黄连解毒汤联合白虎汤加减对脓毒血症(热毒壅滞型)患者CAT、TNF-α、D-D、CHE及脏器功能的影响

Effects of Huanglian Jiedu(黄连解毒)Decoction Combined with Baihu(白虎)Decoction on CAT TNF-α,D-D,CHE and Organ Function in Patients with Sepsis of Reduyongzhi(热毒壅滞)Type

目的:探讨黄连解毒汤联合白虎汤加减对热毒壅滞型脓毒血症患者氧化应激指标、炎性指标及脏器功能的影响。方法:将2017年4月至2020年3月在我院就诊的124例脓毒血症(热毒壅滞型)患者于纳入研究前随机分组。观察组62例行黄连解毒汤联合白虎汤加减口服治疗,对照组62例行西医常规治疗,治疗2 w后比较疗效。结果:与治疗前比较,两组治疗后的血清脑尿钠肽(Brain natriuretic peptide,BNP)、降钙素原(Procalcitonin,PCT)、肌酐(Creatinine,Scr)、C反应蛋白(C reactive protein,CRP)、谷丙转氨酶(Glutamic-pyruvic transaminase,ALT)、白介素-6(Interleukin-6,IL-6)、血浆凝血酶原时间(Prothrombin time,PT)及D二聚体(D dimer,D-D)、急性生理学和慢性健康状况评分(Acute Physiology and Chronic Health Status Score,APACHEⅡ评分)、中医总症状积分(主要症状发热、气促,次要症状大便秘结、口干)均明显降低(P<0.05),血清NK细胞、胆碱酯酶(Cholinesterase,CHE)、过氧化氢酶(Catalase,CAT)含量、氧化物歧化酶(Oxide disproportionase,SOD)活力明显升高(P<0.05);治疗后,观察组各指标升高和降低的水平均明显大于对照组(P<0.05);观察组总有效率为95.16%(59/62)明显高于对照组的77.42%(48/62)(P<0.05)。结论:对于热毒壅滞型脓毒血症患者而言采用联合黄连解毒汤及白虎汤加减效果显著,有助于促进感染好转,提高机体抗氧化能力,减轻炎症反应,保护脏器功能,进而辅助提高临床疗效。

Objective:To investigate the effect of Huanglian Jiedu decoction combined with Baihu decoction on oxidative stress indexes,inflammatory indexes and organ function in patients with sepsis of Reduyongzhi(热毒壅滞)type.Methods:A total of 124 patients with sepsis of Reduyongzhi type admitted to our hospital from April 2017 to March 2020 were randomly assigned into two groups before inclusion in the study.The 62 patients in the observation group received oral treatment with Huanglian Jiedu decoction combined with Baihu decoction,and 62 patients in the control group received conventional Western medicine treatment.The curative effect was compared after 2 weeks of treatment.Results:Compared with before treatment,the serum levels of brain natriuretic peptide(BNP),procalcitonin(PCT),creatinine(Scr),C reactive protein(CRP),glutamic-pyruvic transaminase(ALT),interleukin-6(IL-6)and D-dimer(D-D),prothrombin time(PT),Acute Physiology and Chronic Health Evaluation II(APACHE I),and TCM total symptom score(major symptoms:fever and shortness of breath;minor symptoms:constipation and dry mouth)were reduced(P<0.05).The serum contents of NK cells,cholinesterase(CHE)and catalase(CAT),and the activity of superoxide dismutase(SOD)were increased(P<0.05).After the treatment,the change of each index in the observation group was greater than that in the control group(P<0.05).The total effective rate of observation group was 95.16%(59/62),which was higher than that of the control group(77.42%,48/62,P<0.05).Conclusion:For patients with sepsis of Reduyongzhi type,the combination of Huanglian Jiedu decoction and Baihu decoction has a significant therapeutic effect,which is helpful to promote the improvement of infection,enhance the antioxidant capacity,reduce inflammation and protect organ function,thus improving clinical efficacy.