中药复方治疗脓毒症患者疗效观察及对部分细胞因子和免疫学因子的影响

Clinical Effect of Traditional Chinese Medicine on the Treatment of Sepsis Patients and Some Cytokines and Immune Factors

目的:观察中药复方清瘟败毒饮对脓毒症(气营两燔证)患者的临床疗效、血清促炎因子肿瘤坏死因子a(TNF-a)、白介素(IL-6、IL-1)和抗炎因子IL-10水平及IgG、IgA、IgM、C3、CRP水平(值)的变化的影响。方法:将38例脓毒症患者随机分为治疗组(西医常规治疗和清瘟败毒饮)18例和对照组(西医常规治疗)20例,疗程7 d,分别比较治疗前后上述血清相关因子水平的变化。结果:2组总疗效比较差异无统计学意义(P>0.05),但治疗组临床控制率优于对照组(P<0.05),治疗后2组患者的TNF-a、IL-1、IL-6和IL-10水平均较治疗前降低(P<0.05或P<0.01),治疗组优于对照组(P<0.05);治疗后2组患者治疗前后的IgG、IgA、IgM、C3、CRP水平(值)均较治疗前降低(P<0.05或P<0.01),但治疗组优于对照组(P<0.05)。结论:中药复方清瘟败毒饮能提高脓毒症的临床疗效,可抑制脓毒症患者过度炎症反应及免疫应答、减轻过度炎症反应及免疫应答对机体自身的损害。

Objective: To observe the clinical effect of Compound Qingwen Baidu Decoction on sepsis patients and the changes of serum proinflammatory cytokine tumor necrosis factor(TNF-a),interleukin(IL-6,IL-1) and anti-inflammatory factor IL-10 levels and IgG,IgA,IgM,C3,CRP levels(values)of the patients.Methods: 38 patients with sepsis were randomly divided into a treatment group(Qingwen Baidu Decoction),18 patients and a control group(conventional western treatment),20 patients.7 days was a course of treatment.The changes of the serum-related factors above were compared before and after the treatment.Results: Both the groups showed no significant difference statistically(P>0.05),but the clinical control rate of the treatment group was superior to that of the control group(P<0.05).TNF-a,IL-1,IL-6 and IL-10 levels of the patients in the two groups were lower(P<0.05,P<0.01) after the treatment.The treatment group was better than the control group(P<0.05).IgG,IgA,IgM,C3,CRP levels(values) of the patients in the two groups decreased(P<0.05,0.01) after the treatment,but the treatment group was better than the control group(P<0.05).Conclusion: Compound Qingwen Baidu Decoction can improve the clinical effect,inhibit the excessive inflammation and immune response and reduce the damages caused by the excessive inflammation and immune responses.