参附注射液对感染性休克患者氧代谢促进作用

Effect of Shenfu Injection on Oxygen Metabolism in Patients with Infection Shock

目的：观察中药参附注射液对感染性休克（阳气暴脱证）患者氧代谢的作用。方法：将符合标准的78例患者按随机数字表法分为观察组（38例）和对照组（40例）。两组患者均予常规西医治疗,包括早期及时快速的容量复苏、积极处理原发病、使用敏感抗生素抗感染、多巴胺稳定血压及对症支持治疗等措施。观察组加用参附注射液静脉滴注。观察记录患者治疗前后氧摄取率、动脉血乳酸水平、APACHEⅡ评分和Marshall评分变化情况,以及不良反应发生情况和28 d死亡率。结果：两组患者治疗后第1 d氧摄取率组间比较,差异无统计学意义（P〉0.05）;第2~7 d氧摄取率组间比较,差异均有统计学意义（P〈0.05）。2组患者治疗后动脉血乳酸水平均降低,以第1 d下降最为明显;第1~7 d动脉血乳酸水平组间比较,差异均有统计学意义（P〈0.05）。两组患者治疗后APACHEⅡ评分和Marshall评分均下降;第3 d组间比较,差异均无统计学意义（P〉0.05）;第7 d组间比较,差异均有统计学意义（P〈0.05）。治疗28 d内观察组和对照组死亡率分别为31.58%、37.50%,差异无统计学意义（P〉0.05）。两组患者治疗期间均未见明显不良反应。结论：在常规西医治疗的基础上加用中药参附注射液,可提高＂高排低阻型＂感染性休克（阳气暴脱证）患者的氧摄取率,降低动脉血乳酸水平,降低APACHEⅡ评分和Marshall评分。

Objective： To observe the effect of Shenfu Injection on oxygen metabolism in patients with infection shock （Yang Qi sudden exhaustion）. Methods： 78 patients met the criteria were randomly divided into observation group （38 cases ） and control group （40 cases）. 2 groups were treated with conventional western medicine treatment, including early volume resuscitation, timely and active treatment of the primary disease, the use of antibiotics, dopamine stable blood pressure and treatment measures. The observation group added Shenfu Injection by intravenous dripping. We observed and recorded the oxygen uptake rate,arterial blood lactic acid level of patients before and after treatment and the APACHE Ⅱ score and Marshall score changes, and the occurrence of adverse reactions and the mortality of 28d. Results： The 2 groups patients oxygen uptake rate were compared between the groups 1 d after treatment and there was no significant difference （ P 〉 0.05 ）. Compared with the 2 - 7 d oxygen uptake rate, the differences were statistically significant （ P 〈 0.05 ）. Arterial blood lactate levels after treatment in 2 groups were decreased, the 1 d decreased significantly. Compared the 1 - 7 d arterial blood lactate, the differences were statistically significant （ P 〈 0.05 ）. After treatment, APACHE I1 score and Marshall score were decreased in two groups. Compared between groups on 3d, the differences were not statistically significant （P 〉0.05）. Compared between groups on 7d,the differences were statistically significant （P 〈 0.05 ）. 28d after treatment, the observation group and the control group＇s mortality rates were 31.58% ,37.50% with no significant difference （ P 〉 0.05 ）. During the treatment, the 2 groups had no obvious adverse reactions. Conclusion ： On the basis of routine treatment of Western medicine, Shenfu Injection can improve the oxygen uptake rate of patients with high output and low resistance shock （ Yang Qi sudden exhaustion）, reduce the level of blood lactic acid, and reduce the APACHE Ⅱ score and Marshall score. Key words： Shenfu Injection; infection shock; oxygen metabolism; combined treatment of traditional Chinese and Western medicine