维生素C联合犀角地黄汤对防治脓毒症合并DIC的疗效观察

Effect of vitamin C combined with Xijiao Dihuang Decoction on prevention and treatment of sepsis complicated with DIC

目的 探讨维生素C联合犀角地黄汤治疗脓毒症合并弥散性血管内凝血(DIC)的临床疗效。方法 选取2018年1月~2022年12月收治的60例脓毒症合并DIC患者为研究对象,按照随机数字表法分为对照组(n=30)和观察组(n=30)。两组患者均给予西医常规治疗,对照组予以静脉滴注氯化钠注射液治疗,观察组予以静脉滴注维生素C注射液联合犀角地黄汤口服治疗。比较两组患者临床疗效、凝血功能指标、血小板计数(PLT)、炎症指标、出血倾向以及28 d死亡率。结果 观察组治疗有效率为96.7%,高于对照组治疗有效率80.0%,差异有统计学意义(P <0.05)。治疗后,观察组凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)低于对照组,纤维蛋白原(FIB)高于对照组,差异有统计学意义(P <0.05)。治疗后,观察组PLT高于对照组,白细胞计数(WBC)、C反应蛋白(CRP)、降钙素原(PCT)低于对照组,差异有统计学意义(P <0.05)。两组患者28 d死亡率比较差异无统计学意义(P> 0.05),但观察组患者住院期间出血倾向低于对照组,差异有统计学意义(P <0.05)。结论 维生素C联合犀角地黄汤治疗脓毒症合并DIC的临床效果显著,有助于改善患者凝血指标和炎症反应,降低患者出血倾向。

Objective To explore the clinical efficacy of vitamin C combined with Xijiao Dihuang Decoction in the treatment of sepsis complicated with disseminated intravascular coagulation(DIC). Methods 60 patients with sepsis complicated with DIC treated in our hospital from January 2018 to December 2022 were selected as the research objects and randomly divided into the control group(n = 30) and the observation group(n = 30).Both groups were treated with routine western medicine, the control group was treated with intravenous drip of sodium chloride injection, and the observation group was treated with intravenous drip of vitamin C injection combined with oral administration of Xijiao Dihuang Decoction. The clinical efficacy, coagulation function indexes, platelet count(PLT), inflammatory indexes, bleeding tendency and 28 day mortality were compared between the two groups. Results The effective rate of the observation group was 96.7%, which was higher than 80.0% of the control group(P < 0.05). After treatment, prothrombin time(PT) and activated partial thromboplastin time(APTT) in the observation group were lower than those in the control group, and fibrinogen(FIB) was higher than those in the control group(P < 0.05). After treatment, PLT in the observation group was higher than that in the control group, and leukocyte count(WBC), C-reactive protein(CRP) and procalcitonin(PCT) in the observation group were lower than those in the control group(P < 0.05).There was no significant difference in 28 day mortality between the two groups(P > 0.05), but the bleeding tendency of the observation group was lower than that of the control group(P <0.05). Conclusion Vitamin C combined with Xijiao Dihuang Decoction has a significant clinical effect in the treatment of sepsis complicated with DIC, which is helpful to improve the coagulation indexes and inflammatory response, and reduce the bleeding tendency of patients.