加味凉膈散对早期脓毒症解毒抗炎 攻邪安正作用观察

Anti-inflammatory effects of modified Liangge San on earlier period of sepsis

目的:观察加味凉膈散在脓毒症早期阶段的抗炎解毒作用,以及对ICU住院时间、28天病死率的影响。方法:57例早期脓毒症患者随机分为A组(西医常规治疗,29例)与B组(加味凉膈散加西医常规治疗,28例),健康志愿者12例为对照组C组,比较3组外周血TNF-α、IL-6、CRP、PCT水平和两组患者之间住ICU时间、28天病死率的差异。结果:两组患者入院当天WBC、IL-6、TNF-α、CRP、PCT水平较健康对照组明显升高,治疗第7天B组IL-6、TNF-α、CRP较A组下降幅度大,有统计学意义,两组28天病死率无统计学差异,但B组住ICU时间较A组明显缩短。结论:西医联合应用加味凉膈散在早期脓毒症解毒抗炎、攻邪安正方面显示出良好的治疗前景。

Objective： To explore the anti-inflammatory effects of modified Lianggesan on earlier period of sepsis patients. Methods ：57 septic patients were included in this study and randomly divided into two groups： 29 cases received the western medine only（ group A） and 28 cases were treated by the western medicine combined with modified Lianggesan. 12 healthy volunteers were taken as the control group （ group C）. Then changes of tumor necrosis factor （ TNF - α）, interleukin - 6 （ IL - 6）, C - reactive protein, procalcitonin（PCT）, APACHE H score, ICU stay time and 28 -day mortality were monitored and compared. Results： Compared with group C, the cytokine of the septic patients was significantly higher. After seven days, the levels of IL -6,TNF - α and CRP of group B were lower than those of group A （ P 〈 0. 05 ）. Although the treatment combinded with modified Lianggesan couldn t decrease the 28 -day mortality of patients with sepsis, but showed superior to the group of western medicine in shortening the ICU stay time. Conclusion：Modified Lianggesan can alleviate septic inflammatory reaction especially at earlier period based on the western medine.