救逆通瘀汤在心肺复苏自主循环恢复患者中的应用研究

Application study of Jiuultongyu decoction in the patients with restoration of spontaneous circulation after cardiopulmonary resuscitation

目的 观察＂救逆通瘀汤＂对心肺复苏自主循环恢复患者的治疗效果.方法 94例患者分为标准治疗组和中药干预组（各47例）,分别采取常规治疗方法和常规治疗方法加＂救逆通瘀汤＂中药治疗,比较两组患者自主循环恢复后24 h、72 h、7 d、1个月和6个月存活率,72 h、7 d急性生理和慢性健康状况评分Ⅱ（APACHEⅡ）,1个月和6个月格拉斯哥预后评分（GOS）.结果 ①存活率：标准治疗组和中药干预组自主循环恢复后24 h（63.8% vs. 65.9%）、72 h（44.6% vs. 51.0%）、7 d（36.1% vs. 46.8%）、1个月（23.4% vs. 40.4%）比较差异无统计学意义（P均＞0.05）;6个月比较差异有统计学意义（21.2% vs. 40.4%,P＜0.05）.②APACHEⅡ评分：72 h比较差异无统计学意义[（24.3±7.9）分 vs.（22.1±6.8）分,P＞0.05],7 d比较差异有统计学意义[（21.6±4.8）分vs.（17.1±6.5）分,P＜0.05].③GOS评分：1个月[（3.1±1.1）分vs.（3.7±1.2）分]和6个月[（3.2±1.4）分vs.（4.2±1.5）分]比较差异有统计学意义（P均＜0.05）.结论 ＂救逆通瘀汤＂有促进心肺复苏自主循环恢复患者脑功能恢复的作用,可提高患者远期存活率和生存质量.

Objective To observe the curative effect of Jiunitongyu decoction in the patients with restoration of spontaneous circulation （ROSC） after cardiopulmonary resuscitation （CPR）. Methods 94 of patients with ROSC after CPR were divided into two groups （standard treatment group and Chinese medicine group）. Patients （ 47 of 94 ） in standard treatment group were treated with routine methods; patients （ 47 of 94） in Chinese medicine group were treated with Jiunitongyu decoction besides routine methods. Survivor rate of patients on 24 hour, 72 hour, 7 day, 1 month and 6 month; Acute Physiology and Chronic Health Evaluation Ⅱ （ APACHE Ⅱ ） score on 72 hour and 7 day; Glasgow Outcome Scale （ GOS ）on 1 month and 6 month were compared between standard treatment group and Chinese medicine group respectively. Results （i）There were no significant differences in survivor rate of the patients on 24 hour （63.8% vs. 65.9% ）, 72 hour （44. 6% vs. 51.0% ）, 7 day （36. 1% vs. 46. 8% ）, 1 month （23.4% vs. 40. 4% ） between standard treatment group and Chinese medicine group （ all P 〉0. 05 ）. On the contrary, there was significant difference on 6 month （21.2% vs. 40.4% ,P 〈 0. 05）. （2）There was no significant difference in APACHEⅡ score on 72 hour [ （24. 3 ± 7.9 ）vs. （22.1±6.8）,P〉0.05], but the reverse on7 day [（21.6±4.8）vs. （17.1 ±6.5）, P〈0.05]. （3）There was significantly difference in GOS score on 1 month [ （3. 1 ± 1.1 ） vs. （3.7 ± 1.2）, P 〈0. 05 ] and on 6 month [ （3.2 ± 1.4） vs. （4. 2 ± 1.5 ）, P 〈 0. 05 ]. Conclusion Jiunitongyu decoction can promote the restoration of cerebral function in the patients with ROSC after CPR, and improve long - term survivor rate and quality of life.