脓毒症常见中医证型与患者炎症反应、器官功能及病情危重程度关系的研究

Study on the Relationship between TCM Syndromes of Sepsis and Inflammatory Reaction,Organ Function and Diseaseseverity

目的根据山东中医药大学附属医院脓毒症常见中医证型患者序贯器官衰竭(SOFA)评分、急性生理与慢性健康(APACHEⅡ)评分及西医理化指标,总结不同中医证型炎症反应、器官功能障碍及病情危重程度。方法 108例患者参照脓毒症西医诊断标准及中医辨证方法,明确其证侯分型并根据现代医学相关评分及理化指标,总结不同中医证型患者机体炎症反应程度、器官功能障碍及病情严重程度。结果脓毒症炎症反应程度以毒热内盛证组为重,器官功能障碍及病情以瘀毒损络气化不利证组及气阴耗竭组为重,且与其他各证型组比较差异明显(P<0.05)。结论脓毒症应重视早期治疗,祛邪而不忘扶正,如毒热内盛证应重视抗生素的恰当应用,辅以中医中药祛邪,虚证应主以扶正为主,助机体驱邪外出。

Objective： To summarize the inflammation status,organ dysfunction and diseasesewrity of different TCM syndromes of sepsis according to the SOFA score, APACHE Ⅱ score and laboratory indexes of patients with sepsis in the Affiliated Hospital of Shandong University of TCM. Methods： 108 cases of patients with sepsis were selected according to the diagnostic criteria of Western medicine and traditional Chinese medicine dialectical method, and the syndromes was cleared according to the modern medical score and physicochemical indexes ;the degree of inflammatory reaction,organ dysfunction and the severity of the disease in patients with different TCM syndromes were summarized. Results： The degree of inflammatory reaction of sepsis was mainly in the group of toxic heat and internal heat,and the organ dysfunction and the condition of blood stasis,poison and collateral gasification, the negative syndrome group and the gas Yin depletion group were more serious, and compared with the other syndrome types,the difference was obvious （P〈 0.05）. Conclusion： The treat of sepsis should attach importance to the early treatment ,and when eliminating evil ,don＇t forget to strengthen the body resistance. For example ,patients with heat toxin syndrome should pay attention to antibiotics application, and eliminate evil sup- plemented by TCM. And deficient syndrome should mainly rely on strengthening the body resistance to help out of evil.