生脉注射液配合西药治疗脓毒性休克临床观察

Clinical Observation of Shengmai Injective Combined with Western Medicine on Septic Shock

目的：观察生脉注射液治疗脓毒性休克的临床疗效.方法：回顾性分析脓毒症休克病例56例,按照治疗情况分为对照组（28例）及治疗组（28例）.对照组单纯予常规西药治疗,治疗组常规西药治疗加用生脉注射液100～ 200 mL/日静脉滴注治疗.统计并分析两组病例治疗12小时前后的心率、平均动脉压、尿量、血氧饱和度、血乳酸清除率,观察10天休克纠正情况、液体复苏总量、血管活性药物总量、受损器官数目、维持血压稳定总时间及28天病死率和APACHEⅡ、SOFA评分情况.结果：在西药常规治疗基础上联合应用生脉注射液治疗脓毒性休克的纠正率为89.29％ （95％ CI=71.70％～ 97.70％）,对照组为71.43％（95％ CI =51.20％ ～86.80％）,两组比较,x2=3.694 1,P=0.056 5.治疗后（12 h）,治疗组的血压、心率、乳酸检测、血压稳定用时参数与对照组比较,差异有统计学意义（P＜0.01）.28天两组死亡率比较,治疗组病死率为42.86％ （95％ CI =24.53％ ～61.19％）,对照组为50.00％（95％CI =31.48％ ～68.52％）,两组比较,差异未达到显著性意义（P＞0.05）.结论：与对照组比较,治疗组纠正休克的收益为OR =0.3 （95％ CI =0.07 ～ 1.28）,NNT=3（95％ CI=2.00～11.79）;其降低死亡率的收益为OR =0.75（95％CI =0.04～2.15）,NNT=14（95％ CI =2.87 ～ 18.88）.

To observe the clinical efficacy of chinese medicine preparations shengmai injection in treatment for septic shock. Methods： For retrospective analysis of 56 cases with septic shock, the 56 cases divided into two groups according to treatment. The control group of 28 cases was therapied simple with conventional western medicine. On the basis of control group, the treatment group of 28 cases was therapied additionally with intravenous infusion of shengmai injection. Results： The rate of shock recovery in the treatment group was 71.43% （95% CI = 51.20% -97.70% ）, and that in the control group was 89.29% （95% CI = 71.70% -86. 80% ）. The difference has a statistically significant （X2 = 3. 694, P = 0. 056 5 ）. After 12h, the treatment group were better than the control group in improving of blood pressure, heart rate, oxygen saturation increasing, urine output recovery, decreasing of blood lactate levels. The mortality rate of 28 days in the treatment group was 42. 86% （95% CI = 24. 53% -61.19% ）, and that in the control group was 50. 00% （95% CI = 31.48% -68.52% ） ,the difference has not a statistically significant （ P 〉 0. 05 ）. Conclusion ： Compared the rate of shock recovery in the control group, OR =0. 3（95% CI =0. 07 - 1.28） ,NNT = 3 （95% CI = 2. 00 - 11.79） in the treatment group. Compared the mortality rate decreased in the control group, OR =0. 75（95% CI =0. 04 -2. 15） ,NNT =3（95% CI =2. 87 - 18.88）.