早期应用大黄中药方治疗百草枯中毒临床研究

Clinical Study on Early Application of Radix et Rhizoma Rhei Prescription for Paraquat Poisoning

目的:探讨早期应用大黄中药方对百草枯中毒患者血清细胞因子及脏器损伤的影响。方法:选择90例百草枯中毒患者,按照就诊顺序分为对照组和观察组各45例。对照组采用常规遵医嘱治疗,观察组在对照组的基础上联合大黄中药方治疗。比较2组患者治疗12 h、24 h、3 d、7 d后血清细胞因子白细胞介素-10(IL-10)、肿瘤坏死因子-α(TNF-α)、转化生长因子-β1(TGF-β1)的水平,同时对其治疗后脏器损伤情况、临床疗效及病死率进行比较。结果:观察组治疗24 h、3 d、7 d后,血清细胞因子IL-10、TNF-α、TGF-β1水平优于对照组,差异有统计学意义(P<0.05)。观察组脏器损伤总发生率为33.33%(15/45),显著低于对照组的62.22%(28/45),差异有统计学意义(P<0.05)。观察组总有效率及病死率分别为86.67%(39/45)、13.33%(6/45),优于对照组的75.56%(34/45)、24.44%(11/45),差异有统计学意义(P<0.05)。结论:给予百草枯中毒患者常规遵医嘱治疗的基础上联合早期大黄中药方治疗,减少了脏器损伤的同时降低了患者的病死率,临床效果较好。

Objective:To observe the curative effect of Radix et Rhizoma Rhei prescription on cytokines in serum and organ injury in patients with paraquat poisoning.Methods:A total of 90 patients with paraquat poisoning were divided into the control group and the observation group,45 cases in each group.The control group was treated with routine treatment according to doctor's advice,and the observation group was additionally treated with Radix et Rhizoma Rhei prescription based on the treatment of the control group.The levels of cytokines including interleukin-10(IL-10),tumor necrosis factor-α(TNF-α),and transforming growth factor-β1(TGF-β1)in serum were compared between the two groups twelve hours,twenty four hours,three days,and seven days after treatment respectively.At the same time,the organ injury,clinical effect and case fatality rate were compared.Results:Twenty four hours,three days,and seven days after treatment,the levels of IL-10,TNF-αand TGF-β1 in the observation group were better than those in the control group,the difference being significant(P<0.05).The total incidence of organ injury in the observation group was 33.33%(15/45),which was significantly lower than that of 62.22%in the control group(28/45),the difference being significant(P<0.05).The total effective rate and case fatality rate in the observation group were 86.67%(39/45)and 13.33%(6/45)respectively,which were better than that of 75.56%(34/45)and 24.44%(11/45)in the control group respectively,the difference being significant(P<0.05).Conclusion:The additional early application of Radix et Rhizoma Rhei prescription based on routine treatment according to doctor's advice for patients with paraquat poisoning,can reduce the organ injury of patients and decrease the mortality at the same time.