芪参活血颗粒治疗脓毒症心肌损伤的随机对照临床研究

Clinical study of Qishen Huoxue Granules for the treatment of myocardial injury in patients with sepsis

目的观察芪参活血颗粒治疗脓毒症心肌损伤的疗效。方法纳入脓毒症合并心肌损伤患者70例,随机分为芪参活血颗粒组(QHG组)36例和常规治疗组(对照组)34例,对照组给予常规治疗,QHG组在常规治疗基础上给予芪参活血颗粒。比较2组患者治疗前后心肌损伤、心功能及临床预后等指标的变化。结果所有纳入患者治疗后心肌损伤血清生物标志物水平均有所下降,QHG组患者治疗3天时N端前脑钠肽(NT-proBNP)、心肌肌钙蛋白T(cTnT)较对照组明显降低(P<0.05),治疗7天时cTnI较对照组降低显著(P<0.01);QHG组患者治疗后左心射血分数(LVEF)、E/A比值较对照组升高(P<0.05),2组患者治疗后E/e'比值无明显差异(P>0.05)。2组患者机械通气时间、应用血管活性药物时间、住ICU时间、28天死亡率均无明显差异(P>0.05)。结论芪参活血颗粒可改善脓毒症患者心肌损伤,对机械通气、血管活性药物应用时间及预后无影响。

Objective To observe the therapeutic effects of Qishen Huoxue Granules（QHG） on myocardial injury in patients with sepsis.Methods 70 patients with sepsis in combination with myocardial injury were included and randomly divided into routine treatment group（34 cases） and QHG group（36 cases）.The control group was given the routine treatment and QHG group was given Qishen Huoxue Granules based on routine treatment.The myocardial injury,cardiac function and clinical prognosis were compared between two groups before and after the treatment.Results All enrolled patients＇ serum biomarkers were lowered,NT-proBNP and cTnI level were more obviously lowered in day 3 treatment in QHG group than that of the control group（P〈0.05）,cTnI level were more obviously lowered than that of the control group in day 7（P〈0.01）.QHG group patients＇ LVEF,E/A ratio were increased compared with that of the control group（P〈0.05）,E/e＇ratio in both two groups had no significant difference after treatment（P〉0.05）.There were no significant differences in use of ventilation time,vasoactive drugs time,days in ICU and 28-day mortality between the two groups（P〉0.05）.Conclusion Qishen Huoxue Granules can improve myocardial injury in patients with sepsis,but it had no effect on the use of ventilation time,vasoactive drugs time and prognosis of patients.