注射液治疗急性脓毒性心肌病疗效观察

Curative effect of Shengmai injection(生脉注射液) and composite Danshen injection(复方丹参注射液) on acute septic cardiomyopathy

目的:探讨急性脓毒性心肌病(A SC)与炎症的关系,并观察生脉注射液和复方丹参注射液治疗A SC的短期临床疗效及其对炎症指标的影响。方法:将60例A SC患者随机均分为治疗组与对照组。两组均予西医常规处理;治疗组加用生脉注射液联合复方丹参注射液,均每日1次,共治疗14 d。观察治疗后心肌肌钙蛋白(cT n)、心电图和临床综合疗效、中医证候积分改善率以及炎症指标如C-反应蛋白(CRP)、降钙素原(PCT)及白细胞计数(W BC)水平的变化情况。结果:治疗组cT n、心电图疗效、临床综合疗效及中医证候积分的改善均优于对照组(P均<0.05);两组治疗后CRP、PCT、W BC均明显下降,且治疗组下降更为明显(P均<0.01)。结论:生脉注射液联合复方丹参注射液对A SC有比较肯定的治疗效果,并能降低A SC近期的病死率;推测其可能机制是通过抗凝血和抗血栓形成、抗炎,从而抑制患者体内炎症反应,下调各项炎症因子,以及改善心肌缺血缺氧、消除自由基、减少心律失常的发生等。

Objective： To study the curative effect of Shengmai injection （生脉注射液） and composite Danshen injection （复方丹参注射液） on acute septic cardiomyopathy （ASC）. Metbods： Sixty patients clinically. diagnosed as ASC were randomly divided into two groups ： treatment group and control group. All the patients received western routine treatment, and Shengmai injection and composite Danshen injection were added to the patients in the treatment group once per day for 14 days. Cardiac troponin （cTn）, electrocardiogram （ECG）, clinical synthetic curative effect and amelioration rate of traditional Chinese medicine syndrome scores as well as inflammatory indexes including C-reactive protein （CRP）, procalcitonin （PCT） and white blood cell count （WBC） were observed after treatment. Results： The levels of cTn, ECG, clinical synthetic curative effect and amelioration rate of traditional Chinese medicine syndrome scores were more improved in the treatment group than those of the control group （all P〈0.05）. The CRP, PCT and WBC were obviously more decreased in the treatment group than those in the control group （all P〈0.01）. Conclusion： Shengmai injection combined with composite Danshen injection has a relatively definite therapeutic effect in the treatment of ASC, and can reduce the fatality rate in the near future. The mechanisms are possibly via anti blood coagulation, anti-thrombosis and anti-inflammation in order to suppress the systemic inflammatory reaction, down-regulate inflammatory factors, improve myocardial blood and oxygen supply, eliminate free radicals and reduce the occurrence of arrhythmia.