扶阳固脱法辅助治疗脓毒症休克(阳气暴脱证)患者的临床观察

Clinical Efficacy of Fuyang Gutuo method in the Adjuvant Treatment of Patients with Sudden Collapse of Sepsis Shock

目的 观察扶阳固脱法对脓毒症休克(阳气暴脱证)患者的临床疗效并探讨其作用机制。方法 患者72例随机分为两组,对照组参照脓毒性休克集束化治疗予以西医常规治疗;观察组在西医常规治疗基础上加用中医扶阳固脱法,主要以参附注射液联合雷火灸疗法,以足三里(双)、关元、膻中、内关(双)为主穴,配合辨证选穴。观察两组在相同的治疗时间内患者的呼吸、循环功能及两组患者的序贯性器官功能衰竭(SOFA)评分、急性生理与慢性健康状况(APACHEⅡ)评分和死亡率的改善情况。结果 治疗后两组平均动脉压(MAP)、中心静脉压(CVP)较治疗前均上升(P <0.05),心率较治疗前均下降(P <0.05),且观察组均优于对照组(P <0.05)。治疗后两组pH、氧分压(PaO2)、氧合指数(PaO2/FiO2)较治疗前均上升(P <0.05),二氧化碳分压(PaCO_(2))、血乳酸(Lac)较治疗前均下降(P <0.05),且观察组均优于对照组(P <0.05)。治疗后两组APACHEⅡ、SOFA较治疗前均下降(P <0.05),且观察组均低于对照组(P <0.05)。治疗1周后两组死亡率,观察组较对照组显著降低(P <0.05)。结论 扶阳固脱法对脓毒症休克(阳气暴脱证)患者临床症状、指标有明显的治疗效果,同时可以降低患者死亡率。

Objective:To observe the effect of Fuyang Gutuo method on the clinical efficacy of patients with sudden collapse of sepsis shock. Methods:A total of 72 patients were randomly divided into two groups. The control group was treated with western medicine treatment regimen for septic shock;the observation group was added with traditional Chinese medicine Fuyang Gutuo method,which was mainly Shenfu Injection combined with thunder fire moxibustion,with Zusanli(double),Guanyuan,Danzhong,Neiguan(double) as the main acupuncture points,and syndrome differentiation was conducted for the selection of acupoints. The improvement of respiratory,circulatory function,sequential organ failure(SOFA)score,APACHEⅡ score and mortality in both groups during the same treatment was observed. Results:After treatment,the MAP and CVP increased(P < 0.05)and HR decreased(P < 0.05)in the two groups compared with those before treatment,and the observation group was better than that in the control group(P < 0.05). After treatment,p H,PaO2 and PaO2/FiO2 increased in the two groups compared with before treatment(P < 0.05),PaCO_(2) and Lac decreased compared with before treatment(P < 0.05),and the observation group was better than the control group(P < 0.05). After treatment,the APACHEⅡ and SOFA scores decreased in both groups(P < 0.05),and the observation group was lower than those in the control group(P < 0.05). After one week of treatment,the mortality rate of the two groups was significantly lower in the observation group than that in the control group(P < 0.05). Conclusion:Fuyang Gutuo method has obvious therapeutic effect on the clinical symptoms and indicators of patients with sudden collapse of septic shock,and can reduce the mortality of patients.