穿心莲内酯总酯磺化物治疗脓毒症临床研究

Clinical study of andrographolide total ester sulfonate on sepsis

目的探讨穿心莲内酯总酯磺化物治疗脓毒症的临床疗效。方法将80例脓毒症患者随机分为治疗组和对照组,每组40例。对照组给予西医常规治疗,治疗组在常规治疗基础上加用穿心莲内酯总酯磺化物,2组疗程均为7 d。分别测定治疗前、治疗后第3天和第7天血清中炎性因子IL-6、CRP、hs-CRP、PCT的浓度,观察2组治疗前后生命体征指标及白细胞计数、中性粒细胞比例、APACHEⅡ评分、死亡风险系数变化,比较2组病原学转阴率及治疗效果。结果 2组治疗后各时间段白细胞数、中性粒细胞比例比较、炎性因子浓度等均明显降低(P均<0.05),且治疗组降低程度优于对照组(P均<0.05),2组治疗后3 d各生命体征指标均明显好转(P均<0.05),且治疗组改善情况优于对照组(P均<0.05);2组治疗后第7天比较差异无统计学意义(P>0.05)。治疗后第3天、第7天,治疗组APACHE评分、死亡风险系数、病死率、无效率等均低于对照组(P均<0.05),病原学转阴率、有效率高于对照组(P均<0.05)。结论穿心莲内酯总酯磺化物可降低脓毒症患者血清中炎性因子浓度、死亡风险及病死率,提高有效率,治疗脓毒症效果显著。

Objective It is to study the clinical sepsis effect of andrographolide total ester sulfonate on sepsis.Methods 80 patients with sepsis patients were randomly divided into treatment group and control group,each group of 40 people.The control group was given routine treatment of western medicine,the treatment group was given andrographolide total ester sulfonate on the basis of normal routine therapy,both the treatment courses were 7 days.The concentrations of serum inflammatory factor IL-6,CRP,hs-CRP PCT were determined before treatment,in 3 days and 7 days after treatment.The changes of body signs,WBC number,neutrophil ratio,APACHE Ⅱ scores,death risk coefficient were observed,and negative transformation rate of etiology and the curative effect were compared.Results The number of white blood cells,neutrophil ratio and inflammatory factor concentration all decreased obviously in both groups at every time point after treatment （P 〈 0.05）,but the decrease were more significant in treatment group than that in control group （P 〈 0.05）.After 3 days＇ treatment,every body sign index was obviously improved in both group （P 〈 0.05）,but the improvements in treatment group were more significant than that in control group （P 〈 0.05）,the differences were not significant after 7 days＇ treatment （P 〉 0.05）.After 3 days＇ and 7 days＇ treatment,APACHE scores,death risk coefficient,non-effective rate and death rate in treatment group were all lower,while negative transformation rate and effective rate were higher than that in the control group （P 〈 0.05）.Conclusion Andrographolide total ester sulfonate can reduce inflammatory factor concentration in serum of patients with sepsis,decrease the death risk and rate,increase effective rate,thus has a significant effect on sepsis.