清热解毒组方治疗四肢开放性骨折患者术后全身炎症反应综合征的疗效观察

Clinical effects of qingre jiedu formula on post-operative SIRS in the patients with open fracture of four extremities

目的评估清热解毒组方对四肢开放性骨折术后全身炎症反应综合征(Systemic Inflam Matory Response Syndrome,SIRS)的疗效。方法选取符合纳入标准的四肢开放性骨折术后SIRS患者52例。随机分为治疗组和对照组,每组26例,对照组采用抗感染,保持呼吸道通畅,营养支持,补液和维持水、电解质酸碱平衡,重要器官保护等常规治疗;治疗组在对照组基础上加用清热解毒验方,水煎口服,连用2周,治疗过程中监测患者体温(Temperature,T)、心率(Heart rate,HR)、呼吸(Respiration rate RR)、血白细胞(whitebloodcell,WBC)、血超敏C反应蛋白(hypersensitive C-reactive Protein,hs-CRP)指标变化水平,并通过统计两组SIRS症状改善在治疗后3 d,4~5 d,6~7 d的病例数,比较两种治疗法对SIRS治疗后的症状改善时间。结果治疗后两组患者T、HR、RR、血WBC和hs-CRP指标下降,差异具有统计学意义(P<0.05);与对照组相比,治疗组T、HR、血WBC和hs-CRP指标下降更显著,差异均具有统计学意义(P<0.05),其中治疗组的SIRS的症状改善时间明显优于对照组,差异具有统计学意义(P<0.05)。结论在常规治疗基础上加用清热解毒组方可明显改善患者炎症反应指标和SIRS症状持续时间,有效减轻机体全身炎症反应症状。

Objective To evaluate the clinical effects of qingre jiedu formula on post-operative systemic inflammatory response syndrome(SIRS)in the patients with open fracture of four extremities.MethodsA total of 52 eligible patients with SIRS after operation for open fracture of four extremities were collected according to inclusion criteria.They were randomized into a treatment group and a control group,26 cases in each one.In the control group,the routine treatment was provided,such as anti-infection,maintaining airway ventilation,nutrition supports,fluid supplementation,maintaining balance of water,electrolyte,acid and base and protecting major organs.In the treatment,on the base of the treatment as the control group,qingre jiedu formula was added for oral administration.The treatment was given consecutively for 2 weeks.During treatment,body temperature(T),heart rate(HR),respiration rate(RR),white blood cell(WBC),hypersensitive C-reactive protein(hs-CRP)were monitored.Through analyzing statistically the case numbers of SIRS symptom improvements in 3 days,4 to 5 days and 6 to 7 days after treatment successively,the improvement time of symptoms was compared between the two groups.Results After treatment,the levels of T,HR,RR,WBC and hs-CRP were all reduced in the two groups,indicating the significant differences versus before treatment(P<0.05).Compared with the control group,the reduction of T,HR,WBC and hs-CRP were more significant in the treatment group,indicating the significant differences(P<0.05),in which,the improvement time for symptoms in the treatment group was better obviously than the control group,indicating the significant difference(P<0.05).Conclusion On the base of the routine treatment,qingre jiedu formula improves obviously in the inflammatory reactive indicators and symptom persistent time and effectively alleviates the symptoms of SIRS in the patients.