活血解毒汤辅治脓毒症心力衰竭的临床效果及对患者血清前列腺素-2和缺氧诱导因子-1α水平的影响

Efficacy of Huoxue Jiedu Decoction in the adjuvant treatment of septic heart failure and its effect on serum prostaglandin E2 and hypoxia-inducible factor-1αlevels in patients

目的研究活血解毒汤在脓毒症心力衰竭中的临床应用效果及对患者血清前列腺素-2(PGE2)以及缺氧诱导因子-α(HIF-α)水平的影响。方法前瞻性将西安市中医医院2018年1月至2021年1月间收治的126例脓毒症心力衰竭患者采用随机数表法分为A组与B组,每组63例,其中B组患者接受常规治疗,A组患者在常规治疗基础上联合服用活血解毒汤,连续治疗1周。比较两组患者治疗前后的心功能指标[每分钟搏出量(SV)、心脏指数(CI)、心输出量(CO)、左心室射血分数(LVEF)]、血浆B型尿钠肽(BNP)、降钙素原(PCT)、血清PGE2、HIF-α、高敏C反应蛋白(hs-CRP)以及序贯器官衰竭评分(SOFA);治疗1周后,比较两组患者的临床治疗疗效及证候疗效。结果治疗后,两组患者的心功能相关指标SV、CI、CO、及LVEF水平均较同组治疗前上升,血浆BNP、PCT、血清hs-CRP、PGE2、HIF-α以及SOFA评分均较同组治疗前下降,差异均具有统计学意义(P<0.05),且A组患者治疗后的SV、CI、CO、LVEF水平明显高于B组,血浆BNP、PCT、血清hs-CRP、PGE2、HIF-α及SOFA评分明显低于B组,差异均具有统计学意义(P<0.05);治疗后,A组患者的临床有效率及证候有效率分别为88.89%、95.24%,明显高于B组的66.67%和79.37%,差异均具有统计学意义(P<0.05)。结论在常规治疗的基础上联合应用活血解毒汤能有效改善脓毒症心力衰竭患者的心功能及相关临床症状,提高疾病的治疗效果。

Objective To analyze the effect of Huoxue Jiedu Decoction in the adjuvant treatment of septic heart failure,and to investigate its effect on serum prostaglandin E2(PGE2)and hypoxia-inducible factor-1α(HIF-α)levels in patients.Methods A prospective study was conducted on 126 patients with septic heart failure in Xi'an Hospital of Traditional Chinese Medicine from January 2018 to January 2021.Patients were classified into two groups via random number table,each with 63 patients.Patient in group B received routine treatment only,while those in group A received Huoxue Jiedu Decoction combined with routine treatment.Treatment in both groups lasted for 1 week.Comparison was performed between the two groups on cardiac function parameters[stroke volume(SV),cardiac index(CI),cardiac output(CO),and left ventricular ejection fraction(LVEF)],plasma B-type natriuretic peptide(BNP),procalcitonin(PCT),PGE2,HIF-α,high-sensitivity C-reactive protein(hs-CRP),and Sequential Organ Failure Assessment(SOFA)score.Then the clinical efficacy and TCM syndrome efficacy were recorded after treatment.Results After treatment,an increase in SV,CI,CO,and LVEF was observed in both groups,and a decrease in BNP,PCT,hs-CRP,PGE2,HIF-α,and SOFA score was observed,with statistically significant difference(all P<0.05).Compared with group B,group A had significantly higher SV,CI,CO and LVEF levels,and significantly lower plasma BNP,PCT,serum hs-CRP,PGE2,and HIF-αlevels,and SOFA score,with statistically significant difference(all P<0.05).The clinical efficacy and TCM syndrome efficacy were 88.89%and 95.24%in group A,which were significantly higher than 66.67%and 79.37%in group B,with statistically significant difference(all P<0.05).Conclusion Huoxue Jiedu Decoction based on routine treatment in the treatment of septic heart failure can effectively ameliorate the cardiac function and clinical symptoms,which is of great clinical value.