白虎汤联合血必净注射液治疗脓毒症(毒热内盛证)的临床疗效观察

Observation on the clinical effect of baihu decoction combined with xuebijing injection in the treatment of sepsis(syndrome of toxic heat and internal excess)

目的:探讨白虎汤联合血必净注射液治疗脓毒症(毒热内盛证)的临床疗效。方法:采用随机数字表法将2020年6月—2022年12月收治的80例脓毒症患者分为对照组(40例)和观察组(40例)。对照组采用常规治疗,观察组在对照组基础上加用白虎汤联合血必净注射液治疗,两组均治疗7 d。比较两组临床疗效、凝血功能、血小板计数、乳酸水平、中医证候积分、体温、疾病严重程度、ICU住院时间和不良反应。结果:观察组治疗总有效率高于对照组,差异有统计学意义(P<0.05)。两组用药后凝血酶原时间(PT)、D-二聚体(DD)、纤维蛋白原(FIB)、部分凝血酶原时间(APTT)、乳酸水平、中医证候积分、体温、急性生理及慢性健康评分(APACHEⅡ)评分、感染相关器官功能衰竭(SOFA)评分低于用药前,且观察组低于对照组,差异有统计学意义(P<0.05)。两组用药后血小板计数高于用药前,且观察组高于对照组,差异有统计学意义(P<0.05)。结论:白虎汤联合血必净注射液治疗脓毒症(毒热内盛证)安全有效,将中医整体辨证与现代西医相结合可为脓毒症的治疗提供新的思路。

Objective:To investigate the clinical efficacy of baihu decoction combined with xuebijing injection in the treatment of sepsis(syndrome of toxic heat and internal excess).Methods:All 80 patients with sepsis admitted from June 2020 to December 2022 were divided into control group(40 cases)and observation group(40 cases)by random number table method.The control group was treated with conventional treatment,and the observation group was treated with baihu decoction combined with xuebijing injection.The efficacy of both groups was evaluated after 7 days of treatment.The clinical efficacy,coagulation function,platelet count,lactic acid level,TCM syndrome score,body temperature,disease severity,ICU stay and adverse reactions were compared between the two groups.Results:The total effective rate of the observation group was higher than that of the control group.Prothrombin time(PT),D-dimer(DD),fibrinogen(FIB),partial prothrombin time(APTT),lactic acid level,TCM syndrome score,body temperature,acute physiology and chronic health score(APACHEⅡ),and infection-related organ failure estimate(SOFA)score were lower than those of control group.The platelet count was higher than that of control group(P<0.05).The platelet count of the two groups after treatment was higher than that before treatment,and the observation group was higher than the control group,the difference was statistically significant(P<0.05).Conclusion:Baihu decoction combined with xuebijing injection is safe and effective in the treatment of sepsis(syndrome of toxic heat and internal excess).Combining TCM holistic syndrome differentiation with modern western medicine provides a new way for the prognosis of sepsis.