四君子汤联合乌司他丁治疗烧伤患者的疗效及其安全性

The Clinical Efficacy and Safety of Sijunzi Decoction Combined with Ulinastatin

目的探讨四君子汤联合乌司他丁治疗烧伤患者临床疗效及对血小板5-羟色胺水平(5-hydroxytryptaphane,5-HT)、血小板计数和细胞因子的影响。方法以2014年3月-2016年3月期间,我院收治的127例因热蒸汽、热水、火焰等热力因素烧伤的患者为研究对象,用随机数字表法分为治疗组(64例)、对照组(63例)。对照组在西医常规疗法的基础上静脉滴注乌司他丁,治疗组在对照组的基础上予以四君子汤治疗,连续用药14d后对两组烧伤患者临床疗效、细胞因子、PLT计数与5-HT水平、不良反应进行比较。结果治疗组患者总有效率为90.63%,对照组为76.19%,差异有统计学意义(P<0.05);与治疗前比较,治疗后两组患者血清中IL-6与TNF-α明显降低,且治疗组明显低于对照组,IL-2与IL-10明显升高,且治疗组高于对照组,差异有统计学意义(P<0.05);经治疗,两组患者PLT计数与血小板5-HT明显升高,且治疗组显著高于对照组(P<0.05);两组不良反应比较,差异无统计学意义(P>0.05)。结论四君子汤联合乌司他丁治疗烧伤患者疗效显著,可以明显改善患者炎症反应,稳定微循环状态,无严重不良反应发生,值得在临床上推广。

Objective To study the clinical efficacy of Sijunzi decoction combined with ulinastatin and effect on platelet 5-hydroxytryptaphane, platelet counts and cytokines in treatment of burns.Methods The study selected 127 cases of burns patients treated in our hospital from March 2014 to March 2016, who were divided into two groups according to the method of random number table, with 64 cases in clinical group and 63 in control group.Patients in control group were treated with the routine therapy and intravenous drip of ulinastatin, while the clinical group was given extra Sijunzi decoction on the basis of control group.Then the treatment effect, the value of platelet 5-hydroxytryptaphane, platelet counts,cytokines and adverse reactions were compared after the 14 days treatment.Results Compared with 76.19% in the control group, the total effective rate of the clinical group was 90.63%.The difference was statistically significant（P〈0.05）.Compared with the pre-therapy, IL-6 and TNF-α of the two groups decreased while IL-2 and IL-10 increased after the treatment（P〈0.05）.Compared with the control group, the value of IL-6 and TNF-α in patients of the clinical group were lower after the treatment while IL-2 and IL-10 were higher（P〈0.05）.Compared with the pre-therapy,value of platelet 5-hydroxytryptaphane and platelet counts of the two groups increased after the treatment.And the treatment group was significantly higher than the control group（P〈0.05）.The difference of the two groups of adverse reactions was not statistically significant（P〉0.05）.Conclusion Sijunzi decoction has better effect on burns and can significantly improve inflammatory response, and make microcirculation stable.No serious adverse reactions occurred.It is worthy of clinical promotion.