锦红汤保护脓毒症早期心肌损伤的临床研究

Clinical Study on Protective Effect of Jinhong Decoction on Early Myocardial Injury in Sepsis

目的观察锦红汤对脓毒症早期心肌损伤的保护作用。方法 60例患者分为对照组与治疗组各30例,对照组给予西医常规治疗抗感染、液体复苏、营养支持、对症支持治疗和重要脏器功能支持治疗等。治疗组在西医常规治疗基础上加用锦红汤治疗。疗程1周。检测两组疗前及治疗后血清心肌肌钙蛋白Ⅰ(c TnⅠ)、心肌肌酸激酶同工酶(CK-MB)、B型脑利钠肽(BNP)、血清降钙素原(PCT)、超敏C反应蛋白(hs-CRP)水平,以及APACHEⅡ评分、SOFA评分。结果两组治疗前APACHEⅡ、SOFA评分差异无统计学意义(均P>0.05)。治疗后两组APACHEⅡ、SOFA评分与治疗前比较值均有不同程度下降(均P<0.05),且治疗组APACHEⅡ、SOFA评分下降更明显(均P<0.05)。治疗前,两组外周血c Tn I、CK-MB、BNP水平比较,差异均无统计学意义(均P>0.05)。经过7 d治疗,治疗组c TnⅠ、BNP水平与治疗前比较均降低(均P<0.05);但对照组c TnⅠ和BNP值与治疗前比较,差异无统计学意义(均P>0.05);治疗后治疗组c Tn I、BNP水平优于对照组(均P<0.05)。两组治疗后CK-MB水平相较治疗前差别不大(均P>0.05)。治疗前,两组外周血PCT、hsCRP水平比较,差异不明显(均P>0.05)。两组PCT、hs-CRP与治疗前比较均降低(均P<0.05),且治疗后治疗组PCT、hs-CRP水平低于对照组(均P<0.05)。结论锦红汤在西药常规治疗的基础上可以有效保护脓毒症早期出现的心肌损伤,改善患者的心脏功能。

Objective： To investigate the protective effect of Jinhong Decoction on patients with early myocardial injury in sepsis. Methods： 60 patients with sepsis were randomly divided into the treatment group （n = 30） and the control group n = 30）. Both groups were treated with conventional therapy including anti-inflammation treat- ment, transfusion for resuscitation, nutritional support, symptomatic and supportive treatment and supportive treat- ment for keeping vital organ function. The treatment group was given Jinhong Decoction based on the conventional therapy with the course of 7 days, taking orally or nasal feeding twice a day. Before and after treatment, the pe- ripheral blood concentrations of cTnI,CK-MB,BNP,PCT,hs-CRP,APACHE II and SOFA were detected. Re- suits： Compared with before treatment, the treatment group decreased the levels of cTn I and BNP, and the dif- ference was statistically significant （P〈 0.05 ）. However,cTn I and BNP values of the control group were not sig- nificantly different from those before treatment （P〉 0.05）. After treatment, the treatment group was superior to the control group in reducing the level of cTn I and BNP, and the difference between the two groups was statistically significant （P〈 0.05 ）. The CK and-MB levels were slightly decreased in the two groups after treatment,compared with those before treatment,but the difference was not statistically significant （P〉 0.05）. Compared with before treatment,the two groups could reduce the PCT and hs-CRP values,with statistical significance （P〈 0.05）. But after treatment,the treatment group was better than the control group in reducing the level of PCT and hs-CRP, and the difference between the two groups was statistically significant （P〈0.05）. There was no significant differ- ence in APACHE II and SOFA scores between the two groups before treatment （P〉 0.05）. After treatment,A- PACHE II ,SOFA score values of the two groups decreased in varying degrees,but the treatment group decreasedmore significantly, and the difference between the two groups was statistically significant （P〈 0.05 ）. Conclusion： Jinhong Decoction based on the conventional medical treatment can effectively protect against the myocardial damage in the early stage of sepsis, and improve the patient＇s cardiac function.