益气解毒法治疗脓毒症早期的疗效观察

Clinical Observation on the Effect of Replenishing Qi and Detoxicating Method on the Treatment of Early Sepsis

目的观察益气解毒法治疗对脓毒症早期患者的临床疗效。方法采用随机、平行对照的方法将97例脓毒症患者分为治疗组49例和对照组48例。治疗组在西医常规治疗基础上给予黄芪注射液静脉滴注,每次30m L,并联用中药复方清瘟败毒饮,观察疗程7d。分别比较2组治疗前后APACHEⅡ评分,MODS评分,SOFA评分,外周血象,血清CRP、TNF-a、IL-6水平(值)变化和临床疗效积分。结果 2组治疗后APACHEⅡ评分均有下降,但治疗组下降更明显(P<0.01);治疗组7d后总有效率93.88%,对照组为87.50%,经统计学分析有显著性差异(P<0.05);2组患者与治疗前比较,WBC、N、CRP、TNF-a、IL-6水平(值)均有明显下降(P<0.05,P<0.01),治疗7d后治疗组WBC、N、CRP水平(值)较对照组下降明显,但无统计学差异(P>0.05),TNF-a、IL-6水平(值)较对照组改善更明显(P<0.01)。结论脓毒症早期运用益气解毒法能够有效抑制机体过度炎症反应和过度免疫应答机制,提高脓毒症的临床疗效。

Objecti ve： To observe the clinical effect of Replenishing Qi and Detoxicating Method on early sepsis. Methods： 97 pa-tients were divided into a treatment group （49 c a se s） and a control group （48 c a se s） by randomized and parallel control. The treatmentgroup was given intravenous infusion of Astragalus injection on the basis of routine treatment of western medicine, each 30mL,combined with TCM compound Qingwen Baidu Drinking. 7 - day was a course of treatment. The value changes of APACHE ＋ score, MODS score, SOFA score, peripheral blood, serumCRP, TNF - a, IL - 6 level and clinical effect scores of the two groups were compared before and af-ter treatment. Results： After the treatment, APACHE ＋ score of the two groups decreased after the treatment, but the treatment group de-creased more significantly （ D 〈 0. 01 ）. The total effective rate of the treatment group after the 7 - day treatment was 93. 88% and the rate of the control group was 87. 50L. The statistical analysis was very significant diference （ D 〈 0 . 0 1 ）. Compared with the prior treatment, the levels of WBC, N, CRP, TNF - a and IL - 6 of the two groups were significantly lower （ D 〈 0 . 05 ）（ D 〈 0 . 0 1 ）. Compare with that of the control group, the level of NBC, N and CRP of the treatment group was significantly lower after the 7 - day treatment, but there was no statistical difference （ D 〈 0. 05 ）, and the level of TNF - a and IL - 6 significantly improved （ D 〈 0. 0 1 ）. Conclusion： The use of Replen-ishing Qi and Detoxicating method in early sepsis can effectively inhibit the mechanism of excessive inflammation and excessive immune re-sponse and improve the clinical curative effect of sepsis.