清瘟败毒饮对脓毒症毒热证患者凝血功能和炎症指标的影响

Effects of Qingwen Baidu Decoction on coagulation function and inflammatory indexes in sepsis patients of toxic heat syndrome

目的观察清瘟败毒饮对脓毒症毒热证患者凝血功能和炎症指标的影响。方法将江苏省南通市中医院重症监护病房(ICU)70例脓毒症毒热证患者,按照随机数字表法分为2组。对照组35例予常规西医治疗,治疗组35例在对照组治疗基础上予清瘟败毒饮治疗。2组均治疗7 d。比较2组治疗前及治疗3、7 d血小板计数(PLT)、凝血酶原时间(PT)、纤维蛋白原(FIB)、活化部分凝血活酶时间(APTT)、D-二聚体(DD)、白细胞计数(WBC)、中性粒细胞百分比(N%)、降钙素原(PCT)、红细胞沉降率(ESR)、C反应蛋白(CRP)水平,比较2组治疗前后中医证候评分、急性生理学和慢性健康状况评分系统(APACHEⅡ)评分、脓毒症相关序贯器官衰竭(SOFA)评分变化。结果治疗3、7 d后,与本组治疗前比较,2组PLT、FIB均升高,治疗组CRP、PT、APTT、DD、WBC、N%、PCT、ESR均降低,对照组DD、WBC、N%、PCT、ESR均降低(P<0.05);治疗7 d后,2组PLT、FIB高于本组治疗前和治疗3 d后,PT、APTT、DD低于治疗前和治疗3 d后(P<0.05);治疗组治疗3、7 d后的凝血功能相关指标、炎症相关指标改善均优于对照组(P<0.05)。治疗后,2组中医证候各项评分、APACHEⅡ评分、SOFA评分均低于本组治疗前(P<0.05),治疗组治疗后上述各项评分均低于对照组(P<0.05)。结论清瘟败毒饮治疗脓毒症毒热证可改善凝血功能,抑制炎症指标的表达,减轻病情。

Objective To observe the effect of Qingwen Baidu Decoction on coagulation function and inflammatory indexes in sepsis patients of toxic heat syndrome.Methods A total of 70 sepsis patients of toxic heat syndrome received in the Intensive Care Unit(ICU),Nantong Hospital of Traditional Chinese Medicine were randomly divided into 2 groups,35 cases in each.The treatment group was additionally treated with Qingwen Baidu Decoction on the basis of Western medicine.Treated for 7 days,the key observation was Platelet count(PLT),prothrombin time(PT),fibrinogen(FIB),activated partial thromboplastin time(APTT),D-dimer(DD),white blood cell count(WBC),neutrophils Percentage(N%),procalcitonin(PCT),erythrocyte sedimentation rate(ESR),and C-reactive protein(CRP)levels,and the scores of TCM syndromes,acute physiology and chronic health status(APACHEⅡ),as well as sepsis-related sequential organ failure(SOFA)score on day 0 and on days 3 and 7.Results PLT and FIB on days 3 and 7 were increased in groups than those on day 0;CRP,PT,APTT,DD,WBC,N%,PCT,ESR in the treatment group were decreased,DD,WBC,ESR in the control group were decreased(P<0.05).PLT and FIB in groups on day 7 were higher than those on day 0 and day 3,while PT,APTT and DD in groups on day 7 were lower than those on day 0 and day 3(P<0.05).The improvement of coagulation function and inflammatory indexes on days 3 and 7 in the treatment group were better than those in the control group(P<0.05).After treatment,the scores of TCM syndromes,APACHEⅡand SOFA scores in groups were lower than before treatment(P<0.05),and the scores in the treatment group were lower than those in the control group(P<0.05).Conclusion For sepsis patients of toxic heat syndrome,Qingwen Baidu Decoction can improve coagulation function,inhibit the expression of inflammatory indexes and reduce the condition.