参附注射剂联合多巴胺治疗感染性休克患者的疗效及相关机制

Effect of Shenfu injection combined with dopamine in treatment of septic shock and its related mechanism

目的观察参附注射剂联合多巴胺治疗感染性休克患者的临床疗效,及对细胞免疫功能、心肌酶和细胞因子的影响。方法选择2015年3月至2017年3月ICU收治的感染性休克患者82例,按照随机数字表法分为对照组与观察组,各41例。对照组给予多巴胺2μg·kg^(-1)·min^(-1),iv gtt;观察组在对照组基础上静脉注射参附注射剂。疗程均为7d。结果观察组总有效率高于对照组(85.37%vs 60.98%,P<0.05)。2组治疗后心率、呼吸频率、APACHEⅡ评分及WBC均较治疗前降低(P<0.05),且观察组低于对照组(P<0.05)。2组治疗后CD3^+、CD4^+及CD4^+/CD8^+较治疗前升高(P<0.05),且观察组高于对照组(P<0.05)。2组治疗后CK-MB和cTnI较治疗前降低(P<0.05),且观察组低于对照组(P<0.05)。2组治疗后CRP较治疗前降低而IL-10较治疗前升高(P<0.05),且观察组CRP低于对照组而IL-10高于对照组(P<0.05)。结论参附注射剂联合多巴胺治疗感染性休克患者疗效显著,且可改善细胞免疫功能、心肌酶和细胞因子水平。

AIM To investigate the effect of Shenfu injection combined with dopamine in treatment of septic shock and its effects on cellular immune function, myocardial enzymes and cytokines. METHODS A total of 82 patients with septic shock in ICU admitted from March 2015 to March 2017 in the hospital were divided into the control group and observation group （41 cases in each group）. The control group was given dopamine 2 μg·kg^-1·min^-1, iv gtt. The observation group was injected with intravenous injection of Shenfu injection on the basis of the control group. The 2 groups were treated with 7 days. RESULTS The total effective rate of the observation group （85.37 % ） was higher than that of the control group, （60.98%） （ P 〈 0.05 ）. After treatment, the heart rate, respiratory rate, APACHE II scores and WBC decreased in 2 groups （ P 〈 0.05 ）. After treatment, the heart rate, respiratory rate, APACHE I1 scores and WBC of the the observation group were lower than those of the control group （P〈0.05）. After treatment, the CD3^＋, CD4^＋ and CD4^＋/CD8^＋ increased in 2 groups（P 〈0.05）. After treatment, the CD3^＋, CD4^＋ and CD4^＋/CD8^＋ of the observation group was higher than those of the control group （P 〈 0.05 ）. After treatment, the CK-MB and cTn I decreased in 2 groups （P 〈 0.05 ）. After treatment, the CK-MB and cTn I of the observation group were lower than those of the control group （ P 〈 0.05 ）. After treatment, the CRP decreased and IL-10 increased in 2 groups （ P 〈 0.05 ）. After treatment, the observation group CRP was lower than the control group and IL-IO higher than the control group （ P 〈 0. 05 ）. CONCLUSION Shenfu injection combined with dopamine is effective in the treatment of septic shock, and can improve the cellular immune function, myocardial enzymes and cytokine levels, and is worthy of clinical application.