生脉注射液联合乌司他丁治疗感染性休克的临床研究

Clinical study on Shengmai Injection combined with ulinastatin in treatment of septic shock

目的探讨生脉注射液联合乌司他丁治疗感染性休克的临床疗效。方法对2013年3月—2016年3月在屯昌县人民医院接受治疗的感染性休克患者80例,随机分为对照组(40例)和治疗组(40例)。对照组患者静脉滴注注射用乌司他丁,20万U加入生理盐水200 m L,2次/d。治疗组在对照组的基础上静脉滴注生脉注射液,60 m L加入生理盐水250 m L,1次/d。两组患者均连续治疗7 d。比较两组患者治疗前后临床效果、血清细胞因子水平和免疫功能变化。结果治疗后,对照组和治疗组总有效率分别为80.00%和95.00%,两组总有效率比较差异有统计学意义(P<0.05)。治疗后,两组患者血清白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、血小板(PCT)、内皮素-1(ET-1)及NO水平都显著降低,IL-10则升高,同组治疗前后比较差异具有统计学意义(P<0.05);且治疗组上述指标水平优于对照组,两组比较差异具有统计学意义(P<0.05)。治疗后,两组患者CD^(3+)和CD^(4+)水平及CD^(4+)/CD^(8+)都显著升高,同组治疗前后比较差异具有统计学意义(P<0.05);且治疗组患者免疫功能显著优于对照组,两组比较差异具有统计学意义(P<0.05)。结论生脉注射液联合乌司他丁治疗感染性休克疗效显著,可增强机体免疫功能及减轻炎症反应,具有一定的临床推广应用价值。

Objective To study Shengmai Injection combined with ulinastatin in treatment of septic shock. Methods Patients（80 cases） with septic shock in Tunchang County People＇s Hospital from March 2013 to March 2016 were randomly divided into control（40 cases） and treatment（40 cases） groups. Patients in the control group were iv administered with Ulinastatin for injection, 0.2 million U added into normal saline 200 m L, twice daily. Patients in the treatment group were iv administered with Shengmai Injection on the basis of the control group, 60 m L added into normal saline 250 m L, once daily. Patients in two groups were treated for 7 d. After treatment, the clinical efficacy, serum inflammatory factors level, and immune function in two groups before and after treatment were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 80.00% and 95.00%, respectively, and there was difference between two groups（P〈 0.05）. After treatment, IL-6, TNF-α, PCT, ET-1, and NO levels in two groups were significantly decreased, IL-10 was obviously increased, and the difference was statistically significant in the same group（P〈 0.05）. And these indicators in the treatment group were significantly better than those in the control group, with significant difference between two groups（P〈 0.05）. After treatment, CD^3＋,CD^4＋CD^4＋/CD^8＋and in two groups were significantly increased, and there was difference in the groups（P〈 0.05）. And immune function of patients in the treatment group was significantly better than that in the control group, with significant difference between two groups（P〈 0.05）. Conclusion Shengmai Injection combined with ulinastatin has a significant effect in treatment of septic shock, can enhance immune function and reduce inflammation, which has a certain clinical application value.