化瘀方对脓毒症休克患者心肌损伤影响的临床观察

Effects of “Huayu Decoction”on myocardial injury in patients with septic shock

目的观察化瘀方联合西医常规疗法治疗脓毒症休克的临床疗效。方法将60例脓毒症休克患者随机分为治疗组与对照组,每组30例。对照组予西医常规疗法,治疗组在常规治疗基础上加用化瘀方治疗。两组疗程均为7天,观察临床疗效,比较血浆心肌损伤相关指标(LDH、CK-MB、c TNI)水平的变化情况。结果 1治疗组、对照组临床改善率分别为70.00%和40.00%;组间临床疗效比较差异有统计学意义,治疗组优于对照组(P<0.05)。2治疗前与治疗24 h后组内比较,两组LDH、CK-MB水平差异均无统计学意义(P>0.05),两组c TNI水平差异有统计学意义(P<0.05);组间治疗24 h后比较,LDH、CK-MB水平差异无统计学意义(P>0.05),c TNI水平差异有统计学意义(P<0.05)。治疗前与治疗7天后比较,治疗组LDH、CK-MB水平差异有统计学意义(P<0.05),对照组LDH、c TNI水平差异有统计学意义(P<0.05);组间治疗7天后比较,LDH、CK-MB、c TNI水平差异有统计学意义(P<0.05)。结论化瘀方联合西医常规疗法治疗脓毒症休克,可在一定程度上降低患者心肌受损程度、改善心功能,对心脏起到保护作用。

Objective To observe the clinical efficacy of ＂Huayu Decoction＂and western medicine in the treatment of myocardial injury in patients with septic shock. Methods Sixty subjects were randomized into two groups,30 cases in each group; the control group was treated just with conventional western medicine,and the treatment group was treated with＂Huayu Decoction ＂and conventional western medicine. After 7-day treatment,the clinical efficacy and the levels of serum myocardial injury indexes（ LDH and CK- MB,c TNI） were observed. Results 1The effective rate was 70. 00% in the treatment group and 40. 00% in the control group,with better efficacy in the treatment group than in the control group（ P 〈 0. 05）. 2Between before and 24 hours after treatment,there were no differences in the LDH and CK-MB levels in the two groups（ P 〉 0. 05）,but there was a difference in c TNI level in the two groups（ P 〈 0. 05）. Twenty-four hours after treatment,there was no statistical significance in the levels of LDH and CK-MB between the two groups（ P 〉 0. 05）,and significant difference in c TNI level between the two groups（ P 〈 0. 05）. Between before and 7 days after treatment,there were significant differences in the LDH and CK-MB levels in the treatment group（ P 〈 0. 05）,and there were striking differences in the LDH and c TNI levels in the control group（ P 〈 0. 05）. Seven days after treatment,there were statistical significances in the levels of LDH,CK-MB and c TNI between the two groups（ P 〈 0. 05）. Conclusion ＂Huayu Decoction＂with western medicine is effective to reduce myocardial injury and improve heart function in the treatment of myocardial injury in patients with septic shock.