化瘀解毒汤对脓毒血症APACHEⅡ评分、ISTH DIC评分及外周血树突状细胞表面物质表达水平的影响

Study on Effect of Huayu Jiedu Decoction in Treatment of Patients with Sepsis on Scores of APACHE II, ISTH DIC and Expression of Dendritic Cells in Peripheral Blood

目的探讨化瘀解毒汤对脓毒血症患者APACHEⅡ评分、ISTH DIC评分及外周血树突状细胞表面物质表达水平的影响。方法将66例脓毒症患者随机分为对照组和化瘀解毒组,每组33例。对照组给予抗感染、补充血容量、积极治疗原发疾病、吸氧等综合治疗,化瘀解毒组在上述基础上加用化瘀解毒汤治疗,每日1剂,持续治疗2周。检测血清炎症因子[白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、降钙素原(PCT)]水平变化,应用急性生理与慢性健康状况评分Ⅱ(APACHEⅡ)、DIC评分评估脓毒症患者病情严重程度,应用流式细胞仪分析树突状细胞相关表面分子CD80、CD83、CD86表达情况,比较临床疗效。结果与治疗前比较,两组血清IL-6、TNF-α、PCT水平均降低(P<0.01),APACHEⅡ评分、ISTH DIC评分均降低(P<0.01),CD80、CD86水平均降低(P<0.01),CD83水平无差异(P>0.05);与对照组比较,化瘀解毒组血清IL-6、TNF-α、PCT水平均较低(P<0.01),APACHEⅡ评分、ISTH DIC评分均较低(P<0.01),CD80、CD86水平均较低(P<0.01),总有效率较高(P<0.01)。结论化瘀解毒汤辅助治疗脓毒血症疗效显著,可有效降低APACHEⅡ评分、ISTH DIC评分,可能与调节外周血树突状细胞表面物质表达有关。

Objective To investigate the effect of Huayu Jiedu Decoction in the treatment of patients with sepsis on scores of APACHE II, ISTH DIC and the expression of dendritic cells in peripheral blood.Methods Sixty-six patients with sepsis were randomly divided into control group and Huayu Jiedu Decoction group, 33 cases in each group. The control group was treated with anti-infection, blood volume supplementation, active treatment of primary diseases, oxygen inhalation and other comprehensive treatments. Huayu Jiedu Decoction group was additionally treated with Huayu Jiedu Decoction, one dose a day, and two groups were both treated for 2 weeks. Serum levels of inflammatory factors[interleukin-6(IL-6), tumor necrosis factor-alpha(TNF-alpha), procalcitonin(PCT)] were measured. The severity of sepsis was assessed by acute physiology and surface molecules CD80, CD83 and CD86 were analyzed by flow cytometry, and the clinical efficacy was compared. Results Compared with those before treatment, the levels of IL-6, TNF-α and PCT in serum of the two groups decreased(P<0.01), APACHE II score and ISTH DIC score decreased(P<0.01), the levels of CD80 and CD86 decreased(P<0.01), and the levels of CD83 had no difference P>0.05). Compared with those of the control group, the levels of IL-6, TNF-α and PCT in the Huayu Jiedu Decoction group were lower(P<0.01), APACHE II score and ISTH DIC score were lower(P<0.01). The levels of CD80 and CD86 were lower(P<0.01) and the total effective rate was higher(P<0.01). Conclusion Huayu Jiedu Decoction is effective in the treatment of sepsis. It can effectively reduce APACHE II score and ISTH DIC score, which may be related to regulating the expression of dendritic cell surface substances in peripheral blood.