不同中医证型脓毒性休克患者的微循环变化

Microcirculaton Changes of Different TCM Syndrome Types In Patients with Septic Shock

目的探讨脓毒性休克患者不同中医证型的微循环指标变化。方法 2010年2月～2011年9月收住笔者医院重症医学科脓毒性休克患者61例,分为热伤气阴证(20例)、阴竭阳脱证(20例)、热盛腑实证(10例)、热伤营血证(11例),应用SDF技术检测舌下微循环指标。结果各证型组微循环灌注血管密度(PVD)测定值,热伤气阴证9.95±2.12mm/mm2,阴竭阳脱证7.24±3.11mm/mm2,热盛腑实证7.41±2.39mm/mm2,热伤营血证6.83±3.98mm/mm2,与热伤气阴证相比,其他证型组PVD下降有统计学意义(P<0.05)。结论不同中医证型脓毒性休克患者微循环改变各异,灌注血管密度可以作为热伤气阴证及阴竭阳脱证辩证分型的辅助指标。

Objective To investigate sublingual microcirculation changes of different TCM syndrome types in patients with septic shock. Methods Totally 61 patients with septic shock were collected form Critical Care Medicine of Bei Jing Friendship Hospital from 2010 Feb to 2011 Sep and were divided into the following groups： heat impairing Qi -Yin syndrome （n = 20） , exhausted Yin and Yang syndrome （n = 20） , excessive heat and obstructed FU -organ syndrome （n = 10） and heat impairing blood （n = 11 ）. Sublingual micro- circulation image was collected by using of sidestream dark - field （SDF） imaging equipment. Results The perfused vessel density （PVD） of different TCM syndrome types were 9.95 ± 2.12mm/mm2 in heat impairing Qi - Yin syndrome, 7.24 ± 3.11 mm/mm2 in ex- hausted Yin and Yang syndrome, 7.41 ±2.39mm/mm2 in excessive heat and obstructed FU -organ syndrome, 6.83 ±3.98mm/mm2 in heat impairing blood. Compared with heat impairing Qi - Yin syndrome, PVD of other groups decreased significantly （ P 〈 0.05 ）. Con- clusion Microcirculation changes of septic shock patients with different TCM syndrome types is different. PVD is helpful in syndrome dif- ferentiation of heat impairing Qi - Yin syndrom and exhausted Yin and Yang syndrome.